Lee, Jae-Geun;Beom, Jong Wook;Choi, Joon Hyouk;Kim, Song-Yi;Kim, Ki-Seok;Joo, Seung-Jae
Journal of Cardiovascular Imaging
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v.26
no.4
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pp.217-225
/
2018
BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.
Purpose: This study was to investigate factors influencing the Framingham risk score-Coronary heart disease (FRS-CHD) according to gender and body mass index (BMI) of adults who participated in the 5th Korea National Health and Nutrition Examination Survey (KNHANES V-3). Methods: This study used a cross-sectional design with secondary analysis with KNHANES V-3. The FRS-CHD scores were measured with ages, sex, blood pressure, cholesterol, high density lipoprotein, smoking, and diabetes mellitus. With demographic characteristics, family history of ischemic heart disease, types (intensity) and days of physical activities, perceived stress, drinking, menopause (in female), and BMI scores were measured. The data were analyzed with descriptive statistics, Pearson's correlation coefficients, and multiple regressions. Results: FRS-CHD was significantly associated with types (intensity) and days of physical activities, educational level, occupation, and marital status, explaining 19.1~76.8% of the variance in men. FRS-CHD was significantly associated with types (intensity) and days of physical activities, menopause, and education level, explaining 55.0~59.5% of the variance in women. Conclusion: Factors influencing FRS-CHD were significantly different according to gender and BMI. To reduce the risk of coronary artery disease, it is necessary to develop gender-specific physical activity programs according to BMI.
This study attempted to analyze the trend of studies related to IHD(Ischemic Heart Disease). This article reviewed 102 researches on IHD conducted from 1980 to 2003, by examining them according to their characteristics, such as sources by publication period, research design, nursing intervention, outcome of experimental research, and theme of qualitative research. The results were as follows : 1. The number of studies related to IHD has steadily increased year by year since 1985, and that of the articles was the highest during the post-2000 period. Especially, the majority of researches has published since 1995. 2. The 69 studies were degree of all 102 studies related to IHD, and the majority of articles' authors belonged to graduate school. Thirty three studies were non-degree articles. As for study design, the number of quantitative studies were 99 and that of qualitative studies were 3. Non-experimental research design were largely survey and correlational study. 3. Non-experimental study makes up a high proportion of the quantitative study. The most of experimental studies were accomplished after 2000. The main subjects were patients, chart records and general subjects. The majority number of subjects was like this : while the number of non-experimental study was between 51 and 100, that of experimental study was below 50. The number of subject of qualitative study is like this : the number of phenomenology study was 21 and 11, and that of case study is 14. 4. Nursing interventions used in the experimental study comprised teaching program, cardiac rehabilitation program, massage, relaxation, music therapy and providing of sense information. And the most nursing intervention effects included physiological effect, increased self-efficacy, relieved pain and increased quality of life. Most studies proved to have the affirmative effects. 5. The number of qualitative studies related to IHD is like this : the number of degree articles was 2 and that of non-degree articles was 1. Its themes included resources of hope, the experience of coronary artery angiography and the experience of admission at ICU(Intensive Care Unit).
Min Jae Cha;Yoo Jin Hong;Chan Ho Park;Yoon Jin Cha;Tae Hoon Kim;Cherry Kim;Chul Hwan Park
Korean Journal of Radiology
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v.24
no.12
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pp.1200-1220
/
2023
Dilated cardiomyopathy (DCM) is one of the most common types of non-ischemic cardiomyopathy. DCM is characterized by left ventricle (LV) dilatation and systolic dysfunction without coronary artery disease or abnormal loading conditions. DCM is not a single disease entity and has a complex historical background of revisions and updates to its definition because of its diverse etiology and clinical manifestations. In cases of LV dilatation and dysfunction, conditions with phenotypic overlap should be excluded before establishing a DCM diagnosis. The differential diagnoses of DCM include ischemic cardiomyopathy, valvular heart disease, burned-out hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, and non-compaction. Cardiac magnetic resonance (CMR) imaging is helpful for evaluating DCM because it provides precise measurements of cardiac size, function, mass, and tissue characterization. Comprehensive analyses using various sequences, including cine imaging, late gadolinium enhancement imaging, and T1 and T2 mapping, may help establish differential diagnoses, etiological work-up, disease stratification, prognostic determination, and follow-up procedures in patients with DCM phenotypes. This article aimed to review the utilities and limitations of CMR in the diagnosis and assessment of DCM.
Journal of agricultural medicine and community health
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v.24
no.2
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pp.301-314
/
1999
To evaluate the ischemic heart disease risk factors and analysis on the its relationship between risk factors and ischemic heart disease on EKG findings in a rural area, We conducted cross-sectional health screening test for 1304 persons aged over 30 years. Blood pressure, total cholesterol, HDL cholesterol, fasting blood glucose, BMI and Waist/hip ratio, smoking data and EKG data were collected. Hypertension was classified by the sixth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure and the cutpoints of hyperlipidemia was used National Cholesterol Education Program. The cutpoint of hyperglycemia was used National Diabetes Data Group and those for obese was 30%. The results obtained were as follows; 1. Prevalence of definitive hypertension was 41.2% in males and 41.6% in females. The prevalence of hypertension showed Increasing tendency according to age increase(p<0.05). 2. Prevalence of hyperlipidemia was 20.6% in males and 20.4% in female. In females prevalence of hyperlipidemia showed increasing tendency according to age increase(p<0.001). 3. Prevalence of obese was 23.4% in males and 28.8% in females. Upper body type was predominant in females, but lower body type was predominant in males. 4. Prevalence of hyperglycemia was 11.0% in males and 12.1% in females. The prevalence of hyperglycemia showed increasing tendency according to age increase(p<0.01). 5. The smoking rate was 63.7% in males and 2.6% in females. 6. On the EKG findings, the prevalence of myocardial ischemia and myocardial infarction was 6.7% in males and 7.5% in females. 7. The prevalence of Ischemic heart disease was higher in hypertension than normal in females and higher in obese than normal in males. In males and females the prevalence of ischemic heart disease was higher in hyperglycemia than normal and higher in upper body type than lower body type. But there is no statistical association among them.
Background and Purpose: Stroke in young adults is relatively uncommon. Only 3.7-14.4% of all strokes occur in patients aged 15-45 years. Stroke in young adults has more various and diverse possible causes than stroke in the elderly. We studied to gain further insight into both pathogenic and etiologic determinants in young adults with stroke. Methods : We retrospectively reviewed the medical records of 230 young patients aged 15-45 years who were admitted to the 2nd internal medicine department of Kyung Hee Oriental Medical Center with a diagnosis of stroke between May 1995 and May 1999. We analysed clinical features and diagnostic tests, such as brain imaging, cerebral angiography, echocardiography, 24 hours holter monitoring and other laboratory tests. Results : 1. Of 230 young patients with stroke aged 15-45 years(176 males(76.5%) and 54 females(23.5%)), 140 patients(60.9%) showed ischemic stroke and 90 patients(39.1 %) showed hemorragic stroke. 2. The most prevalent age group was from 40 to 45 years with 142 patients(61.7%) 3. The most frequent site of 140 ischemic stroke was MCA territory in 93 cases(66.4%) and Multiple, VA territory, PCA territory, ACA territory in order of frequency. 4. The most frequent site of 90 hemorrhagic stroke was basal galglia hemorrhage 57 cases(63.3%) and subcortical 13 cases(14.5%), pons, thalmus, subarachnoid, cerebellum in order of frequency. 5. The causes of hemorrhagic stroke were hypertension 49 cases(54.5%), arteriovenous malformation 7 cases(7.8%), ruptured aneurysm 4 cases(4.5%), angioma 3 cases(3.3%). 6. The risk factors of ischemic stroke were smoking, alcohol drinking, hyperlipidemia, hypertension, obesity, heart disease, history of CVA, diabetes mellitus, in order of frequency. 7. The comparison of risk factors between ischemic and hemorrhagic stroke: hypertension was prevalent in hemorrhagic stroke, heart disease and history of CVA were prevalent in ischemic stroke. Conclusions: From the above results, we found that stroke in young adults had various possible causes. Young adults with stroke deserve an extensive but tailored evaluation which include angiography and echocardiography for diagnosis.
Son, Gi Hoon;Park, Seong Hwan;Kim, Yunmi;Kim, Ji Yeon;Kim, Jin Wook;Chung, Sooyoung;Kim, Yu-Hoon;Kim, Hyun;Hwang, Juck-Joon;Seo, Joong-Seok
Molecules and Cells
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v.37
no.3
/
pp.241-247
/
2014
Sudden cardiac death (SCD), which is primarily caused by lethal heart disorders resulting in structural and arrhythmogenic abnormalities, is one of the prevalent modes of death in most developed countries. Myocardial ischemia, mainly due to coronary artery disease, is the most common type of heart disease leading to SCD. However, postmortem diagnosis of SCD is frequently complicated by obscure histological evidence. Here, we show that certain mRNA species, namely those encoding hemoglobin A1/2 and B (Hba1/2 and Hbb, respectively) as well as pyruvate dehydrogenase kinase 4 (Pdk4), exhibit distinct postmortem expression patterns in the left ventricular free wall of SCD subjects when compared with their expression patterns in the corresponding tissues from control subjects with non-cardiac causes of death. Hba1/2 and Hbb mRNA expression levels were higher in ischemic SCD cases with acute myocardial infarction or ischemic heart disease without recent infarction, and even in cardiac death subjects without apparent pathological signs of heart injuries, than control subjects. By contrast, Pdk4 mRNA was expressed at lower levels in SCD subjects. In conclusion, we found that altered myocardial Hba1/2, Hbb, and Pdk4 mRNA expression patterns can be employed as molecular signatures of fatal cardiac dysfunction to forensically implicate SCD as the primary cause of death.
The main cause of ischemic heart disease combined with aortic valve disease is the systemic atherosclerotic process. Coronary artery embolism by a particle from the calcified aortic valvular tissue is very rare. A 73-year-old female patient was admitted due to chest tightness of recent onset. Two dimensional echocardiogram showed severe calcific aortic valve stenosis. Preoperative coronary angiogram exhibited a stenotic lesion at the distal right coronary artery, which seemed to be embolic in origin. The coronary embolus was removed through the coronary arteriotomy and then the arteriotomy site was repaired by onlay patch angioplasty technique. Aortic valve was replaced by a bioprosthetic valve. The embolus was reported as a fibrocalcified particle of diseased valve.
Ahn, So Hyun;Song, Hong-ki;Kim, Cheol Ho;Jang, Min Uk;Sohn, Jong-Hee;Choi, Hui Chul
Annals of Clinical Neurophysiology
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v.18
no.1
/
pp.1-6
/
2016
Background: Moyamoya disease is characterized by a progressive stenosis or occlusion of the intracranial internal carotid artery and/or the proximal portion of the anterior cerebral artery and middle cerebral artery. Whether the onset time was childhood or adulthood, the bony carotid canal diameter might be different, but reflects the size of internal carotid artery passing through the bony carotid canal. In this study, we aimed to identify the relationship between bony carotid canal diameter and clinical manifestation. Methods: 146 consecutive patients diagnosed with moyamoya disease by brain imaging studies were included. We measured the diameter of a transverse portion of bony carotid canal on bone window of a brain computed tomography(CT) image. Patients were divided into two groups, ischemic or hemorrhagic stroke according to clinical manifestation. As a result, 115 patients were included. The Suzuki stage was used as criteria for disease progression. Results: Bony carotid canal diameter was $3.6{\pm}0.5$ (right) and $3.6{\pm}0.4$ (left) in the hemorrhagic stroke group, and $3.7{\pm}0.4$ (right) and $3.6{\pm}0.4$ (left) in the ischemic stroke group. The bony carotid canal diameter of the moyamoya vessels (3.6 mm) was smaller than the diameter of non-moyamoya vessels (3.8 mm), significantly (p = 0.042). However, there was no difference in the collateral patterns and clinical manifestation in a comparison of both groups. Conclusions: In our study, there was no significant difference of clinical manifestations and collateral patterns depend on the bony carotid canal diameter in patients with moyamoya disease. These findings suggest that the clinical presentations of moyamoya disease are not related to the onset time of the disease.
Aggressive revascularization of the ischemic lower extremities in atherosclerotic, occlusive diseases or acute embolic arterial occlusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by some authors. We have performed 68 first time vascular operations, including thromboembolectomies on RR patients with ischemic lower extremities, within an 11-year-and-6-month period, from January 1974 to June 1984. We have reviewed and analyzed our vascular operative procedures and post operative results. The patients upon whom thromboembolectomies were performed were 42 males and 13 females ranging from 5 to 72 years of age. The major arterial occlusive sites were common iliac artery in 20 cases, femoral artery in 21 cases, popliteal artery in 8 cases, common iliac artery and femoral artery in 4 cases, and femoral artery and popliteal artery in 3 cases. The underlying causes of arterial occlusive disease were atherosclerosis obliterans in 34 cases; Buerger`s disease in 3 cases; emboli due to cardiac valvular disease in 13 cases; and vascular trauma in 4 cases, including cardiac catheterization in I of those cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 31 cases. Amputations were done on 2 patients carrying out any more vascular operative procedures would have been of no benefit to them. Our bypass operations for ischemic lower extremities were classified as follows: those done between the abdominal aorta and the femoral artery in 17 cases, including those done between the aorta and the bifemoral arteries with a Y graft in four of those cases and long ones done from the axillary to the femoral artery in 4 cases. Five patients died in the hospital following vascular surgery for ischemic lower extremities, the causes of death were not directly related to the vascular reconstructive operative procedures. The leading causes of death were respiratory failure due to metastatic lung carcinoma: renal failure due to complications from atherosclerosis obliterans; sepsis from open, contaminated fractures of the tibia and fibula; and myocardial failures due to open heart surgery in one case and reconstructive surgery of the ascending aorta in another.
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