• Journal of Chest Surgery
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• v.50 no.2
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• pp.71-77
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• 2017

Background: Cardiac computed tomography (CT) has emerged as an alternative to magnetic resonance imaging (MRI) for ventricular volumetry. However, the clinical use of cardiac CT requires external validation. Methods: Both cardiac CT and MRI were performed prior to pulmonary valve implantation (PVI) in 11 patients (median age, 19 years) who had undergone total correction of tetralogy of Fallot during infancy. The simplified contouring method (MRI) and semiautomatic 3-dimensional region-growing method (CT) were used to measure ventricular volumes. Results: All volumetric indices measured by CT and MRI generally correlated well with each other, except for the left ventricular end-systolic volume index (LV-ESVI), which showed the following correlations with the other indices: the right ventricular end-diastolic volume index (RV-EDVI) (r=0.88, p<0.001), the right ventricular end-systolic volume index (RV-ESVI) (r=0.84, p=0.001), the left ventricular end-diastolic volume index (LV-EDVI) (r=0.90, p=0.001), and the LV-ESVI (r=0.55, p=0.079). While the EDVIs measured by CT were significantly larger than those measured by MRI (median RV-EDVI: $197mL/m^2$ vs. $175mL/m^2$, p=0.008; median LV-EDVI: $94mL/m^2$ vs. $92mL/m^2$, p=0.026), no significant differences were found for the RV-ESVI or LV-ESVI. Conclusion: The EDVIs measured by cardiac CT were greater than those measured by MRI, whereas the ESVIs measured by CT and MRI were comparable. The volumetric characteristics of these 2 diagnostic modalities should be taken into account when indications for late PVI after tetralogy of Fallot repair are assessed.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.3
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• pp.253-261
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• 2000

Head-out water immersion induces marked increase in the cardiac stroke volume. The present study was undertaken to characterize the stroke volume change by analyzing the aortic blood flow and left ventricular systolic time intervals. Ten men rested on a siting position in the air and in the water at $34.5^{circ}C$ for 30 min each. Their stroke volume, heart rate, ventricular systolic time intervals, and aortic blood flow indices were assessed by impedance cardiography. During immersion, the stroke volume increased 56%, with a slight (4%) decrease in heart rate, thus cardiac output increased ${\sim}50%.$ The slight increase in R-R interval was due to an equivalent increase in the systolic and diastolic time intervals. The ventricular ejection time was 20% increased, and this was mainly due to a decrease in pre-ejection period (28%). The mean arterial pressure increased 5 mmHg, indicating that the cardiac afterload was slightly elevated by immersion. The left ventricular end-diastolic volume index increased 24%, indicating that the cardiac preload was markedly elevated during immersion. The mean velocity and the indices of peak velocity and peak acceleration of aortic blood flow were all increased by ${\sim}30%,$ indicating that the left ventricular contractile force was enhanced by immersion. These results suggest that the increase in stroke volume during immersion is characterized by an increase in ventricular ejection time and aortic blood flow velocity, which may be primarily attributed to the increased cardiac preload and the muscle length-dependent increase in myocardial contractile force.

• Journal of the Korean Institute of Telematics and Electronics
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• v.26 no.2
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• pp.132-139
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• 1989

We have designed a real-time Cardiac digital substraction angiography system (C-DSA) and tested the system for the diagnosis of Cardiac patients. The system was developed by interfacing a radiographic angiography system to a computerized motional image analysis system. This new cardiac DSA can perform the real time processing of averaging and subtraction of the 32 image frames to measure the volume changes of the left ventricle after elimination of motional artrifacts, caused by the heart contraction of beats per minute in average. Each frame has a resolution of 512 x 512 pixels and 256 gray levels. Two image data with maximal and minimal volume were moved to the interfaced IBM PC computer system by high speed computer link line for computation of the heart's contraction parameters. First, the boundary of the left ventricule was detected using a dynamic programming of the gray levels, and its volume was computered to determine the parameters, such as the maximal volume of end-diastolic volume (EDV), the minimal volume of end systolic volume (ESV), and ejection fraction (EF).

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.11-18
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• 2022

Background: The vasoconstrictive effect of epinephrine in local anesthetics affects the heart, which leads to hesitation among dentists in injecting local anesthetics into patients with cardiovascular disease. Due to its vasoconstrictive effects, the present study investigated the effects of vasopressin administration on cardiac function in rats. Methods: Experiment 1 aimed to determine the vasopressin concentration that could affect cardiac function. An arterial catheter was inserted into the male Wistar rats. Next, 0.03, 0.3, and 3.0 U/mL arginine vasopressin (AVP) (0.03V, 0.3V, and 3.0V) was injected into the tongue, and the blood pressure was measured. The control group received normal saline only. In Experiment 2, following anesthesia infiltration, a pressure-volume catheter was placed in the left ventricle. Baseline values of end-systolic elastance, end-diastolic volume, end-systolic pressure, stroke work, stroke volume, and end-systolic elastance were recorded. Next, normal saline and 3.0V AVP were injected into the tongue to measure their effect on hemodynamic and cardiac function. Results: After 3.0V administration, systolic blood pressures at 10 and 15 min were higher than those of the control group; they increased at 10 min compared with those at baseline. The diastolic blood pressures at 5-15 min were higher than those of the control group; they increased at 5 and 10 min compared with those at baseline. The preload decreased at 5 and 10 min compared to that at baseline. However, the afterload increased from 5 to 15 min compared with that of the control group; it increased at 10 min compared with that at baseline. Stroke volume decreased at 10 and 15 min compared with that of the control group; it decreased from 5 to 15 min compared with that at baseline. Stroke work decreased from 5 to 15 min compared with that of the control group; it decreased from 5 to 15 min compared with that at baseline. Conclusion: Our results showed that 3.0 U/mL concentration of vasopressin resulted in increased blood pressure, decreased stroke volume and stoke work, decreased preload and increased afterload, without any effect on myocardial contractility.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.683-689
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• 2019

We are trying to evaluate usefulness of Wide Coverage Volume Axial Mode by comparing and analyzing for exposure doses to patients and video quality extracted from two materials. First material is a computer tomography scanning of paediatric cardiac made by using High Pitch Mode, which is designed for diagnosing Congenital cardiac diseases. Second material is computer tomography scanning of paediatric cardiac made by using Wide Coverage Volume Axial Mode. When we did computer tomography scanning of paediatric cardiac, we used High Pitch Mode and Wide Coverage Volume Axial Mode to 50 patients of each, overall 100 patients. Also, we compared exposure doses to patients using videos got from each protocol. Then we compared video quality by calculating SNR and CNR by setting ROI of each. Not only exposure doses to patients were reduced by 13.07 %, but also SNR and CNR were improved when testing used Wide Coverage Volume Axial Mode rather than using High Pitch Mode. Wide Coverage Volume Axial Mode reduced testing time by using high-speed scanner. Furthermore, we can find out that Wide Coverage Volume Axial Mode is an useful method through improving video quality and reducing exposure doses to patients than using High Pitch Mode from ASiR-V, which is low-dose technology.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.450-461
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• 2020

Objective: We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters. Materials and Methods: PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods. Results: A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL), -0.4 mL (5.7 to 5.0 mL), and -1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87-0.93). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA. Conclusion: Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.

• Proceedings of the KIEE Conference
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• 1988.07a
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• pp.727-730
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• 1988

In this paper, cardiac parameters and relationship between stroke volume and impedance change were explained, and an impedance cardiograph was designed and constructed, and its accuracy was verified by experiment. Useful cardiac parameters such as stroke volume and contractility of cardiac muscle were measured noninvasively. The reproducibility of the instrument was measured to be better(less than 10%) than that of clinical standard method such as thermodilution. Hence impedance cardiography was found to be better technique for monitoring stroke volume and contractility of patients for pre and post operation, and pharmacological studies.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.311-317
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• 2015

Background: Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods: Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results: Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001) more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion: Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.61 no.12
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• pp.1932-1938
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• 2012

The impedance cardiogram has been proposed as a non-invasive, continuous, operator independent, and cost-effective method for cardiac output monitoring. However, it can not be completely considered as non-restrictive method because of attached spot and band type electrodes. Therefore, we developed a improved convenient hand-held typed measurement system for cardiac output by electrical impedance technique. 80 subjects from Yonsei University and the surrounding areas, participated. All subjects measured stroke volume and cardiac output through Physioflow and developed system. To verify the developed system, statistical methods such as correlation, Wilcoxon signed ranks test, and the Bland-Altman analysis were used. The proposed system showed significant correlation in both male and female stroke volume(r=0.715, r=0.704) and cardiac output(r=0.826; r=0.804). From these results, it can be concluded that stroke volume and cardiac output could be improved convenient measurement using the both hands without the help of a specialist.

• Journal of Chest Surgery
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• v.54 no.1
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• pp.45-52
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• 2021

Background: Atrial septal defect (ASD) is the most common congenital heart disease. However, the details of cardiac chamber remodeling after surgery are not well known, although this is an important issue that should be analyzed to understand long-term outcomes. Methods: Between November 2017 and January 2019, cardiac magnetic resonance imaging was performed preoperatively, at a 1-month postoperative follow-up, and at a 1-year postoperative follow-up. Cardiac chamber volume, valve regurgitation volume, and ejection fraction were measured as functions of time. Results: Thirteen patients (10 men and 3 women) were included. The median age at surgery was 51.4 years. The preoperative median ratio of flow in the pulmonary and systemic circulation was 2.3. The preoperative mean right ventricular (RV) end-diastolic volume index (EDVi) and RV end-systolic volume index (ESVi) had significantly decreased at the 1-month postoperative follow-up (p<0.001, p=0.001, respectively). The decrease in the RVEDVi (p=0.085) and RVESVi (p=0.023) continued until the postoperative 1-year follow-up, although the rate of decrease was slower. Tricuspid valve regurgitation had also decreased at the 1-month postoperative follow-up (p=0.022), and continued to decrease at a reduced rate (p=0.129). Although the RVEDVi and RVESVi improved after ASD closure, the RV volume parameters were still larger than the left ventricular (LV) volume parameters at the 1-year follow-up (RVEDVi vs. LVEDVi: p=0.016; RVESVi vs. LVESVi: p=0.001). Conclusion: Cardiac remodeling after ASD closure is common and mainly occurs in the early postoperative period. However, complete normalization does not occur.