• The Korean Journal of Physiology and Pharmacology
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• v.23 no.1
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• pp.71-79
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• 2019

Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.

• Korean Journal of Biological Psychiatry
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• v.15 no.4
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• pp.275-287
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• 2008

Depression and coronary artery disease are both highly prevalent diseases. Many previous studies suggest that depression is a common comorbid condition in patients with coronary artery disease and has a significant negative impact on the onset, course, and prognosis of coronary artery disease. However, the exact mechanisms that underlie the association between these two diseases remain unclear. Pathophysiologic mechanisms that may explain the effect of depression on coronary artery disease include hypercoagulability, hypothalamus-pituitary-adrenal axis and autonomic nervous system dysregulation, altered inflammatory response. On the contrary, pathophysiologic mechanisms in coronary artery disease that affect depression are less well known. It is also suggested that both diseases may share a common genetic vulnerability. The authors reviewed the literature on the pathophysiologic relationships of depression and coronary heart disease.

• Journal of Korean Academy of Nursing
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• v.44 no.6
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• pp.630-638
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• 2014

Purpose: The purpose of this study was to develop a scale to evaluate stress in elderly patients with coronary artery diseases (CAD) and to examine validity and reliability of the scale. Methods: The development process for the preliminary scale included construction of a conceptual framework and initial items, verification of content analysis, sentence correction, and pilot study. This study was conducted using a questionnaire survey with one-to-one interviews during January and February, 2012. Participants were 240 elderly patients with CAD. Data were analyzed using item analysis, factor analysis, criterion related validity, and internal consistency. Results: The developed scale consisted of 32 items and 6 factors - aging and disease (7 items), family relations (5 items), anxiety and withdrawal (9 items), management of daily living (3 items), compliance of medical regimen (4 items), poverty and finance (4 items), and explained 68.5% of total variance. The scale had significantly positive correlation with the Korean Perceived Stress Scale (KPSS). Cronbach's alpha was .96, and Guttman split half coefficient was .91. Conclusion: Results indicate that the Stress Scale for Elderly Patients with CAD has validity and reliability, and is a suitable scale in health care settings to assess stress in elderly patients with CAD.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.11
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• pp.4985-4994
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• 2011

The purpose of this study was to investigate the level of knowledge, health belief and sick role behavior, and the influencing factors on them among the patients with coronary artery disease. The study subjects were 168 patients diagnosed as having coronary artery disease at a university hospital during the period from July 1st, to August 31th, 2010. As a results, Based on the mean scores of knowledge about coronary artery disease according to the general characteristics, they were significantly higher in males than in females(p=0.033). The mean scores of health belief were significantly higher according to age decrease(p=0.043). The mean scores of sick role behaviors were significantly higher in females than in males(p=0.006), with their increasing tendency in the age range from 40's to 60's and decreasing tendency in the age over 70's(p=0.015), the group with religion were significantly higher than the one without(p=0.050). In terms of the mean scores of knowledge and sick role behaviors about coronary artery disease according to the related characteristics, there was a significant difference with the time period elapsed after diagnosed as coronary artery disease, frequency of admissions, perception about the disease, information gathering through mass com. but in terms of those of health belief, there was a not significant difference in all the variables. The significantly influencing factors on degree of knowledge by multivariate regression analysis included degree of perception about a disease, scores of sick role behavior, presence of coronary artery diseases in a family or friends, and the time period elapsed after diagnosed as having coronary artery disease. Those on health belief included age and scores of sick role behavior, and those on sick role behaviors included score of knowledge, perception about a disease, age, BMI, and religion. The results showed a significant difference with their general characteristics or coronary artery disease-related factors.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.699-704
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• 2005

Background: Coronary artery fistula is rare congenital anomaly, which account for $0.27\~0.40\%$ of all congenital heart diseases. We report the clinical observations of 45 patients with coronary artery fistula. Material and Method: We reviewed all patients presented with or without symptoms of coronary artery fistula between 1987 and 2004. Age ranged from 1 to 83 years. Twenty-six patients were female. The patients were divided into 2 groups according to the presenting symptoms. Twelve patients were in group A (asymptomatic) and 33 patients in group B (symptomatic). The most common clinical presentation in group B was angina (18) followed by dyspnea (7), atypical chest pain (5), syncope (1), fatigue (1), and palpitation (1). Twenty-five patients were associated with other cardiac diseases, which were atrial septal defect (4), coronary artery occlusive disease (6), hypertension (12), and valvular heart disease (2). Result: Patients were followed-up for a mean period of $64.8\pm62.7$ months. There was no complication related to coronary artery fistula during the follow-up period in both group. There was no mortality related to coronary artery fistula. Conclusion: In symptomatic patients, early surgical treatment is recommended considering the low perioperative morbidity. In asymptomatic patients receiving medical treatment, close follow up may be necessary.

• BLOOD RESEARCH
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• v.53 no.4
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• pp.269-275
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• 2018

Coronary artery ectasia (CAE) is defined as the dilation of a segment of a coronary vessel to at least 1.5 times the diameter of its normal adjacent segment. Mean platelet volume (MPV) plays a role in acute coronary syndromes, with high MPV correlating to poor prognosis for acute thrombotic events and CAE. Several studies investigated the relationship between MPV and CAE, resulting in conflicting results. These results led us to systematically review all studies investigating the relationship between MPV and ectatic heart diseases by performing a meta-analysis study in order to report a unified result. This meta-analysis study investigated all case-control articles examining the relationship between MPV and CAE. All studies in the following databases published until January 31, 2018, were investigated: Science Direct, Scopus, PubMed, Google Scholar, and Web of Science. Following a quality control evaluation, 14 articles, all of which were published following studies performed in Turkey from 2007 to 2016, met the criteria for study inclusion. After pooling the results from all of the articles, a total standardized mean difference (SMD) value of 0.584 (95% CI, 0.219, 0.95) was obtained using the D+L pooled SMD, indicating a significant difference (P=0.002) between the two groups, with higher MPV values in ectatic patients when comparing to healthy individuals. Therefore, increased MPV levels were significantly related to CAE, suggesting that platelets, with their inflammatory and thrombotic activities, play a role in this disease. Therefore, anti-platelet and anti-inflammatory therapies may be effective in treating CAE.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.25-32
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• 2010

Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.996-1000
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• 1989

Open heart surgery begun at 1959 in Korea. From that time to 1979, the surgery was performed below 100 cases in a year. However,that was performed above, 1,000 cases in a year from 1981. During the recent three years, i.e., 1985, 1986, and 1987, the annual operative cases were 3614,4503, and 4906, and then the mortality rates were progressively decreased to 6.2%, 5.3 %, and 5.0 %. In these time, overall mortality rate above 1 year old was 5.0 % versus that below 1 year old 17.9 9o in congenital heart diseases. These results are statistically different between two groups. Of the valvular heart disease cases, which occupied 97 % of total acquired heart disease, individual incidence was in mitral 68 %, and aortic 28%. The operative method was mainly valve replacement. Operative mortality for valve surgery in total was 4.4 %. Until 1985, bioprosthetic valve was frequently implanted but mechanical valve has been done more frequently in these days. Coronary artery bypass graft was large portion [67 * 75 %] of open heart surgery in western, but was below 1 % in Korea. However our diet patterns have been changed. Therefore we think the incidence of coronary artery disease will be increased. So we will be familiar to this field.

• Korean Circulation Journal
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• v.54 no.4
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• pp.165-171
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• 2024

Beta blockers are one of the commonest prescription drugs in medicine and they have been thought to revolutionize the treatment of heart failure (HF) with reduced ejection fraction (HFrEF) in the last century. In addition to HFrEF, they are prescribed for a variety of diseases in cardiology from hypertension to HF, angina, and stable coronary artery disease (CAD). The increased prescription of beta blockers in conditions like HF with preserved ejection fraction (HFpEF), and stable CAD may be doing more harm than good as per the data we have so far. The available data shows that beta blockers are associated with increased stroke risk and atrial fibrillation (AF) in hypertension and in patients with HFpEF, they have been associated with decreased exercise capacity. In patients with stable CAD and patients with myocardial infarction with normal systolic functions, beta blockers don't offer any mortality benefit. In this article, we critically review the common indications and the uses of beta blockers in patients with HFpEF, CAD, hypertension and AF and we propose that beta blockers are overprescribed under the shadow of their beneficial effects in patients with HFrEF.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.606-617
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• 1986

During the period from November 1981 through June 1986, 18 cases of coronary arterial bypass graft were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. They consisted of 13 males and 5 females with the mean age of 49 [range: 28-69 years]. History of myocardial infarction was noted in 50% of the patients and cardiomegaly on chest PA in 2 patients with preserved LV function. On resting EKG, except the evidences of old myocardial infarction, the findings of LVH were noted in 7 cases, acute myocardial infarction in 2, diffuse myocardial ischemia in 1, and significant ventricular arrhythmia in 2 cases. The angina by type of presentation is stable in 3 patients, unstable in 15 patients with resting, postinfarction and progressive angina as the criteria of unstability. The patterns of involvement of significant disease were single vessel involvement [5 cases] double vessel involvement [8 cases], and triple vessel involvement [5 cases] including 5 cases of left main coronary arterial diseases. The pattern of coronary arterial disease in individual patient was one or more stenosis of the proximal left coronary arterial system with or without right coronary involvement, in every case. We performed 9 cases of double bypass and 9 cases of triple bypass with great saphenous vein using single anastomosis technique except in 4 cases, One of the 4 cases is our first case, sequential anastomosis between LAD and diagonal was performed due to shortage of the prepared vein graft. In the other 3 cases, our latest experience, we adopted the left internal mammary artery for the left anterior descending coronary revascularization. The distribution of sites of distal anastomosis revealed more striking predilection to LAD, showing our attention on the significance of the revascularization of LAD system. The ischemic time was 35 minutes per graft and mean number of grafts per patient was 2.5. Of the 18 patients, 13 [77.2%] had complete revascularization, and incomplete in 5 cases with the causes of incompleteness as presented. The early results of operation were as followed: surgical death in 2 [11%], perioperative infarction 2 [11%], need of inotropic support 5 [28%], arrhythmia 2 [11%], wound problem, bleeding, and emotional dysfunction. The actuarial anginal free survival during the period of 6 months through 2 years was 85.2% with excellent symptomatic control according to the angina classification of Canadian Cardiovascular Society.