• Journal of Cardiovascular Imaging
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• 제31권3호
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• pp.135-141
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• 2023

BACKGROUND: Global longitudinal strain (GLS) is an accurate and reproducible parameter of left ventricular (LV) systolic function which has shown meaningful prognostic value. Fast, user-friendly, and accurate tools are required for its widespread implementation. We aim to compare a novel web-based tool with two established algorithms for strain analysis and test its reproducibility. METHODS: Thirty echocardiographic datasets with focused LV acquisitions were analyzed using three different semi-automated endocardial GLS algorithms by two readers. Analyses were repeated by one reader for the purpose of intra-observer variability. CAAS Qardia (Pie Medical Imaging) was compared with 2DCPA and AutoLV (TomTec). RESULTS: Mean GLS values were -15.0 ± 3.5% from Qardia, -15.3 ± 4.0% from 2DCPA, and -15.2 ± 3.8% from AutoLV. Mean GLS between Qardia and 2DCPA were not statistically different (p = 0.359), with a bias of -0.3%, limits of agreement (LOA) of 3.7%, and an intraclass correlation coefficient (ICC) of 0.88. Mean GLS between Qardia and AutoLV were not statistically different (p = 0.637), with a bias of -0.2%, LOA of 3.4%, and an ICC of 0.89. The coefficient of variation (CV) for intra-observer variability was 4.4% for Qardia, 8.4% 2DCPA, and 7.7% AutoLV. The CV for inter-observer variability was 4.5%, 8.1%, and 8.0%, respectively. CONCLUSIONS: In echocardiographic datasets of good image quality analyzed at an independent core laboratory using a standardized annotation method, a novel web-based tool for GLS analysis showed consistent results when compared with two algorithms of an established platform. Moreover, inter- and intra-observer reproducibility results were excellent.

• Journal of Cardiovascular Imaging
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• 제31권2호
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• pp.98-104
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• 2023

BACKGROUND: We aimed to investigate left ventricular (LV) global longitudinal strain (GLS) in end-stage renal disease patients and its change after kidney transplantation (KT). METHODS: We retrospectively reviewed patients who underwent KT between 2007 and 2018 at two tertiary centers. We analyzed 488 patients (median age, 53 years; 58% male) who had obtained echocardiography both before and within 3 years after KT. Conventional echocardiography and LV GLS assessed by two-dimensional speckle-tracking echocardiography were comprehensively analyzed. Patients were classified into three groups according to the absolute value of pre-KT LV GLS (|LV GLS|). We compared longitudinal changes of cardiac structure and function according to pre-KT |LV GLS|. RESULTS: Correlation between pre-KT LV EF and |LV GLS| were statistically significant, but the constant was not high (r = 0.292, p < 0.001). |LV GLS| was widely distributed at corresponding LV EF, especially when the LV EF was > 50%. Patients with severely impaired pre-KT |LV GLS| had significantly larger LV dimension, LV mass index, left atrial volume index, and E/e' and lower LV EF, compared to mildly and moderately reduced pre-KT |LV GLS|. After KT, the LV EF, LV mass index, and |LV GLS| were significantly improved in three groups. Patients with severely impaired pre-KT |LV GLS| showed the most prominent improvement of LV EF and |LV GLS| after KT, compared to other groups. CONCLUSIONS: Improvements in LV structure and function after KT were observed in patients throughout the full spectrum of pre-KT |LV GLS|.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2002년도 추계학술대회 논문집
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• pp.1085-1087
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• 2002

Deformation of soft tissue is known inhomogeneous and non-linear in general. In this study, we propose a measurement methodology of local/global strain during soft tissue elongation precisely using laser extensometer which has high accuracy, resolution and is possible to measure global/local strain. The mechanical tensile test are performed on tibialis cranialis, flexor hallucis longus, extensor digitorum longus of swine hindlimb. In order to measure target displacement, reflective marker is attached to detect elongation on specimen using surgical adhesive. The result of this study is to show that laser extensometer is valid to measure longitudinal elongation which is inhomogeneous and non-linear fur soft tissue.

• Journal of Cardiovascular Imaging
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• 제31권4호
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• pp.191-199
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• 2023

BACKGROUND: Assessment of left ventricular (LV) function plays a pivotal role in the management of patients with valvular heart disease, including those caused by rheumatic heart disease. Noninvasive LV pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate global LV systolic function, integrating longitudinal strain by speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work. The aim of this study was to characterize global LV myocardial work efficiency in patients with severe rheumatic mitral stenosis (MS) with preserved ejection fraction (EF). METHODS: We retrospectively included adult patients with severe rheumatic MS with preserved EF (> 50%) and sinus rhythm. Healthy individuals without structural heart disease were included as a control group. Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS: A total of 45 individuals with isolated severe rheumatic MS with sinus rhythm and 45 healthy individuals were included. In healthy individuals without structural heart disease, the mean global LV myocardial work efficiency was 96% (standard deviation [SD], 2), Compared with healthy individuals, median global LV myocardial work efficiency was significantly worse in MS patients (89%; SD, 4; p < 0.001) although the LVEF was similar. CONCLUSIONS: Individuals with isolated severe rheumatic MS and preserved EF, had global LV myocardial work efficiencies lower than normal controls.

• Journal of Cardiovascular Imaging
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• 제31권4호
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• pp.200-206
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• 2023

BACKGROUND: Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients. METHODS: We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients. RESULTS: A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = -0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E' ratio(r = -0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025). CONCLUSIONS: In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.

• Earthquakes and Structures
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• 제13권5호
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• pp.485-496
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• 2017

The behavior of 8 steel reinforced high-strength concrete (SRHSC) columns, which comprised of four identical columns with cross-shaped steel and other four identical columns with square steel tube, was investigated experimentally under cyclic uniaxial and biaxial loading independently. The influence of steel configuration and loading path on the global behavior of SRHSC columns in terms of failure process, hysteretic characteristics, stiffness degradation and ductility were investigated and discussed, as well as stress level of the longitudinal and transverse reinforcing bars and steel. The research results indicate that with a same steel ratio deformation capacity of steel reinforced concrete columns with a square steel tube is better than the one with a cross-shaped steel. Loading path affects hysteretic characteristics of the specimens significantly. Under asymmetrical loading path, hysteretic characteristics of the specimens are also asymmetry. Compared with specimens under unidirectional loading, specimens subjected to bidirectional loading have poor carrying capacity, fast stiffness degradation, small yielding displacement, poor ductility and small ultimate failure drift. It also demonstrates that loading paths affect the deformation capacity or deformation performance significantly. Longitudinal reinforcement yielding occurs before the peak load is attained, while steel yielding occurs at the peak load. During later displacement loading, strain of longitudinal and transverse reinforcing bars and steel of specimens under biaxial loading increased faster than those of specimens subjected to unidirectional loading. Therefore, the bidirectional loading path has great influence on the seismic performance such as carrying capacity and deformation performance, which should be paid more attentions in structure design.

• 대한기계학회논문집A
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• 제28권10호
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• pp.1435-1450
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• 2004

The investigation, which includes the material homogenization and the calculation of local stress concentration of long-fibrous composites in a microscopic level, has been performed to analyze the behavior of fiber-reinforced composites by using finite element method. In order to carry out this study, the finite element models of composites have been generated by the idealized arrays as square and hexagonal-packed type. In the FE analysis, the boundary conditions of micromechanical finite element method(MFEM) have been defined and verified by comparing with the results from multi-cells, and the effective material properties of composites composed of graphite/epoxy have been also evaluated by rules of mixture. For acquiring the relation between the global and local behaviors of composites, the magnifications of strain, stress, and interfacial stress of composites subjected to a longitudinal and transverse loading respectively have been calculated. And the magnifications have been proposed as the stress concentration in the microscopic level at composite material.

• Journal of Cardiovascular Imaging
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• 제31권3호
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• pp.125-132
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• 2023

BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul's Hospital. At 4-18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson's, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4-18 weeks post diagnosis, but over half had abnormal LV GLS.

• 대한원격탐사학회지
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• 제35권5_2호
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• pp.831-840
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• 2019

최근 장대교량의 경간장이 길어지면서 주탑간 거리(span)가 기존의 한계를 넘는 교량에 대해 초장대교량이라는 개념이 새롭게 제시되었다. 또한 장대교량의 구조가 복잡해지고, 안전성이 중요해지면서 시공 중 계측의 필요성이 더욱 커졌다. 하지만 장대교량에 기존 계측센서를 지속적으로 적용하는 데는 한계가 있다. 이에 기존 계측센서들의 한계를 보완하고자 위성항법시스템(GNSS: Global Navigation Satellite System)을 활용하기 위한 연구가 진행되고 있다. 본 연구는 최종적으로 2축경사계, 변형률계, 풍향풍속계와 GNSS를 혼용하여 초장대현수교의 거동 특성을 파악하고, 세부 모니터링 방법을 제시하고자 하였다. 이를 위해 GNSS를 이용하여 주탑의 절대좌표와 교축진행방향을 산출하였고, 장기거동을 분석하여 시공 직후 주탑의 영구 변위와 안정화 여부를 평가하였다. 또한 풍향이 대상교량의 거동에 미치는 영향을 수치적으로 나타냈으며, 이를 통해 대상교량의 거동특성을 분석하였다. 본 연구 결과, GNSS를 활용한 교량 계측은 분석 목적에 따라 데이터 처리가 용이한 것으로 나타났다. 또한, 초장대교량의 유지관리에 있어 기존의 계측센서와 GNSS을 활용한다면 각 계측 데이터의 오차 파악 및 보정을 통한 모니터링 시스템의 개선과 정확한 변위관측, 그리고 거동특성을 함께 파악하는 효과적인 모니터링 시스템을 구축 할 수 있다는 점을 확인할 수 있었다.