• The Korean Journal of Nuclear Medicine
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• v.19 no.2
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• pp.43-50
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• 1985

With the improvement of hemodialysis, the course of the disease in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (early and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis. 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe due to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

• The Korean Journal of Nuclear Medicine
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• v.39 no.2
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• pp.100-106
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• 2005

Non-invasive evaluation of cardiac function by nuclear medicine technologies are one of the major contribution of nuclear medicine. Gated cardiac blood pool scan was once a novel and robust technique which enabled evaluation of ventricular function. Concept of EKG gating was one of the major breakthrough in nuclear cardiology. According to the evolution of echocardiographic techniques, and as the evaluation of myocardial perfusion by perfusion SPECT became feasible, number of gated blood pool study dong in nuclear medicine laboratory is declining. And recently, evaluation of ventricular function with gated perfusion SPECT further decreased the use of gated blood pool scan. In this article, assessment of ventricular function using gated blood pool scan is discussed including some insight about the role of gated blood pool SPECT.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.785-791
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• 2000

Left ventricular dysfuction is common in immediate postoperative periods after surgical correction of heart diseases with chronic left ventricular volume overload. We speculated postoperative changes of left ventricular volume and unction in patients with patent ductus osus(PDA) who had underwent surgical repair at ages older than 16 years. Factors influencing postoperative left ventricular volume and function were also analyzed. Material and Method: From August 1989 to August 1999 thirty-siz adult patients with PDA 28 females and 8 males. were enrolled in this study. Their age ranged from 16 years to 57 years(mean :32 years). Types of surgical repair were division with primary closure in 22, division with patch closure in 6, internal obliteration using cardiopulmonary bypass in 4 and ligation in 4. Aortic clamping was combined during surgical repair in 22(61%) and cardiopulmonary bypass was used in 8(22%) Two-dimensional echocardiography studies were performed in 34(94%) preoperatively and in 25(66%) immediate postoperatively to assess postoperative changes of left ventricular internal dimensions. left ventricular volume and ejection fraction. Duration of postoperative follow-up ranged from 1 month to 99 months (mean:22 months) and 10 patients underwent 16 echocardiographic evaluation during this period Result : Preoperative and postoperative left ventricular systolic dimensions(LVIDs) were 42$\pm$8.0mm and 42$\pm$8.3mm left ventricular diastolic dimensions(LVIDd) were 64$\pm$10.0mm and 56$\pm$7.4mm left ventricular end systolic volumes(LVESV) were 62$\pm$19cc (z=1.87$\pm$0.06) and 59$\pm$24cc(z=1.78$\pm$0.08) left ventricular end diastolic volumes(LVEDL) were 169$\pm$40cc(z-1.17$\pm$0.1) and 112$\pm$29cc(z=0.85$\pm$0.1) and ejection fractions(EF) were 66$\pm$6.7% and 48$\pm$12.6% respectively. There were statistically significant differences between preoperative and postoperative values in LVDIDd(p=0.001) LVEDV(p=0.001) and EF(p=0.0001) while no significant difference is LVIDs and LVESV. Postoperative depression of ejcection fraction was significantly related with z-score of preoperative LVESV and LVEDV by univariateanalysis while LVEDV only was significant risk factor for postoperative LV dysfunction by multiple regressioin analysis ($\Delta$LVEF=-13.3-4.62$\times$LVEDV(z), p=0.001) During the follow-up periods ejection fractions become normalized in all except one patients. Conclusion ; Left ventricular function is usually deteriorated after the surgical correction of PDA in adult age and preoperative LVEDV is a major determinant of postoperative LV function.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.563-570
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• 1994

Effect of ischemic preconditioning on left ventricular function after cardiac arrest in isolated rat heart.Ischemic preconditioning reduces infarct size caused by sustained ischemia. However, the effects of preconditioning on post ischemic cardiac function are not well-known. The objective of the present study was to determine whether preconditioning would improve the recovery of left ventricular functions after cardiac arrest in isolated rat heart model.Isolated rat hearts were allowed to equilibrate for 20 minutes and were then subjected to either 5 minutes of global, normothermic transient ischemia [Group 2 and 4] or not [Group 3]. A stabilization period of perfusion lasting 5 minutes after the termination of transient ischemia was followed by a standard global, normothermic 20 minute-ischemia and 35-minute reperfusion challenge [Group 3 and 4]. These following results were odtained.1. The recovery of left ventricular developed pressures showed no significant differences between Group 3 and Group 4 at 50 [P>0.3] and 85 minute [P>0.2].2. Heart rates showed no significant differences throughout all the course of experiment and between groups [P>0.5].3. The recovery of left ventricular maximum dP/dt showed no significant differences between Group 3 and Group 4 at 50 [P>0.1] and 85 minute [P>0.2].4. The recovery of pressure-rate products showed no significant differences between Group3 and Group 4 at 50 [P>0.5] and 85 minute [P>0.1].These results suggest that ischemic preconditioning does not provide significant benefit for the postischemic left ventricular functions in isolated rat hearts.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.252-256
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• 2000

There have been few reports documenting the outcome of arterial swich operations(ASO) in selected patients with transposition of great arteries(TGA) and with left ventricular outflow tract obstruction(LVOTO). In the case of TGA with LVOTO, if the atrial septal defect(ASD) is large and the ventricular septal defect(VSD) is restricive, this deprives the left ventricle(LV) of approporiate preload and could lead to underdevelopment of the ventircular mass and lead poor LV performance after the arterial switch operation, dspite a high pressure in the LV preoperatively. Because an increase in the systolic ventricular pressure is not necessarily paralleled by an increase in ventricular mass, which is also essential for optimal ventricular performance after the operation. We report here a case of rapid LV training after ASO in TGA with unprepared LV (because of large ASD and restrictive VSD) despite a high pressure in the LV(due to LVOTO) preoperatively.

• The Korean Journal of Nuclear Medicine
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• v.14 no.1
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• pp.29-36
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• 1980

Most of clinical morbidity in cardiology are associated with abnormalities of the left ventricle. Several methods have been developed to measure the left ventricular function, including cardiac catheterization with cineangiography, echocardiography, and systolic time interval. But these methods have many limitations. ECG gated cardiac blood pool scan provides a safe, noninvasive, repeatable method for determining the left ventricular function. Utilizing the cardiac blood pool scan, we measured the left ventricular function in 165 cardiac patients, and in 26 normal subject. 1. Left ventricular ejection fractions were measured by cardiac blood pool scan, and compared in 20 patients with that measured by x-ray cineangiography. Correlation coefficient was 0.885. 2. Ejection fractions were classified by funtional class made in New York Heart Association. Ejection fractions well represented the functional status. 3. Ejection fractions decreased in cardiomyopathy ($20.1{\pm}4.8%$) and ischemic heart disease ($34.4{\pm}16.7%$). Impaired ejection fractions in myocardial infarction were associated with the extent of infarction. 4. Regional left ventricular wall motion was evaluated from the end-diastolic and end-systolic images. In cardiomyopathy diffuse hypokinesia was noted and in myocardial infarction akinesia was noted on the infarcted areas.

• The Korean Journal of Nuclear Medicine
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• v.16 no.1
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• pp.1-6
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• 1982

To evaluate the usefulness of radionuclide cardiac angiography in the assessment of right ventricular function, we measured right ventricular ejection fraction (RVEF) using single pass method. In 12 normal persons, RVEF averaged $52.7{\pm}5.9%(mean{\pm}S.D.)$. In 25 patients with chronic obstructive lung disease, RVEF was $37.2{\pm}10.6%$ and significantly lower than that of normal persons (p<0.01). All 10 patients with right ventricular failure had abnormal RVEF, which was significantly lower than that of 14 patients without right ventricular failure ($27.6{\pm}5.7%,\;43.9{\pm}8.5%$, respectively. p<0.01). It concluded thal RVEF measured by single pass radionuclide cardiac angiography was a useful, noninvasive method to assess right ventricular function.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.97-107
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• 2001

Background : Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. Method: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both $FEV-1$ and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. Results : There was no significant difference in the demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the $PaCO_2$ was higher ($42.9{\pm}4.7$ vs $38.8{\pm}3.1\;mmHg$ at rest; $47.9{\pm}7.0$ vs $41.1{\pm}5.9\;mmHg$ after exercise; p<0.01) and the right ventricular ejection fraction was lower ($57.6{\pm}6.5$ vs $61.4{\pm}4.7%$ at rest; $51.1{\pm}10.8$ vs $59.8{\pm}6.6%$ after exercise; p<0.01) both at rest and after exercise. The $PaCO_2$ after exercise was also lower ($65.7{\pm}12.6$ vs $80.2{\pm}14.4\;mmHg$, p<0.01), while the Pa02 at rest tended to be lower($82.9{\pm}12.0$ vs $87.8{\pm}7.5$, p>0.05). In both groups, right ventricular ejection fraction correlated with the $PaCO_2$ after exercise(PTE r=0.536, PE r=0.557), and the $PaCO_2$ at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). Conclusion : Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.128-131
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• 2017

Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.135-139
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• 1993

Radionuclide cardioangiography has been widely applied and has played major roles in non-invasive assessment of cardiac function. Three techniques, first-pass, gated first and gated equilibrium methods, have commonly been used to evaluate right ventricular ejection fraction which usually abnormal in the patients with cardiopulmonary disease. It has been known that the gated first pass method is the most accurate method among the three techniques in assessment of right ventricular ejection fraction. The radionuclide right ventricular ejection fraction values were determined in 13 normal subjects and in 15 patients with chronic obstructive pulmonary disease by the gated first pass method and compared with those of the first pass method because there ha,j been no published data of right ventricular ejection fraction by the gated first pass method in Korea. The values of right ventricular ejection fraction by the gated first pass method were compared with the detas from the pulmonary function test performed in the patients with chronic obstructive pulmomary disease. The results were as follows: 1) The values of right ventricular ejection fraction by the gated first pass method were $50.1{\pm}6.1%$ in normal subjects and $38.5{\pm}8.5$ in the patients with chronic obstructive pulmonary disease. There was statistically significant difference between the right ventricular ejection fraction of each of the two groups (p < 0.05). 2) The right ventricular ejection fraction by the gated first pass method was not linearly correlated with $FEV_1$, VC, DLCO, and FVC as well as $P_aO_2$ and $P_aCO_2$ of the patients with chronic obstructive pulmonary disease. We concluded that right ventricular ejection fraction by the gated first pass method using radionuclide cardioangiography may be useful in clinical assessment of the right ventricular function.