• Title/Summary/Keyword: Coronary diseases

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The Usefulness of Obesity Indices for the Coronary Risk Factors in an Urban Inhabitants (도시지역 주민의 관상동맥질환 위험인자에 관련한 비만지표의 유용성 검토)

  • Park, Sung-Kyeong;Kim, Kwang-Hwan;Cho, Young-Chae
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.447-454
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    • 2006
  • Objectives : To determine obesity for the screening of individuals at high risk of coronary heart disease in urban areas. Methods : Data were obtained from 4,137 adults between 19 and 85 years of age (2,372 males, 1,765 females), not recognized as taking medicines for cardiovascular diseases, who underwent a health check-up at the health promotion center of university hospitals in cities between Jan. 2003 and Dec. 2004. The variables studied were divided into two broad categories, and their relationships examined. obesity indices and risk factors for coronary heart disease. To reveal the relation between each of the obesity indices and the proportion of individuals at risk of coronary heart disease, the obesity indices were stratified and odds ratios obtained after age adjustment. Results : From a gender comparison of anthropometric measures, men were found to have significantly greater heights, weights, and waist and hip circumferences than women. From a gender comparison by the obesity indices, women were found to have significantly higher BMI, %Fat, waist to hip and waist to stature ratios than men. As obesity indices, the waist to stature ratio and the waist circumference were strongly correlated with coronary risk factors, both in men and women. The age-adjusted odds ratio of coronary risk factors increased significantly with increasing waist circumference, BMI, %fat, waist to hip and waist to stature ratios, and were highest specifically for the waist to stature ratio and the waist circumference. Conclusions : The study results showed that the waist to stature ratio and the waist circumference, as obesity indices, were most closely correlated with coronary risk factors. It is suggested that the waist to stature ratio and, specifically, the waist circumference can be effectively used in the field of health management for screening those with high levels of coronary risk factors.

Comparision of Myocardial Injury in Cardiac Valvular and Coronary Surgery (심장판막 및 관상동맥 수술시 심근 손상에 대한 비교)

  • 원경준
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.738-745
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    • 1994
  • In order to evaluate the myocardial injury in cardiac valvular and coronary surgery, variables of creatine kinase[CK], myocardial band of CK[CK-MB], lactate dehydrogenase[LDH], aspartate aminotrasferase[AST] were measured in the preoperative[Preop], the operation day[POD0], and the first[POD1], third[POD3], fifth[POD5], seventh[POD7], ninth[POD9] day after operation in 29 patients. The subjects were divided into two groups according to the diseases: group V [valvular disease, n=16] and group C[coronary artery disease, n=13]. Each group was subdivided into two subgroups according to the duration of aortic crossclamping time[ACT]; group VI[ACT 120min, n=7] and group VII[ACT>120min, n=9]; group CI[ACT 120min, n=6] and group CII[ACT>120min, n=7]. The results were as followed 1. The values of CK between group V and group C had no significant difference. The values of CK in group CII were significantly greater than those in group CI and the values of CK in group VII were significantly greater than those in group VI. 2. Percentages of CK-MB between groups had no significant difference. 3. The serum levels of LDH in group V were significantly greater than those in group C. The serum levels of LDH in group VII were significantly greater than those in group VI. 4. The serum levels of AST in group VII were significantly greater than that in group VI. We were concluded that myocardial injury was more related with the duration of aortic cross clamping time rather than the type of diseases.

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Evaluation of Various Cardiae Indices and ROC Analysis in Coronary Artery Disease Employing Resting ECG Gated Blood Pool Scan (관상동맥질환에서 휴식기 심전도게이트혈액풀스캔을 이용한 각종 심기능 지표들의 평가 및 ROC 분석)

  • Choi, Chang-Woon;Lee, Dong-Soo;Kim, Sang-Eun;Chung, June-Key;Lee, Myung-Chul;Park, Young-Bae;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.40-48
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    • 1992
  • Gated blood pool scan is frequently used for evaluating the change in cardiac function in various cardiac diseases. But resting gated blood pool scan using only LVEF as a cardiac index has been consitently shown to have a low sensitivity, which is about 50%, in detecting coronary artery disease. So it is recommended to compare exercise gated blood pool scan to resting gated blood pool scan. Exercise tests, however, are not always possible, especially in patients with musculoskeletal diseases, recent myocardial infarction and in elderly persons. We studied the usefulness of resting gated blood pool scan using multiple indices in evaluating the patients with coronary artery disease. Studied cases were 185 patients with coronary artery disease (angina pectoris 31, myocardial infarction 154) and 25 normals with low likelihood of coronary artery disease. We used $^{99m}Tc-labeled$ RBC, 740 MBq labeled by in vivo method. The data were evaluated by Micro DELTA computer program. The results were as following: 1) The ejection rates (PER, AER) and filling rates (PFR, AFR) were different in normls and patients with angina pectoris or myocardial infarction. 2) Mean phase angle, ejection rates and filling rates could separate normals from coronary artery disease patients with normal LVEF. 3) Regional ejection fraction was decreased at the site of the infarct in patients with myocardial infarction. 4) Peak filling rate was the the most detectable index in evaluation of cardiac function in patients with coronary artery disease. 5) The threshold at 1.5 standard deviation of normal range was considered as the most reliable cut-off value from ROC analysis. These data suggest that the resting gated blood pool scan has an important role in the evaluation of cardiac functional changes using various cardiac indices in patients with coronary artery disease.

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Surgical treatment of unstable angina -Experience in 6 patients- (불안정형 협심증의 외과적 치료 -6예 경험-)

  • 조형곤
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.595-605
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    • 1986
  • From February 1986 through September 1986, the authors have experienced 6 cases of coronary artery bypass graft for patients with unstable angina. There were five males and one female who ranged from 39 to 65 years [mean, 53.3 years]. The extent of coronary disease was as follows: one-, two- and three-vessel diseases, all 2 cases respectively, and among them, 1 case had left main disease. Distal anastomoses were performed first with using saphenous vein grafts as conduits in all cases and sequential bypass methods were employed in 5 cases. Numbers of vein grafts were two in 2 cases and one in 4 cases. The mean time wasted for one distal anastomosis was 36 minutes. Post operative complications were leg-wound disruption [2 cases], transient psychosis [1 case] and perioperative myocardial infarction [MI] [1 case]. Sixty three year-old male patient associated with cardiomegaly, prior MI, ventricular arrhythmia, cardiac dysfunction and endocrinologic diseases preoperatively was expired in the operating room due to perioperative Ml. All survivors were asymptomatic and on discontinuing medical therapy on follow-up varying from 1 to 8 months.

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Cognitive-behavioral Approach to Patients with Cardiovascular Diseases (심장혈관계 질환 환자들에 대한 인지행동적 접근)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.185-196
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    • 1995
  • The author reviewed cognitive-behavioral approach to A type behavior pattern and hypertension which are known to be risk factors for coronary heart diseases. Those cognitive distortions frequently found in persons with A type behavior include all-nothing thinking, selective attention, personalization, and attribution of causality. Cognitive-behavioral techniques were also described, which can be applied to management of each characteristic of A type behavior pattern such as time urgency, perfectionism, achievement striving, low self-esteem, excessive work involvement, hostility, and depression. Cognitive-behavioral intervention for hypertension might help the patients to recognize and monitor anger-engendering conflicts, identify characteristic styles of responding, and experiment with alternative ways of managing conflict and anger. Since different features predominate in different individuals, it is necessary to develop treatment plan on the basis of individual characteristics and problems.

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Tanshinone IIA reduces pyroptosis in rats with coronary microembolization by inhibiting the TLR4/MyD88/NF-κB/NLRP3 pathway

  • Li, Hao-Liang;Li, Tao;Chen, Zhi-Qing;Li, Lang
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.5
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    • pp.335-345
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    • 2022
  • Pyroptosis is an inflammatory form of programmed cell death that is linked with invading intracellular pathogens. Cardiac pyroptosis has a significant role in coronary microembolization (CME), thus causing myocardial injury. Tanshinone IIA (Tan IIA) has powerful cardioprotective effects. Hence, this study aimed to identify the effect of Tan IIA on CME and its underlying mechanism. Forty Sprague-Dawley (SD) rats were randomly grouped into sham, CME, CME + low-dose Tan IIA, and CME + high-dose Tan IIA groups. Except for the sham group, polyethylene microspheres (42 ㎛) were injected to establish the CME model. The Tan-L and Tan-H groups received intraperitoneal Tan IIA for 7 days before CME. After CME, cardiac function, myocardial histopathology, and serum myocardial injury markers were assessed. The expression of pyroptosis-associated molecules and TLR4/MyD88/NF-κB/NLRP3 cascade was evaluated by qRT-PCR, Western blotting, ELISA, and IHC. Relative to the sham group, CME group's cardiac functions were significantly reduced, with a high level of serum myocardial injury markers, and microinfarct area. Also, the levels of caspase-1 p20, GSDMD-N, IL-18, IL-1β, TLR4, MyD88, p-NF-κB p65, NLRP3, and ASC expression were increased. Relative to the CME group, the Tan-H and Tan-L groups had considerably improved cardiac functions, with a considerably low level of serum myocardial injury markers and microinfarct area. Tan IIA can reduce the levels of pyroptosis-associated mRNA and protein, which may be caused by inhibiting TLR4/MyD88/NF-κB/NLRP3 cascade. In conclusion, Tanshinone IIA can suppress cardiomyocyte pyroptosis probably through modulating the TLR4/MyD88/NF-κB/NLRP3 cascade, lowering cardiac dysfunction, and myocardial damage.

Heart Related Disease: Chest CT Interpretation (흉부 CT 판독 시 보이는 심장 관련 질환)

  • Kim, Mi-Young
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.127-143
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    • 2004
  • Computed tomography (CT) plays an important supplementary role in the evaluation of patients with heart disease. CT can be used to evaluate the aorta, pulmonary artery, pulmonary vein, cardiac chambers, coronary artery, valves and systemic veins (superior vena cava, inferior vena cava and hepatic veins). The "Learning Objectives" describe the normal anatomy and typical pathological conditions seen on axial scans and reformatted images from CT in patients with heart disease, focusing focus on frequent, fatal, and rare but characteristic diseases encountered in routine practice.

Association between Periodontitis and Coronary heart disease in Korea : Inflammatory markers and IL-1 gene polymorphism (한국인에서 치주질환과 관상동맥질환의 관련성에 대한 염증표지자와 IL-1 유전자 다변성의 영향)

  • Jeong, Ha-Na;Chung, Hyun-Ju;Kim, Ok-Su;Kim, Young-Joon;Kim, Ju-Han;Koh, Jung-Tae
    • Journal of Periodontal and Implant Science
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    • v.34 no.3
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    • pp.607-622
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    • 2004
  • Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

The Effect of Aerobic Exercise Program for Chronic Disease Patients (성인병 환자를 위한 유산소성 운동프로그램의 효과)

  • 최성근
    • Journal of Nutrition and Health
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    • v.28 no.9
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    • pp.904-913
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    • 1995
  • The purpose of this study is to determine the effects of exercise programs on the treatment of chronic diseases. For this purpose, nine middle-aged women suffering from such chronic diseases as obesity, hypertension and coronary heart disease(CHD) were sampled to perform a 4-month-long exercise program which required the lactate threshold(LT) level corresponding to 70% of maximal oxygen uptake(VO2max). Thereupon, their physiques, physical fitness, blood components and physiological varibles were compared pre and post of exercise program. The results were summarized as follows ; 1) After the 4-month-long exercise program, %fat was significantly decreased, while such variables as grip strength, side step, trunk flexion and leg balance were significantly increased. 2) Blood components such as TG, TC, HDL-C, LDL-C, hemoglobin and hematocrit did not show and change in after exercise program. 3) Physiological varables such as HR, SBP, DBP, HR/LT, SBP/LT, DBP/LT, RPE/LT, VE/LT, VO2/LT and VO2 max showed significant increase after 4-month exercise program. These results suggest that regular aerobic exercise in a long period might help to decrease % fat and to increase aerobic capacity in middle-aged women suffering from chronic diseases.

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Aortocoronary bypass surgery in the management of coronary artery disease (관상동맥협측증의 외과적 요법)

  • 이재원
    • 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.

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