• Title/Summary/Keyword: cardiac diseases

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Myocardial Perfusion SPECT as a Screening Test before Planned Vascular Surgery for Predicting Perioperative Cardiac Complications (혈관 수술 후 심장 합병증 발생을 예측하기 위한 선별 검사로서 심근 관류 단일 광자 단층촬영의 유용성에 대한 연구)

  • Lee, Hyung-Chae;Hwang, Youn-Ho;Wi, Jin-Hong;Jun, Hee Jae;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.25-32
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    • 2010
  • Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

Stage specific transcriptome profiles at cardiac lineage commitment during cardiomyocyte differentiation from mouse and human pluripotent stem cells

  • Cho, Sung Woo;Kim, Hyoung Kyu;Sung, Ji Hee;Han, Jin
    • BMB Reports
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    • v.54 no.9
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    • pp.464-469
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    • 2021
  • Cardiomyocyte differentiation occurs through complex and finely regulated processes including cardiac lineage commitment and maturation from pluripotent stem cells (PSCs). To gain some insight into the genome-wide characteristics of cardiac lineage commitment, we performed transcriptome analysis on both mouse embryonic stem cells (mESCs) and human induced PSCs (hiPSCs) at specific stages of cardiomyocyte differentiation. Specifically, the gene expression profiles and the protein-protein interaction networks of the mESC-derived platelet-derived growth factor receptor-alpha (PDGFRα)+ cardiac lineage-committed cells (CLCs) and hiPSC-derived kinase insert domain receptor (KDR)+ and PDGFRα+ cardiac progenitor cells (CPCs) at cardiac lineage commitment were compared with those of mesodermal cells and differentiated cardiomyocytes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses revealed that the genes significantly upregulated at cardiac lineage commitment were associated with responses to organic substances and external stimuli, extracellular and myocardial contractile components, receptor binding, gated channel activity, PI3K-AKT signaling, and cardiac hypertrophy and dilation pathways. Protein-protein interaction network analysis revealed that the expression levels of genes that regulate cardiac maturation, heart contraction, and calcium handling showed a consistent increase during cardiac differentiation; however, the expression levels of genes that regulate cell differentiation and multicellular organism development decreased at the cardiac maturation stage following lineage commitment. Additionally, we identified for the first time the protein-protein interaction network connecting cardiac development, the immune system, and metabolism during cardiac lineage commitment in both mESC-derived PDGFRα+ CLCs and hiPSC-derived KDR+PDGFRα+ CPCs. These findings shed light on the regulation of cardiac lineage commitment and the pathogenesis of cardiometabolic diseases.

Pharmacological and medical applications of Panax ginseng and ginsenosides: a review for use in cardiovascular diseases

  • Kim, Jong-Hoon
    • Journal of Ginseng Research
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    • v.42 no.3
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    • pp.264-269
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    • 2018
  • Panax ginseng, also called Asian or Korean ginseng, has long been traditionally used in Korea and China to treat various diseases. The major active ingredients of P. ginseng are ginsenosides, which have been shown to have a variety of therapeutic effects, including antioxidation, anti-inflammatory, vasorelaxation, antiallergic, antidiabetic, and anticancer. To date, approximately 40 ginsenoside components have been reported. Current research is concentrating on using a single ginseng compound, one of the ginsenosides, instead of the total ginseng compounds, to determine the mechanisms of ginseng and ginsenosides. Recent in vitro and in vivo results show that ginseng has beneficial effects on cardiac and vascular diseases through efficacy, including antioxidation, control of vasomotor function, modulation of ion channels and signal transduction, improvement of lipid profiles, adjustment of blood pressure, improvement in cardiac function, and reduction in platelet adhesion. This review aims to provide valuable information on the traditional uses of ginseng and ginsenosides, their therapeutic applications in animal models and humans, and the pharmacological action of ginseng and ginsenosides.

Radiopharmaceuticals of Cardiac SPECT Imaging (심장스펙트 영상에 사용되는 방사성의약품)

  • Chung, Yong-An
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.69-74
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    • 2005
  • Ever since it was first introduced as a method of scintigraphically measuring regional myocardial perfusion, myocardial perfusion study has been widely used in patients diagnosed or suspected with coronary artery diseases, and continuously improved upon. In addition to the technological enhancement of nuclear medicine equipments, the innovation of radiopharmaceuticals used in the cardiac exams were important contributors to such improvement. Besides the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. More information can be collected before diagnosing coronary vascular disease, evaluating the patient's condition, or assessing therapeutic effects. In this review article, the clinical efficacy and characteristics of radiopharmaceutical products tailored for cardiac SPECT that are commonly used in Korea currently, plus the ones not being used yet but have proven value are briefly described.

Clinical Presentation of the Patients with Non-traumatic Chest Pain in Emergency Department (응급의료센터에 내원한 비외상성 흉통환자의 임상 양상)

  • Chung, Jun-Young;Lee, Sam-Beom;Do, Byung-Soo;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.283-295
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    • 1999
  • Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

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Involvement of TGF-β1 Signaling in Cardiomyocyte Differentiation from P19CL6 Cells

  • Lim, Joong-Yeon;Kim, Won Ho;Kim, Joon;Park, Sang Ick
    • Molecules and Cells
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    • v.24 no.3
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    • pp.431-436
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    • 2007
  • Stem cell-based therapy is being considered as an alternative treatment for cardiomyopathy. Hence understanding the basic molecular mechanisms of cardiomyocyte differentiation is important. Besides BMP or Wnt family proteins, $TGF-{\beta}$ family members are thought to play a role in cardiac development and differentiation. Although $TGF-{\beta}$ has been reported to induce cardiac differentiation in embryonic stem cells, the differential role of $TGF-{\beta}$ isoforms has not been elucidated. In this study, employing the DMSO-induced cardiomyocyte differentiation system using P19CL6 mouse embryonic teratocarcinoma stem cells, we investigated the $TGF-{\beta}$-induced signaling pathway in cardiomyocyte differentiation. $TGF-{\beta}1$, but not the other two isoforms of $TGF-{\beta}$, was induced at the mRNA and protein level at an early stage of differentiation, and Smad2 phosphorylation increased in parallel with $TGF-{\beta}1$ induction. Inhibition of $TGF-{\beta}1$ activity with $TGF-{\beta}1$-specific neutralizing antibody reduced cell cycle arrest as well as expression of the CDK inhibitor $p21^{WAF1}$. The antibody also inhibited induction of the cardiac transcription factor Nkx2.5. Taken together, these results suggest that $TGF-{\beta}1$ is involved in cardiomyocyte differentiation by regulating cell cycle progression and cardiac gene expression in an autocrine or paracrine manner.

The Echocardiographic Assessment and clinical Application of Cardiac Disease in Korean Jin-do dog (진돗개에서 심장초음파 측정치의 평가와 임상적 응용 I. 심장초음파 측정치)

  • 박인철;강병규;손창호
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.178-186
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    • 2000
  • Echocardiography was performed on 29 normal Korea Jin-do dogs(21 adults and 8 prematures) and the images were taken from chordae tendineae level short-axis view, left ventricular outflow tract long-axis view and 4-chamber long-axis view, respectively. The following cardiac parameters, in systole and diastole, were measured on the echoocardographic images: aortic dimension(AO), left atrial dimension(LA), left ventricular internal dimention at end-diastole (LVIDd), left ventricular internal dimention at end-systole(LVIDs), interventricular septal wall thickness at end-diastole(IVSd), interventricular septal wall thickness at end-systole(IVSs), left ventricular wall at end-diastole(LVWd), left ventricular wall at end-systole(LVWs). The cardiac parameters were not significantly different between sex and among imaging planes. The size of cardiac parameters increaed as regression lines according to body weights. These results suggest that the chordae tendineae level short-axis view, left ventricular outflow tract long-axis view and 4-chamber long-axis view can be utilized for the left cardiac examination, and these cardiac parameters can be used to basic dat for diagnosing the cardiac diseases in Korea Jin-do dog.

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Defibrillator(AED) in prehospital care (병원전 처치에서 자동제세동기의 사용)

  • Koh, Bong-Yeun
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.25-32
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    • 2005
  • Purpose: There has been an increase in the number of prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population, We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrest. Methods: We studied 57 victims with prehospilal cardiac arrest by EMT's Reports form January to December, 2004. Results: Fifty-seven of 92 victims were trasported with ECG in prehospital cardiac arrest. Ventricular fibrillation(VF)/ ventricular tachycardia was 56.2%, asystole was 33,3%, and pulseless electrical activity(PEA.) was 10.5% in initial rhythm analysis, There weren't attempt CPR in 14.0%. Twenty of the 32(62.5%) were shocked by AED for the adequacy method. There were no statistical differences the transportation time. Conclusion: With the increase in cardiovascular disease and old age, the number out-of-hospital cardiac arrests has risen accordingly. However, there were lack of CPR by bystander, defibrillation, advanced cardiac life support(ACLS) in prehospital stage. To improve the adequancy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

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