• Title/Summary/Keyword: Cardiovascular disease monitoring

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Outcomes of Extracorporeal Membrane Oxygenation in COVID-19: A Single-Center Study

  • Sahri Kim;Jung Hyun Lim;Ho Hyun Ko;Hong Kyu Lee;Yong Joon Ra;Kunil Kim;Hyoung Soo Kim
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.36-43
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    • 2024
  • Background: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods: Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results: Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5-61.5 years), compared to 64 years (IQR, 60.0-68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92-69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95-9,910.14; p=0.0233) were independent predictors of mortality. Conclusion: Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

U-Health Platform based Health Management Service Model using Context Information (유헬스 플랫폼 기반의 상황정보를 활용한 건강관리 서비스 모델)

  • Kim, Jae-Kwon;Kim, Jong-Hun;Park, Dong-Kyun;Lee, Young-Ho
    • Journal of Digital Convergence
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    • v.10 no.8
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    • pp.185-192
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    • 2012
  • Globally, U-health services have been increased according to the increase in interests on health managing and the development of information communication technology (ICT) based on increases in advanced ages and chronic disease. Exiting U-health services provide required services and health information monitoring only through counsels and that represent limitations in preventing and managing cardiovascular disease patients like chronic patients. In this paper, we propose of U-health platform based health management service model using context information. In our service model can provide health monitoring, diet, and exercise service using context information of clinical information and wether in U-health platform environment. Service to offer is the specialized service using external content provider of DB. in addition to, doctor can to provide advice information to patient using monitoring service. The proposed service model provides effective services using context information in U-health platform environments to customers and that will improve the health of chronic patients.

Biomedicinal implications of high-density lipoprotein: its composition, structure, functions, and clinical applications

  • Cho, Kyung-Hyun
    • BMB Reports
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    • v.42 no.7
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    • pp.393-400
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    • 2009
  • High-density lipoprotein (HDL) is a proven biomarker for the monitoring of changes in antioxidant and anti-inflammation capability of body fluids. The beneficial virtues of HDL are highly dependent on its lipids and protein compositions, and their ratios. In normal state, the HDL particle is enriched with lipids and several HDL-associated enzymes, which are responsible for its antioxidant activity. Lower HDL-cholesterol levels (<40 mg/dL) have been recognized as an independent risk factor for coronary artery disease, as well as being a known component of metabolic syndrome. Functional and structural changes of HDL have been recognized as factors pivotal to the evaluation of HDL-quality. In this review, I have elected to focus on the functional and structural correlations of HDL and the roles of HDL-associated apolipoproteins and enzymes. Recent clinical applications of HDL have also been reviewed, particularly the therapeutic targeting of HDL metabolism and reconstituted HDL; these techniques represent promising emerging strategies for the treatment of cardiovascular disease, for drug or gene therapy.

Idiopathic Hypertropic Subaortic Stenosis with Mitral Regurgitation -Report of 3 Cases- (특발성 비후성 대동맥판하 협착증 및 승모판 폐쇄부전증 -3례 보고-)

  • 강청희
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.313-317
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    • 1994
  • Surgical treatment is possible for the obstructive form of hypertrophic cardiomyopathy and transaortic left ventricular septal myectomy and myotomy has been the procedure of choice. If coexisting intrinsic mitral valve disease exists, mitral valve replacement has been performed. But abnormal systolic anterior motion of anterior mitral leaflet[SAM] with intrinsic normal mitral valve disease is the typical feature of IHSS and we prefer not to replace mitral valve. 3 patients underwent transaortic myotomy and myectomy for IHSS with mitral regurgitation. 2 patients of them have coexisting intrinsic mitral valve diseases such as mitral valve vegetation and chorda rupture. Concomittent mitral valve replacement were performed. 1 patient shows SAM of mitral anterior leaflet but has intrinsic normal mitral valve morphologically and transepicardial echocardiogram and direct monitoring of pressure gradient during the operative procedure gives better information for subsided mitral regurgitation. Post operative course during the 12 months follow-up was uneventful.

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CardioSentinal: A 24-hour Heart Care and Monitoring System

  • Gao, Min;Zhang, Qian;Ni, Lionel;Liu, Yunhuai;Tang, Xiaoxi
    • Journal of Computing Science and Engineering
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    • v.6 no.1
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    • pp.67-78
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    • 2012
  • People are willing to spend more for their health. Traditional medical services are hospital-centric and patients obtain their treatments mainly at the clinics or hospitals. As people age, more medical services are needed to exceed the potentials of this hospital-centric service model. In this paper, we present the design and implementation of CardioSentinal, a 24-hour heart care and monitoring system. CardioSentinal is designed for in-home and daily medical services. It mainly focuses on the outpatients and elderly. CardioSentinal is an interdisciplinary system that integrates recent advances in many fields such as bio-sensors, small-range wireless communications, pervasive computing, cellular networks and modern data centers. We conducted numerous clinic trials for CardioSentinal. Experimental results show that the sensitivity and accuracy are quite high. It is not as good as the professional measurements in hospital due to harsh environments but the system provides valuable information for heart diseases with low-cost and extreme convenience. Some early experiences and lessons in the work will also be reported.

Development of a Bath Assistive System with Water Temperature Monitoring to Prevent Heart Attack (수온 모니터링 기능을 탑재한 심장마비 방지용 목욕 보조 시스템)

  • Kang, So Myoung;Wei, Qun
    • Journal of Korea Multimedia Society
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    • v.22 no.2
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    • pp.242-249
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    • 2019
  • Old people and patients with cardiovascular disease could die of a heart attack in the bath with heated water for a long time. Various researches have been studied to prevent these accidents from happening such as measuring the ECG signal when taking bath. However, these devices are hard to use and the higher price is not easily accepted by the public. In this paper, a low-cost and use-friendly, real time high precision water temperature monitoring device to prevent heart attack in the bath was developed. The device with waterproof design that lets the device can float on the surface of the water, and an accurate way to make water temperature measurement method was proposed by this paper that is immerging the sensor into water with 4cm depth to measure the temperature of underwater. The manufactured device was conducted to two experiments; one was to verify the basic functions of the device, and another one was for compare the proposed device with commercial products for monitoring the water temperature in the bathtub. As the experimental results shown, the proposed device has stable performance for the water temperature measurement and communicating with laptop in wireless.

Analysis of the Relationship between the Preoperative Pulmonary Artery Index and the Postoperative Cardiac Performance in Cyanotic Congenital Heart Disease. (폐혈류감소를 동반한 선천성 심장기형에서 술전 폐동맥발육과 조기 술후 혈역학적 변화와의 관계)

  • Han, Jae-Jin;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.601-608
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    • 1989
  • We sought the relationship between the pulmonary artery development and cardiac performance from the analysis of the 36 cyanotic congenital heart disease patients [mainly TOF] who were operated and indwelled the pulmonary artery and left atrial pressure monitoring catheters for the postoperative care at the department of Thoracic and Cardiovascular Surgery SNUH in 1988. They were pre-evaluated of the pulmonary artery index from the cineangiographic films and post-operatively, calculated the cardiac index from the arterial and mixed venous blood gas and also measured the mean left atrial pressure and total inotropic supporting amount after operation. The post-operative cardiac indices were 3.46 * 1.03 1/min/M2 [immediate postoperative], 3.31 [ 1.08 [postoperative 6 hrs], 3.29 [ 1.01 [12 hrs], 3.54 * 1.02 [24 hrs], 3.92 * 1.14 [48 hrs], respectively. We divided the patients the group A and group B from the size of the pulmonary artery index, that is, group A was below 200 mm2/M2 and group B above 200 mm2/M2 of the pulmonary artery index. The cardiac indices and left atrial pressure between the group A and B were not different in the view of the statistical significance but the total post-operative inotropic amount of group A was more than group B and it was significant statistically. We concluded that the smaller the pulmonary artery index is, the more postoperative supportive treatment [for example, inotropics] for the enhancement of cardiac performance is needed, and indirectly, which means that the pulmonary artery index was correlated with the postoperative cardiac performance in cyanotic congenital heart disease.

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Application of Quantitative Assessment of Coronary Atherosclerosis by Coronary Computed Tomographic Angiography

  • Su Nam Lee;Andrew Lin;Damini Dey;Daniel S. Berman;Donghee Han
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.518-539
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    • 2024
  • Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.

Analysis of Relationship between Mixed Venous PO2 and Status of Cardiac Performance with Hemodynamic Values after Correction of Cyanotic Congenital Heart Disease (청색심기형 교정술후 혼합정맥혈 산소분압과 심근상태 및 혈류역학치와의 상관관계 분석)

  • An, Jae-Ho;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.212-219
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    • 1989
  • We utilized pulmonary artery pressure monitoring system in risky patients for preventing the postoperative pulmonary hypertensive crisis and for sampling the mixed venous blood. And this mixed venous blood oxygen saturation [MVSO2] or partial pressure [MVPO2]tells us many meaningful patients state. We selected 59 cyanotic congenital heart diseased patients, who were operated in our hospital from Nov. 1987 to Oct. 1988, in the Department of Thoracic and Cardiovascular Surgery, Seoul National University Children\ulcorner Hospital, who had pulmonary artery pressure monitoring catheter and who made us know their mixed venous oxygen condition. We found that there was no close relationship between MVPO2 and Cardiac Index [C.I.] during early postoperative period, but on the first and second day after operation the correlation coefficient was increased as r=0.35[p=0.008], r=0.78[p=0.0001]. So we concluded that the correlation between MVPO2 and C.I. was more reliable with time going as hemodynamic stabilization. And we experienced no survivors whose MVPO2 was under 20 torr, but that was not the only factor for death. From these results, we conclude that we can consider the MVPO2 [or MVSO2] representing C.I. after stabilized postoperative condition of the open heart surgery patients, but during early postoperative period, in addition to this MVPO2, we should do also apply other parameter such as urine output, arterial blood pressure, left atrial pressure and pulmonary arterial pressure for exact estimation of the patients status.

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Study on the Effectiveness of image inspection Replacement of the Periodontal disease Questionnaire in the Electronic Medical Record Environment (전자의무기록 의료 환경에서 치주 자가설문지의 영상 판독 대체 효용성에 대한 연구)

  • Maeng, You-Jin
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.4
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    • pp.707-714
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    • 2017
  • There have recently been an increasing number of reports claiming that the periodontal disease, the most typical oral disease, is closely associated with various systemic diseases such as cardiovascular disease. Therefore, it is imperative to explore the methods that can ensure effective and cost-effective monitoring of periodontal disease in specific population groups, as well as individuals in the electronic medical record environment. However, traditional periodontal examination methods, such as periodontal probe, are considerably demanding and time-consuming for dental specialists, and furthermore, cause the risk of bacteremia as they are invasive procedures. Thus, the objective of this study was to validate the capability of new method for screening the periodontal disease using the self-reported questionnaire for periodontitis which is the non-invasive procedure to replace radiography.