• Korean Journal of Radiology
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• v.24 no.9
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• pp.827-837
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• 2023

Objective: To investigate the predictive value of radiomics features based on cardiac magnetic resonance (CMR) cine images for left ventricular adverse remodeling (LVAR) after acute ST-segment elevation myocardial infarction (STEMI). Materials and Methods: We conducted a retrospective, single-center, cohort study involving 244 patients (random-split into 170 and 74 for training and testing, respectively) having an acute STEMI (88.5% males, 57.0 ± 10.3 years of age) who underwent CMR examination at one week and six months after percutaneous coronary intervention. LVAR was defined as a 20% increase in left ventricular end-diastolic volume 6 months after acute STEMI. Radiomics features were extracted from the oneweek CMR cine images using the least absolute shrinkage and selection operator regression (LASSO) analysis. The predictive performance of the selected features was evaluated using receiver operating characteristic curve analysis and the area under the curve (AUC). Results: Nine radiomics features with non-zero coefficients were included in the LASSO regression of the radiomics score (RAD score). Infarct size (odds ratio [OR]: 1.04 (1.00-1.07); P = 0.031) and RAD score (OR: 3.43 (2.34-5.28); P < 0.001) were independent predictors of LVAR. The RAD score predicted LVAR, with an AUC (95% confidence interval [CI]) of 0.82 (0.75-0.89) in the training set and 0.75 (0.62-0.89) in the testing set. Combining the RAD score with infarct size yielded favorable performance in predicting LVAR, with an AUC of 0.84 (0.72-0.95). Moreover, the addition of the RAD score to the left ventricular ejection fraction (LVEF) significantly increased the AUC from 0.68 (0.52-0.84) to 0.82 (0.70-0.93) (P = 0.018), which was also comparable to the prediction provided by the combined microvascular obstruction, infarct size, and LVEF with an AUC of 0.79 (0.65-0.94) (P = 0.727). Conclusion: Radiomics analysis using non-contrast cine CMR can predict LVAR after STEMI independently and incrementally to LVEF and may provide an alternative to traditional CMR parameters.

• Korean Journal of Radiology
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• v.21 no.12
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• pp.1294-1304
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• 2020

Objective: To determine whether T1 mapping could monitor the dynamic changes of injury in myocardial infarction (MI) and be histologically validated. Materials and Methods: In 22 pigs, MI was induced by ligating the left anterior descending artery and they underwent serial cardiovascular magnetic resonance examinations with modified Look-Locker inversion T1 mapping and extracellular volume (ECV) computation in acute (within 24 hours, n = 22), subacute (7 days, n = 13), and chronic (3 months, n = 7) phases of MI. Masson's trichrome staining was performed for histological ECV calculation. Myocardial native T1 and ECV were obtained by region of interest measurement in infarcted, peri-infarct, and remote myocardium. Results: Native T1 and ECV in peri-infarct myocardium differed from remote myocardium in acute (1181 ± 62 ms vs. 1113 ± 64 ms, p = 0.002; 24 ± 4% vs. 19 ± 4%, p = 0.031) and subacute phases (1264 ± 41 ms vs. 1171 ± 56 ms, p < 0.001; 27 ± 4% vs. 22 ± 2%, p = 0.009) but not in chronic phase (1157 ± 57 ms vs. 1120 ± 54 ms, p = 0.934; 23 ± 2% vs. 20 ± 1%, p = 0.109). From acute to chronic MI, infarcted native T1 peaked in subacute phase (1275 ± 63 ms vs. 1637 ± 123 ms vs. 1471 ± 98 ms, p < 0.001), while ECV progressively increased with time (35 ± 7% vs. 46 ± 6% vs. 52 ± 4%, p < 0.001). Native T1 correlated well with histological findings (R² = 0.65 to 0.89, all p < 0.001) so did ECV (R² = 0.73 to 0.94, all p < 0.001). Conclusion: T1 mapping allows the quantitative assessment of injury in MI and the noninvasive monitoring of tissue injury evolution, which correlates well with histological findings.

• Journal of Cardiovascular Imaging
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• v.30 no.3
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• pp.185-196
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• 2022

BACKGROUND: Two-dimensional (2D) strain provides more predictive power than ejection fraction (EF) in patients with ST-elevation myocardial infarction (STEMI). 3D strain and EF are also expected to have better clinical usefulness and overcome several inherent limitations of 2D strain. We aimed to clarify the prognostic significance of 3D strain analysis in patients with STEMI. METHODS: Patients who underwent successful revascularization for STEMI were retrospectively recruited. In addition to conventional parameters, 3D EF, global longitudinal strain (GLS), global area strain (GAS), as well as 2D GLS were obtained. We constructed a composite outcome consisting of all-cause death or re-hospitalization for acute heart failure or ventricular arrhythmia. RESULTS: Of 632 STEMI patients, 545 patients (86.2%) had a reliable 3D strain analysis. During median follow-up of 49.5 months, 55 (10.1%) patients experienced the adverse outcome. Left ventricle EF, 2D GLS, 3D EF, 3D GLS, and 3D GAS were significantly associated with poor outcomes. (all, p < 0.001) The maximum likelihood-ratio test was performed to evaluate the additional prognostic value of 2D GLS or 3D GLS over the prognostic model consisting of clinical characteristics and EF, and the likelihood ratio was 15.9 for 2D GLS (p < 0.001) and 1.49 for 3D GLS (p = 0.22). CONCLUSIONS: The predictive power of 3D strain was slightly lower than the 2D strain. Although we can obtain 3D strains, volume, and EF simultaneously in same cycle, the clinical implications of 3D strains in STEMI need to be investigated further.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.30-38
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• 2000

Purpose: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. Results: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Conclusion: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.

• The Journal of Korean Medicine
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• v.22 no.1
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• pp.10-21
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• 2001

Objective : This study was performed to investigate the protective effect of Stephania tetrandra(ST) against ischemic brain damage after a middle cerebral artery(MCA) occlusion. The effect was evaluated using histological tests, neurobehavioral tests, and biochemical tests. Methods : Rats(Sprague-Dawley) were divided into four groups : sham operated group, MCA occluded group, post MCA occlusion Stephania tetrandra administrated (7.6mg/l00g) group, and normal group. The MCA was occluded by intraluminal method. Stephania tetrandra was administrated orally twice at 1 and 4 hours after MCA occlusion. The neurobehavioral test was performed at 3, 6, 9 and 24 hours after MCA occlusion by posture reflex test and swimming behavioral test. All groups were sacrificed then. The brain tissues were stained with 2% triphenyl tetrazolium chloride(TTC) or 1 % cresyl violet solution, to examine infarct size, volume and cell number. Tumor necrosis $factor-{\alpha}$ level was measured from sera using Enzyme-Linked Immunoabsorbent Assay(ELISA). The mRNA expression level of inflammatory cytokines and related receptor type I and II, $IL-1{\beta}$, IL-6, and IL-10 6hours after MCA occlusion were also studied by reverse transcriptase polymerase chain reaction(RTPCR). Results : The results showed that : Stephania tetrandra (1) reduced infarct size and total infarct volume by 52.2% compared to the control group; (2) attenuated significantly in neuronal death, which was shown by a decrease in cell number(P<0.01) and size(P<0.01) in the boundary area of the infarction; (3) significantly reduced serum $TNF-{\alpha}$ level, and increased the mRNA level of IL-10 in the cortex region(P<0.01). However, there was no significant effect on motor deficit in swimming behavioral test. Conclusions : In conclusion, Stephania tetrandra has protective effects against ischemic brain damage at the early stage of ischemia.

• The Korea Journal of Herbology
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• v.26 no.3
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• pp.7-14
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• 2011

Object : This study evaluated the effects of Daeseungkitang(DSK) on cerebral infarct of middle cerebral artery occlusion(MCAO). Method : Sprague-Dawley rats are used for observing to induce cerebral infraction closing its middle cerebral artery temporarily and take DSK by mouth the next 5 days, observe the amount of feces and urine. It is investigated the correlation between them after examining neurological score. Results : It is resulted the below. On the 2nd day of taking DSK, the total amount of feces of the cerebral infarct rats is increased significantly. After taking DSK, the urine volume of the cerebral infarct rats does not change at all. Taking DSK significantly improves neurological score of the cerebral infarct rats. There is a significant correlation between total amount of feces of the cerebral infarct rats and neurological score, otherwise there is no significant correlation between total amount of feces and neurological score which is taken DSK. By taking DSK, the volume of cerebral infarction does not decrease significantly. Taking DSK restrains the expression of iNOS in the cerebral cortex and striatum of the cerebral infarct rats. Taking DSK restrains the expression of MMP-9 in the cerebral cortex of the cerebral infarct rats. Taking DSK restrains the edema of astrocytes of the positive reaction of GFAP in the cerebral cortex of the cerebral infarct rats. Conclusion : According to above results, Daeseungkitang(DSK) is assumed that showing reaction of protecting neuron cell by restraint brain tissue edema thorough controlling water balance.

• Parasites, Hosts and Diseases
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• v.58 no.4
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• pp.461-466
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• 2020

Toxoplasma gondii is an obligate intracellular protozoan parasite that can invade various organs in the host body, including the central nervous system. Chronic intracranial T. gondii is known to be associated with neuroprotection against neurodegenerative diseases through interaction with host brain cells in various ways. The present study investigated the neuroprotective effects of chronic T. gondii infection in mice with cerebral ischemia experimentally produced by middle cerebral artery occlusion (MCAO) surgery. The neurobehavioral effects of cerebral ischemia were assessed by measurement of Garcia score and Rotarod behavior tests. The volume of brain ischemia was measured by triphenyltetrazolium chloride staining. The expression levels of related genes and proteins were determined. After cerebral ischemia, corrected infarction volume was significantly reduced in T. gondii infected mice, and their neurobehavioral function was significantly better than that of the uninfection control group. Chronic T. gondii infection induced the expression of hypoxia-inducible factor 1-alpha (HIF-1α) in the brain before MCAO. T. gondii infection also increased the expression of vascular endothelial growth factor after the cerebral ischemia. It is suggested that chronic intracerebral infection of T. gondii may be a potential preconditioning strategy to reduce neural deficits associated with cerebral ischemia and induce brain ischemic tolerance through the regulation of HIF-1α expression.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2003.11a
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• pp.64-64
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• 2003

It is thought that highly reactive oxygen radicals generated at the ischemia-reperfusion in case of strokes play an important role in damaging the brain. We examined the neuroprotective effects from the several medicinal herbs in the transient ischemic rat model and compared their effects with the free radical scavenging activities. Transient ischemia was induced by intraluminal occusion of the right middle cerebral artety for 120 min and reperfusion was continued for 22 h in rats. The free radical scavenging properties of medicinal herbs were examined in vitro by determination of the interaction with the 1,l-diphenyl-2-picrylhydrazyl (DPPH) stable free radical. Aqueous extracts of 11 medicinal herbs (200 mg/kg) were orally administered, promptly prior to reperfusion and 2 h after reperfusion. Total infarction volume in the ipsilateral hemisphere of ischemia reperfusion rats was significantly lowered by the treatment of 7 medicinal herbs (Sophora flavescens, Lycopus lucidus, Sanguisorba officinalis, Caesalpinia sappan, Albizia julibrissin, Rubia akane, Psoralea corylifolia, Prunella vulgaris). However, all of these medicinal herbs did not show antioxidative activities. These results suggest that neuroprotective effects of several drugs are not always correlated with their antioxidative properties.

• Journal of Korean Academy of Nursing
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• v.17 no.2
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• pp.116-121
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• 1987

This study was undertaken to elucidate effects of ingesting small or large amount of tap or iced water on circulation of normal healthy men with the purpose of furnishing basic data for nursing intervention of myocardial infarction patients. The subjects for this study were normal healthy men consisting of 30men and 30women in age from 22 to 30 years. One group consisting of 30men drank 240m1 tap water on day l and 240m1 iced water 24hours later. The other group drank 960m1 tap water on day 1 and 960m1 iced water 24hours later. Blood pressure and heart rate were taken in a sitting position before ingesting water, and immediately after ingesting it and at 2,5,10,15,30 minute intervals thereafter. Changes of heart rate, systolic and diastolic blood pressure after ingesting water were compared with those of preingestive period. The results obtained were as follows : 1. There were no significant changes in blood pressure and heart rater after ingesting small amount of water regardless of its temperature. 2. No significant decrease in blood pressure after ingesting large amount of tap water at all time peroids was noted. 3. A strongly significant interaction effect bet-ween temperature and volume was demonstrated, that is, there was a highly significant decrease in blood pressure and heart rate at all time periods after ingesting large amount of iced water.

• Archives of Pharmacal Research
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• v.23 no.4
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• pp.413-417
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• 2000

The effect of ischemia/reperfusion-induced neuronal damage on the memory impairment were investigated using active avoidance and Morris water maze tasks in Wistar rats. Focal ischemia was induced by 1 h occlusion of the right middle cerebral artery (MCA) of Wistar male rats. Reperfusion was induced by releasing the occlusion and restoring the blood circulation for 24 h. The acquisition and preservation memory tested by active avoidance showed a significant difference between the sham and ischemia/reperfusion group. The water maze acquisition performance was also significant difference between sham and ischemia/repefusion groups in both latency and moving distance. The infarction volume was increased by the ischemia/reperfusion. Furthermore, the cresyl violet staining of the ischemia/reperfusion brain showed severe neuronal damage (pyramidal cell loss) in the cortex in addition to the striatum lesion of brain. This study shows that pyramidal cell damage in the cortex lesion may be partially related to memorial disturbance in the ischemia/reperfusion brain injury.