A hundred and fifty-one patients with congenital heart disease less than 24 months old underwent intracardiac repairs from January 1982 to July 1983, which consists 24.2% of all the patients with congenital heart diseases operated during the same period. There were 98 patients[64.9%] with acyanotic congenital heart disease and 53 patients[35.1%] with cyanotic congenital heart disease, and 55 patients[36.4%] were less than 1 year of age. Twenty-two patients died within 30 days after surgery and 3 patients died after postoperative 30th day: Ventricular septal defect, four of 90 patients; Tetralogy of Fallot, five of 23 patients; Transposition of great arteries, nine of 17 patients; Tricuspid atresia, four of 5 patients; Pulmonary atresia, all of 2 patients; Single ventricle, one of single patients. Over all mortality was 16.6% and mortality of acyanotic congenital heart disease, cyanotic congenital heart disease and patients less then 1 year of age was 4.1%, 39.6% and 20.0% respectively. Still the mortality of cyanotic congenital heart disease is high. Careful preoperative evaluation of the detailed intracardiac anatomy and hemodynamics of the patients and proper selection of surgical treatment yield better clinical results.
This study was carried out to see dietary intakes of patients with coronary heart disease since we don't understand their dietary patterns even though the mortality and prevalence rate of coronary hear disease are increasing in this country. We studied 75 coronary heart disease patients and 150 randomly selected controls, matched for age, sex, height and weight, in a population based study. All subjects completed a questionnaire that included disease history, diagnosis time, current treatment, etc., a 24 hour dietary recall, and measurement of height and weight. Compared to controls, patients had less likely to drink alcohol and smoke cigarette (p<0.05). The energy intake of patients was significantly lower than that of controls, but the intakes of fiber, $\beta$-carotene, sodium, folate, vitamin C, potassium in male patients and those of vitamin C and sodium in female patients were significantly higher than those of controls (p<0.05). Mean adequacy ratio and dietary variety score of patients were also higher than those of controls (p<0.05). Patient group's consumed less cereals than controls, but more vegetables, milk products, and nuts in male patients and fruits, beans and seasonings in female patients compared to controls'. There were not significant differences of lipid compositions between two groups, except linolenic acid. These data suggest that patients with coronary heart disease in Korea had better dietary nutrient intakes compared to healthy controls, which might be helpful to prevent recurrence of coronary heart disease.
Background: The oxygen uptake efficiency slope (OUES) is the most important index for accurately measuring cardiopulmonary function in patients with acute ischemic heart disease. However, the relationship between the OUES variables and important cardiopulmonary function parameters remain unelucidated for patients with acute ischemic heart disease, which accounts for the largest proportion of heart disease. Objects: The present cross sectional clinical study aimed to determine the multiple relationships among the cardiopulmonary function variables mentioned above in adults with acute ischemic heart disease. Methods: A convenience sample of 110 adult inpatients with ischemic heart disease (age: 57.4 ± 11.3 y; 95 males, 15 females) was enrolled at the hospital cardiac rehabilitation center. The correlation between the important cardiopulmonary function indicators including peak oxygen uptake (VO2 peak), minute ventilation (VE)/carbon dioxide production (VCO2) slope, heart rate recovery (HRR), and ejection fraction (EF) and OUES was confirmed. Results: This study showed that OUES was highly correlated with VO2 peak, VE/VCO2 slope, and HRR parameters. Conclusion: The OUES can be used as an accurate indicator for cardiopulmonary function. There are other factors that influence aerobic capacity besides EF, so there is no correlation with EF. Effective cardiopulmonary rehabilitation programs can be designed based on OUES during submaximal exercise in patients with acute ischemic heart disease.
Alicia Jeanette Fischer;Christin Grundlach;Paul C Helm;Ulrike Mm Bauer;Helmut Baumgartner;Gerhard-Paul Diller;German Competence Network for Congenital Heart Defects Investigators
Korean Circulation Journal
/
v.52
no.3
/
pp.233-242
/
2022
Background and Objectives: For adult men with congenital heart disease (ACHD), data on erectile dysfunction (ED) is limited. We aimed to assess the frequency of ED, its role in patient-physician communication and to identify parameters predicting ED. Methods: Male ACHD ≥18 years registered at the German National Register for Congenital Heart Defects were invited to participate in an online questionnaire about sexual health. Participants with presumed ED according to International Index of Erectile Function Score were compared to patients without ED. Results: The 371 patients responded to the questionnaire (83% with moderate to highly complex ACHD). The 43% presented with more than mild ED. When ED was present, patients complained about general anxiety to be sexually active more often (p<0.05) and underwent sexual activity less frequently compared to those without ED (p<0.05). Age ≥40 years (odds ratio [OR], 3.04; p=0.002), being single (OR, 6.82; p<0.0001), anxiety to be sexually active (OR, 2.64; p=0.0002) and psychiatric disease (OR, 4.33; p<0.0007) emerged as independent predictors for ED. Overall, patients sought medical advice in 6.7% of cases, whilst 29.6% would appreciate an active approach by the physician to address this sensitive topic. Conclusions: ED is affecting one third to one half of male ACHD according to a questionnaire-based analysis. Older age, being single, fear of sexual activity due to ACHD and psychiatric disorder emerged as independent predictors for ED. These parameters can easily be assessed to identify patients at risk. ED should be addressed proactively by health professionals.
From Jan. 1962 to Aug. 1983, one hundred patients with cyanotic heart disease underwent various palliative operations at the department of thoracic and cardiovascular surgery, S.N.U.H. In the period from Jan. 1962 to Dec. 1973, in which the open heart surgery was not routinely performed, sixty-two operations including 2 cases of second shunt operation were performed in sixty patients, and all of them were tetralogy of Fallot except three cases. Various palliative procedures such as Glenn, Brock, Waterston and Blalock-Taussing operation were used in this period with overall mortality rate of 16%. In the period from Jan. 1980 to Aug. 1983, forty patients with cyanotic heart disease were operated and majority of them was complex anomalies. Only Blalock-Taussing operation was used in this period with a mortality rate of 20%. These two groups of patients were compared according to age, diagnosis and results of operations, and it appears that Blalock-Taussing operation is effective palliation for patients with cyanotic heart disease, especially with complex anomaly, with an acceptable mortality.
Background. Ischemic heart disease results from athesclerotic changes of the coronary artery. These changes are aggravated by hypercholesterolemia, smoking, obesity, lack of exercise, coronary-prone personality, and stress. Because these risk factors affect not only the prevalence of the ischemic heart disease but also recurrence of the disease, cardiac rehabilitation programs were introduced to help patients with ischemic heart disease reduce risk factors. Diverse cardiac rehabilitation programs are needed to motivate participation in cardiac rehabilitation and to enhance patients' quality of life. Objectives. To examine the effect of a self-efficacy promoting cardiac rehabiltation program on self-efficacy, health behavior and quality of life of patients with ischemic heart disease. Methods. Data were collected from 45 hospitalized ischemic heart disease patients. Medical records were reviewed to obtain demographic and clinical characteristics. Data regarding self-efficacy, health behavior, and quality of life were obtained from interviews using structured questionnaires. The nonequivalent control group non-synchronized design was used to conduct this study. One session of conventional group education was given to patients in the control group while they were in the hospital. Patients in the experimental group participated in a newly developed cardiac rehabilitation program. It focused on strengthening self-efficacy with four self-efficacy sources-performance accomplishment, vicarious experiences, verbal persuasion and physical status using two individualized in-hospital education sessions and four weekly telephone counseling follow-up calls after discharge. Results. Four weeks after discharge, the increment of total self-efficacy score was significantly higher in the experimental group than in the control group (p<.0l). There was also a significant difference in the total quality of life scores increments between the two groups (p<.0l). However, no significant changes were noted in the increments of total health behavior scores between the two groups. Conclusion. A cardiac rehabilitation program focusing on promoting self-efficacy was effective in improving self-efficacy, and quality of life of patients with ischemic heart disease.
Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.
77 cases of Aortic Valve Replacement, which were composed of 64 rheumatic valvular heart disease and 13 combined congenital heart disease, were operated at Seoul National University Hospital for Aortic valvular disease during the period from June 1968 to December 1983. Among these 64 rheumatic aortic valvular heart disease cases, 8 patients were expired during and immediate after operation and overall mortality rate was 12.5%. For more precise remarks, these patients were divided into two periodic groups, 1st period [from 1968 to 1976] and 2nd [from 1977 to 1983] when annual open heart surgery were over 100 cases, and in 1st period three of four patients were died and in 2nd period five of sixty patients were died and its mortality rate was 8.3%. There were 12 cases of postoperative complication, which were 3 cases of remaining other valvular heart disease required MVR, 2 paravalvular leaks [one of them got Redo AVR], 4 thromboembolism or problem of anticoagulant therapy, 2 late death due to SBE with replaced valve failure and one functional AS with small sized valve. Operative death was affected by pump-time and aortic cross-clamping time, heart size, Ejection Fraction, LVEDP and symptom duration, and other many factors may influence the survival rate. Improved operative technique and myocardial protection and meticulous evaluation of the preoperative patient status will make the AVR safer.
The purpose of this study was to examine the level of intention to quit smoking and to identify factors influencing intention to quit among patients with coronary heart disease. Method: The subjects consisted of 80 male patients with coronary heart disease (angina pectoris, myocardial infarction) at three hospitals in Seoul. The data were collected with self reporting in a structured questionnaire. Stepwise multiple regression was used to identify predictors of intention to quit. Included variables were attitudes toward smoking cessation, subjective norms, perceived behavioral control, usefulness of smoking cessation, and previous attempts to quit. Result: 1. The mean score for intention to quit was 11.1($\pm$6.1) which was lower than median score of the scale. 2. There were significant correlations between the all predictive variables and the intention to quit(r=.24-.48, p<.05). 3. usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit explained 34.6% of the variance for intention to quit. Conclusion: usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit were identified as important variables in explaining the intention to quit smoking among patients with coronary heart disease. Thus, it is necessary to try to enhance this factors for increasing intention to quit among patients with coronary heart disease.
To investigate antioxidant status and platelet antioxidative enzyme activity in patients with ischemic heart disease, 36 male patients admitted to Kyungpook National University Hospital from June to December 1994 were compared to 36 healthy male control subjects. The percentages of heavy smoking and nonexercise were significantly higher in the patient group compared to the control, but the drinking status was not significantly different between groups. Food habit and food frequency scores were significantly lower in patients than in control subjects. Plasma retinol levels tended to be lower in the patient group, and plasma $\alpha$-tocopherol and $\beta$-carotene levels were not different between groups. There was no difference in the level of plasma thiobarbituric acid reactive substances(TBARS) and in the activities of platelet glutathione peroxidase and catalase. Our results indicate that oxidative stress, which is reflected by the plasma levels of antioxidants and TBARS, did not increase in the patients with ischemic heart disease, and the long-term effects due to smoking, poor food habit and other life styles could possibly contribute to the onset of the disease.
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