• Title/Summary/Keyword: Cardiac marker

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Preoperative Levels of Hematological and Biochemical Indices Affect Perioperative Variables in Adult Patients with Coronary Artery Bypass Graft Surgery

  • Choi, Seok-Cheol;Cho, Byung-Kyu;Lee, Yong-Hwan;Chang, Kyung-Soo
    • Biomedical Science Letters
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    • v.16 no.4
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    • pp.247-258
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    • 2010
  • The objective of this research was to evaluate the relationships of preoperative (Pre-OP) levels of hematological and biochemical indices to perioperative variables in patients that underwent coronary artery bypass graft surgery (CABG). Pre-OP levels of hematological factors [total white blood cells (T-WBC), erythrocytes, hemoglobin, hematocrit, glycohemoglobin A1c (HbA1c), or platelet] were negatively or positively related with biochemical indices [alanine aminotransferase (ALT), bilirubin, glucose, fructosamine, triglyceride, and high density lipoprotein cholesterol (HDL)]. Pre-OP levels of hematological factors and biochemical indices were negatively or positively correlated with echocardiographic variables. Pre-OP level of HbA1c had a relationship with C-reactive protein. Pre-OP levels of aspartate aminotransferase (AST), ALT, HDL, glucose, fructosamine, or blood urea nitrogen (BUN) were positively or negatively associated with Pre-OP levels of cardiac markers (brain natriuretic peptide, troponin-I, creatine kinase isoenzyme 2, or CRP). Pre-OP levels of hematological factors (excepting T-WBC) related with operation time (OPT), postoperative mechanical ventilation time (POMVT), intensive care unit-period (ICU-period) or hospitalization. Pre-OP levels of AST, ALT, bilirubin, triglyceride, HDL, low dwensity lipoprotein, fructosamine, or BUN were positively or negatively correlated with OPT, graft numbers, POMVT, ICU-period or hospitalization. Retrospective this study reveals that Pre-OP levels of hematological and biochemical markers are associated with echocardiographic variables, several cardiac markers and postoperative outcomes, suggesting that Pre-OP levels of hematological and biochemical markers may be useful predictors for the diagnosis and prognosis of coronary artery disease.

Fast Marker-based Registration of 3D CT and 2D X-ray Fluoroscopy Images (3차원 전산화 단층촬영영상과 2차원 X-선 투시영상간 표식기 기반 고속 정합)

  • Kim Gye-Hyun;Park Seong-Jin;Hong He-Len;Shin Yeong-Gil
    • Journal of KIISE:Software and Applications
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    • v.33 no.3
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    • pp.335-343
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    • 2006
  • This paper proposes a novel technique of marker-based 2D-3D registration to combine 3D information obtained from preoperative CT images into 2D image obtained from intraoperative x-ray fluoroscopy image. Our method is divided into preoperative and intraoperative procedures. In preoperative procedure, we generate CT-derived DRRs using graphics hardware and detect markers automatically. In intraoperative procedure, we propose a hierarchical two- step registration to reduce a degree of freedom from 6-DOP to 2-DOF which is composed of in-plane registration using principal axis method and out-plane registration using minimal error searching method in spherical coordinate. For experimentation, we use cardiac phantom datasets with confirmation markers and evaluate our method in the aspects of visual inspection, accuracy and processing time. As experimental results, our method keeps accuracy and aligns very fast by reducing real-time computations.

Long-Term Outcomes of Preoperative Atrial Fibrillation in Cardiac Surgery

  • Kim, Hyo-Hyun;Kim, Ji-Hong;Lee, Sak;Joo, Hyun-Chel;Youn, Young-Nam;Yoo, Kyung-Jong;Lee, Seung Hyun
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.378-387
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    • 2022
  • Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

Heart Rate Variability and Autonomic Activity in Patients Affected with Rett Syndrome (Rett 증후군 환자에서의 자율신경 활성도 및 심박수 변이도 측정)

  • Choi, Deok Young;Chang, Jin Ha;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.996-1002
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    • 2003
  • Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

A semi-automatic cell type annotation method for single-cell RNA sequencing dataset

  • Kim, Wan;Yoon, Sung Min;Kim, Sangsoo
    • Genomics & Informatics
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    • v.18 no.3
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    • pp.26.1-26.6
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    • 2020
  • Single-cell RNA sequencing (scRNA-seq) has been widely applied to provide insights into the cell-by-cell expression difference in a given bulk sample. Accordingly, numerous analysis methods have been developed. As it involves simultaneous analyses of many cell and genes, efficiency of the methods is crucial. The conventional cell type annotation method is laborious and subjective. Here we propose a semi-automatic method that calculates a normalized score for each cell type based on user-supplied cell type-specific marker gene list. The method was applied to a publicly available scRNA-seq data of mouse cardiac non-myocyte cell pool. Annotating the 35 t-stochastic neighbor embedding clusters into 12 cell types was straightforward, and its accuracy was evaluated by constructing co-expression network for each cell type. Gene Ontology analysis was congruent with the annotated cell type and the corollary regulatory network analysis showed upstream transcription factors that have well supported literature evidences. The source code is available as an R script upon request.

B-type Natriuretic Peptide (BNP) as a Predictive Marker after Heart Transplantation (심장이식 후 예측인자로서 B-type Natriuretic Peptide (BNP)의 역할)

  • Shin, Hong-Ju;Kim, Hee-Jung;Choo, Suk-Jung;Kim, Jae-Joong;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.552-557
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    • 2007
  • Background: B-type natriuretic peptide (BNP) is a cardiac hormone that is primarily synthesized by the ventricular cardiac myocytes. Increased plasma BNP levels have been observed in patients suffering with congestive heart failure, ventricular hypertrophy and myocaridits and also during heart transplantation rejection. We investigated the serum BNP level as a predictive marker for rejection after heart transplantation. Material and Method: To test the usefulness of measuring the BNP level in cardiac transplant patients, consecutive blood samplings for BNP, right ventricular endomyocardial biopsies, hemodynamic measurements and transthoracic echocardiogram were all done in 10 such patients between January 2004 and August 2005 at the Department of Thoracic and Cardiovascular Surgery in Asan Medical Center. Two groups were identified with using the median value: the low BNP group (n=28, BNP: ${\le}290$ pg/mL) and the high BNP group (n=29, BNP: >290 pg/mL). We retrospectively analyzed rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy, the pulmonary capillary wedge pressure and the right atrial pressure between the 2 groups. Result: There were no differences in age, gender, rejection, the ejection fraction, tricuspid regurgitation, left ventricular hypertrophy and the right atrial pressure between the 2 groups (p>0.05). However, a higher pulmonary capillary wedge pressure and a higher mean pulmonary atrial pressure were observed in the high BNP group (p<0.05). Further, BNP has linear correlation with the pulmonary capillary wedge pressure (r=0.590, p<0.001). Using the cut-off value of 620 pg/mL, the BNP predicted a high PCWP (>12 mmHg) with a sensitivity of 83.3% and a specificity of 91.1% (AUC: $0.900{\pm}0.045$, p<0.001). Conclusion: The BNP level after heart transplantation does not show any significant correlation with rejection, yet it might be a predictive marker of ventricular diastolic dysfunction.

Initial Troponin Level as a Predictor of Prognosis in Patients with Intracerebral Hemorrhage

  • Chung, Pil-Wook;Won, Yu-Sam;Kwon, Young-Joon;Choi, Chun-Sik;Kim, Byung-Moon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.355-359
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    • 2009
  • Objective : It has been suggested that elevated cardiac troponin T (cTnT) level is a marker of increased risk of mortality in acute ischemic stroke and subarachnoid hemorrhage (SAH). However, the association of serum cTnT level and prognosis of intracerebral hemorrhage (ICH) has been sparsely investigated. The aim of this study was to identify the relationship between cTnT level and the outcome in patients with spontaneous ICH. Methods : We retrospectively investigated 253 patients identified by a database search from records of patients admitted in our department for ICH between January 1, 2003 and December 31, 2007. The patients were divided into 2 groups; the patients in group 1 (n=225) with serum cTnT values of 0.01 ng/mL or less, and those in group 2 (n=28) with serum cTnT values greater than 0.01 ng/mL. Results : The serum cTnT level was elevated in 28 patients. There were significant differences in sex, hypertension, creatine kinase-myocardial band, midline shift, side of hematoma, and presence of intraventricular hemorrhage between the 2 groups. Logistic regression analysis identified the level of consciousness on admission, cTnT and midline shift as independent predictors of hospital mortality. Conclusion : Theses results suggest that increased serum cTnT level at admission is associated with in-hospital mortality and the addition of a serum cTnT assay to routine admission testing should be considered in patients with ICH.

Protective effect and mechanism of ginsenoside Rg2 on atherosclerosis

  • Qianqian Xue;Tao Yu;Zhibin Wang;Xiuxiu Fu;Xiaoxin Li;Lu Zou;Min Li;Jae Youl Cho;Yanyan Yang
    • Journal of Ginseng Research
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    • v.47 no.2
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    • pp.237-245
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    • 2023
  • Background: Ginsenoside Rg2 (Rg2) has a variety of pharmacological activities and provides benefits during inflammation, cancer, and other diseases. However, there are no reports about the relationship between Rg2 and atherosclerosis. Methods: We used 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) to detect the cell viability of Rg2 in vascular smooth muscle cells (VSMCs) and human umbilical vein endothelial cells (HUVECs). The expression of inflammatory factors in HUVECs and the expression of phenotypic transformation-related marker in VSMCs were detected at mRNA levels. Western blot method was used to detect the expression of inflammation pathways and the expression of phenotypic transformation at the protein levels. The rat carotid balloon injury model was performed to explore the effect of Rg2 on inflammation and phenotypic transformation in vivo. Results: Rg2 decreased the expression of inflammatory factors induced by lipopolysaccharide in HUVECs-without affecting cell viability. These events depend on the blocking regulation of NF-κB and p-ERK signaling pathway. In VSMCs, Rg2 can inhibit the proliferation, migration, and phenotypic transformation of VSMCs induced by platelet derived growth factor-BB (PDGF-BB)-which may contribute to its anti-atherosclerotic role. In rats with carotid balloon injury, Rg2 can reduce intimal proliferation after injury, regulate the inflammatory pathway to reduce inflammatory response, and also suppress the phenotypic transformation of VSMCs. Conclusion: These results suggest that Rg2 can exert its anti-atherosclerotic effect at the cellular level and animal level, which provides a more sufficient basis for ginseng as a functional dietary regulator.

A case of syncope in a villager with hypertrophic cardiomyopathy after hydrogen sulfide exposure by an unauthorized discharge of wastewater

  • Hyeonjun Kim;Seunghyeon Cho;Inho Jung;Sunjin Jung;Won-Ju Park
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.34.1-34.8
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    • 2023
  • Background: Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident. Case presentation: In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge. Conclusions: We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

Lung/Heart Uptake Ratio and Transient Dilation Ratio of the Left Ventricle During Thallium-201 Imaging with Dipyridamole (Dipyridamole 부하를 T1-201 심근스캔에서 폐/심장 섭취율과 일과성 좌심실 확장율에 관한 연구)

  • Lee, Jae-Tae;Chung, Byung-Chun;Kim, Sang-Hyun;Lee, Kyu-Bo;Chae, Sung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.177-185
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    • 1991
  • Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

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