• Title/Summary/Keyword: Electrocardiography (ECG)

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Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study

  • Choi, So Yoon;Lee, Kyung Jae;Kim, Soon Chul;Lee, Eun Hye;Lee, Yoo Min;Kim, Yu-Bin;Yi, Dae Yong;Kim, Ju Young;Kang, Ben;Jang, Hyo-Jeong;Hong, Suk Jin;Choi, You Jin;Kim, Hyun Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.432-440
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    • 2022
  • Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

Development of a High-Resolution Electrocardiography for the Detection of Late Potentials (Late Potential의 검출을 위한 고해상도 심전계의 개발)

  • 우응제;박승훈
    • Journal of Biomedical Engineering Research
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    • v.17 no.4
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    • pp.449-458
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    • 1996
  • Most of the conventional electrocardiowaphs foil to detect signals other than P-QRS-T due to the limited SNR and bandwidth. High-resolution electrocardiography(HRECG) provides better SNR and wider bandwidth for the detection of micro-potentials with higher frequency components such as vontricular late potentials(LP). We have developed a HRECG using uncorrected XYZ lead for the detection of LPs. The overall gain of the amplifier is 4000 and the bandwidth is 0.5-300Hz without using 60Hz notch filter. Three 16-bit A/D converters sample X, Y, and Z signals simultaneously with a sampling frequency of 2000Hz. Sampled data are transmitted to a PC via a DMA-controlled, optically-coupled serial communication channel. In order to further reduce the noise, we implemented a signal averaging algorithm that averaged many instances of aligned beats. The beat alignment was carried out through the use of a template matching technique that finds a location maximizing cross-correlation with a given beat tem- plate. Beat alignment error was reduced to $\pm$0.25ms. FIR high-pass filter with cut-off frequency of 40Hz was applied to remove the low frequency components of the averaged X, Y, and Z signals. QRS onset and end point were determined from the vector magnitude of the sigrlaIL and some parameters needed to detect the existence of LP were estimated. The entire system was designed for the easy application of the future research topics including the optimal lead system, filter design, new parameter extraction, etc. In the developed HRECG, without signal averaging, the noise level was less than 5$\mu$V$_rms RTI$. With signal averaging of at least 100 beats, the noise level was reduced to 0.5$\mu$V$_rms RTI$, which is low enough to detect LPs. The developed HRECG will provide a new advanced functionality to interpretive ECG analyzers.

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Prognosis evaluation of a great dane dog with dilated cardiomyopathy

  • Kim, Yun-Hye;Na, Jiung;So, Kyung-Min;Park, Chul
    • Korean Journal of Veterinary Service
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    • v.40 no.4
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    • pp.287-292
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    • 2017
  • A five-year-old, male, Great Dane weighing 107 kg was presented with anorexia, abdominal distension, and dyspnea for 5 days. Physical examination, blood works, radiography, electrocardiography (ECG), and echocardiography were performed. Based on severely low fractional shortening (FS) and marked four chamber enlargement in echocardiography, continuous atrial fibrillation and occasional ventricular premature complex (VPC) on ECG, the dog was diagnosed as dilated cardiomyopathy (DCM) concurrent with congestive heart failure. Pleural effusion and ascites were modified transudate. In accordance with DCM scoring system recommended by European Society of Veterinary Cardiology (ESVC), DCM score was 13/15 in this case. Concentrations of cTnI and NT-pro-BNP were 1.0 ng/mL and 693 pmol/L, respectively. Since the former and the latter were remarkably high values, it was certain that the patient had grave prognosis. Intensive care was performed for the dog and the clinical signs as well as the radiographic abnormalities were resolved. However, when he presented serious dyspnea again at 25 days post therapy, the dog was dead. In case of canine DCM, the scoring system for the diagnosis and cardiac biomarkers including NT-pro-BNP and cTnI could be useful to advise owners on the status and prognosis of their dog with DCM.

Analysis of Image Quality and Optimized Reconstruction Window through Heart Rate and Its Variation in Retrospectively ECG-gated Coronary Angiography Using Multi-Detector Row CT

  • Lee, Sang-Ho;Park, Byoung-Wook;Kim, Hee-Joung;Haijo Jung;Kang, Won-suk;Son, Hye-Kyung;Choe, Kyu-Ok
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.461-463
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    • 2002
  • Image quality and selection of optimized window for good quality reconstruction in coronary angiography using multi-detector row CT (MDCT) have not been studied by heart rate and its variation. Therefore, the effect of heart rate and its variation was systemically analyzed. Eighty-three patients were undergone contrast-enhanced coronary angiography using MDCT. In this study, sixty cases were enrolled. Two radiologists graded image quality as follows: 4, excellent; 3, good; 2, fair; l, bad. The starting points of the reconstruction window were chosen at seventy and forty percent of R wave interval. Optimized window was scored as 1 when 40% reconstruction was better quality than 70%, as 2 when 40% reconstruction is same as 70%, and as 3 when 70% reconstruction was better than 40%. Regression analysis was performed. The range of variation of beats per minute (BPM) was well correlated with image quality (r=-0.55, p=0.000), however correlation with optimized window percentage was not statistically significant (p=0.969). By contraries, median value of BPM was comparatively well correlated with optimized window grade (r=-0.24, p=0.086). Median value of BPM was not well correlated with image quality (r=0.l70, p=0.l97). Image quality is more affected by variation of heart rate (VHR) than by higher heart rate. Selection of optimized reconstruction window for good image quality is mainly affected by heart rate and there is a tendency that systolic phase reconstruction is better in image quality than diastolic reconstruction in higher heart rate.

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The Resting Electrocardiographic ST Segment Depression and Related Factors at a Rural Adult Community, Korea (한 농촌 지역 일반 성인의 휴지기 심전도 상 ST 분절 하강과 관련 요인)

  • Kim, Yu-Mi;Kim, Mi-Kyung;Shin, Jin-Ho;Lim, Heon-Kil;Paek, Do-Myung;Choi, Bo-Youl
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.485-492
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    • 2006
  • Objectives : To measure the distribution of electrocardiographic ST segment depression, and evaluate its relationships with cardiovascular risk factors based on the cross-sectional studies within a rural Korean community Methods : This study analyzed 1,343 persons, over 40 years old, who participated in a baseline survey during 2002-2005; the exclusion criteria included: a past history of myocardial infarction and angina pectoris, and specific conduction abnormalities. A Standard 12 leads ECG was recorded using an FCP-2101 (Fukuda Denshi Co.). The ST segment depression was retrospectively measured by a physician, according to the Minnesota code classification. Results : ST segment depression was found in 3.6 and 6.4% of male and female participants, respectively. After adjusting for age, gender, smoking, physical activity and obesity differences, high blood pressure showed significant relations with ST depression in females (male ORs=2.67, 95% CI=0.85-8.50; female ORs=2.62, 95% CI=1.29-5.32) Conclusions : As an ischemic ECG sign, ST depression was related to hypertension in female participants. This relationship remained significant, even after cases with left ventricular hypertrophy were removed.

A Study on Evaluation of Human Arousal Level using PPG Analysis (PPG(Photoplethysmography)분석을 이용한 각성도 평가에 관한 연구)

  • Kim, Chi-Jung;Whang, Min-Cheol;Kim, Jong-Hwa;Woo, Jin-Cheol;Kim, Yong-Woo;Kim, Ji-Hye
    • Journal of the Ergonomics Society of Korea
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    • v.29 no.1
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    • pp.113-120
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    • 2010
  • This research is to evaluate the arousal level by using cardiovascular response. PPG was used in this study as one of the method of measuring it rather than ECG (Electrocardiography) for the purpose of solving ergonomic problem of sensing. The participants were in the age group of 20 (mean=24, standard deviation=1.25): five men and five women. Each experiment composed with four identical sets. First, a black screen was displayed for 30 second rest. Then, the prepared 6 pair images were randomly presented for 10 second stimulation and for 30 second non-stimulation. PPG was measured on the earlobes of experimenters at 200Hz sampling frequency. PPG amplitude, PPI(Pulse to Pulse Interval), and PRV(Pulse Rate Variability) were analyzed according to arousal level. T-test was performed to compare between the PPG variables of rest and relaxation, rest and arousal, and relaxation and arousal. Relative to the rest state, PPG amplitude decreased in relaxed state and increased in aroused state. Relative to the rest state, PPI decreased in both emotional states. However, more significant decline was observed in aroused state. PRV's LF and HF were used in the form of LF/HF to compare between the relaxed and the aroused state. Therefore, PPG signal showed significant differences between relaxed and aroused state. In conclusion, evaluation of human arousal level used in the PPG analysis demonstrated that PPG has better usability and comforter measurement than ECG and is clearly an alternative method of measuring arousal level.

Assessment of covariate-effect of sleeping behavior on heart rate variability during a clinical trial (임상시험 중 수면행위가 심박변이도에 미치는 영향 분석)

  • Lee, Jeon;Oh, Dal-Seok;Lee, Hae-Jung;Choi, Sun-Mi;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.13 no.3
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    • pp.97-103
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    • 2007
  • The object of this study is to evaluate confounding effect of sleeping behavior on heart rate variability (HRV) in healthy volunteers during a randomized clinical trial. From 6 healthy volunteer, we acquired circadian electrocardiography(ECG) with a Holter monitoring device(DigiTrak Plus, Philips). The compatible analytical program, Zymed, was used for calculation of RR intervals of 24h ECG signal. Then, we generated HRV signals and calculated 9 HRV parameters in time domain and frequency domain for every 30 minute with Matlab 6.x software. We also encoded participants' activities as follows; stable condition(1), sleeping behavior(2), eating behavior(3), and undefined condition(4). Using SPSS 12.0, we tested if there was any difference between HRV parameters of day-time and night-time and between those of a subject in stable condition and in sleeping behavior. As a result, one of the most important parameter-LF/HF ratio, which indicates the autonomic balance between sympathetic and parasympathetic nervous systems, as same the other parameters, showed large inter-individual variations in circadian profiles. And, the mean LF/HF ratio of each participant was different between in stable condition and in sleeping behavior (p<.05). Consequently, the effect of sleeping behavior must be considered when one or more of HRV parameters, especially LF/HF ratio, are used as assessment index in clinical studies.

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Role of Magnetocardiography in Emergency Room (응급실에서 심자도의 역할)

  • Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
    • Progress in Superconductivity
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    • v.8 no.1
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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The Importance of Esophageal and Gastric Diseases as Causes of Chest Pain

  • Kim, Yong Joo;Shin, Eun Jung;Kim, Nam Su;Lee, Young Ho;Nam, Eun Woo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.261-267
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    • 2015
  • Purpose: Pediatric chest pain is considered to be idiopathic or caused by benign diseases. This study was to find out how much upper gastrointestinal (UGI) diseases are major causes of chest pain in pediatric patients. Methods: The records of 75 children (42 boys and 33 girls, aged 3-17 years old) who have presented with mainly chest pain from January 1995 to March 2015 were retrospectively reviewed. Chest X-ray and electrocardiography (ECG) were performed in all aptients. Further cardiologic and gastrointestinal (GI) evaluations were performed in indicated patients. Results: Chest pain was most common in the children of 6 and 9 to 14 years old. Esopha-gogastric diseases were unexpectedly the most common direct causes of the chest pain, the next are idiopathic, cardiac diseases, chest trauma, respiratory disease, and psychosomatic disease. Even though 21 showed abnormal ECG findings and 7 showed abnormalities on echocardiography, cardiac diseases were determined to be the direct causes only in 9. UGI endoscopy was performed in 57 cases, and esophago-gastric diseases which thereafter were thought to be causative diseases were 48 cases. The mean age of the children with esophago-gastric diseases were different with marginal significance from that of the other children with chest pain not related with esophago-gastric diseases. All the 48 children diagnosed with treated with GI medicines based on the diagnosis, and 37 cases (77.1%) subsequently showed clinical improvement. Conclusion: Diagnostic approaches to find out esophageal and gastric diseases in children with chest pain are important as well as cardiac and respiratory investigations.

Anti-ischemic Effects of Nimesulide, a Cyclooxygenase-2 Inhibitor on the Ischemic Model of Rabbit Induced by Isoproterenol

  • Saeed, Sheikh Arshad;Ahmed, Sagheer
    • Archives of Pharmacal Research
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    • v.29 no.11
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    • pp.977-983
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    • 2006
  • The objective was to devise an animal model of myocardial infarction (MI) against which cardioprotective drugs might be tested. We describe the effects of nimesulide, a COX experience with development and validation of such a model. The rabbit was chosen in preference to rodents because its heart and cardiac circulation more closely resemble those of human. Thus, the cardiovascular system of anaesthetized male rabbits, 1 to 1.5 kg (n=11), was stressed by a single bolus intravenous injection of isoprenaline (ISP), 65 mg/kg. The effects of the injection were followed for sixteen days and were evaluated in four ways: 1) measurements of creatinine kinase isozyme and troponin-I (TPI) in serum 2) Electrocardiographic (ECG) changes (ST elevation and Q wave development) 3) Cardiac histopathology observed in tissue sections of the isolated of the heart. The histopathological analysis showed that rabbit heart on 2nd day after ISP injection showed changes of coagulation necrosis. Day 4 total coagulation with the loss of nuclear and striation associated with heavy interstitial infiltrate of neutrophils was found. Day 8 after infarction showed collagen deposition with capillary channels in between the remaining islands of myocytes in the infarcted area. On the 16th day scarring was complete. Coronary perfusion rates (CPR) and heart rate (HR) of the infarcted and nimesulide (a COX-2 inhibitor) treated rabbits displayed significant improvement (n=11) on each corresponding day after infarction as compared to the infarcted and saline treated rabbits (P<0.05). All four indices revealed similarities with effects commonly associated with MI in humans.