• 제목/요약/키워드: cardiac diseases

검색결과 469건 처리시간 0.036초

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

  • 이형채;황윤호;위진홍;전희재;이양행;조광현
    • Journal of Chest Surgery
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    • 제43권1호
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    • pp.25-32
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    • 2010
  • 배경: 혈관질환 환자는 관상동맥질환 및 심장질환을 많이 동반함으로 인하여 혈관 수술 후 잠재되어 있는 심장질환이 악화 또는 유발될 수 있는 가능성이 있다. 이러한 심장질환을 확인하기 위한 검사중 비교적 간단하고 비침습적인 SPECT 촬영에 대한 효용성은 아직 논란이 되고 있다. 본 연구에서는 수술 전 SPECT를 촬영하고, 그 결과에 따른 검사 및 처치들이 혈관 수술 후 심장 합병증 발생에 미치는 임상적인 효과를 평가하고자 한다. 대상 및 방법: 2004년 4월부터 2007년 9월까지 3년 6개월간 본 병원에서 혈관 수술 전 아데노신 부하 Tc-99m 테트로포스민 SPECT를 촬영한 63명의 환자를 대상으로 하였다. 결과: SPECT 촬영 유소견의 심장 합병증 발생 예측에 대한 민감도와 특이도는 각각 41.2%와 52.2%로 비교적 낮게 나왔다. 그러나 비정상적인 SPECT 촬영결과를 보인 환자에게 관상동맥 조영술을 시행하고 관상동맥 병변에 대한 비정상 소견이 있을 때 관상동맥 중재적 시술 및 관상동맥 우회로술 등의 적극적인 처치를 한 경우 심장 합병증의 발생률이 낮은 경향을 보였다. 결론: SPECT 촬영은 혈관수술 후 심장 합병증 발생위험을 예측하기 위한 선별검사로서 효용성이 떨어진다.

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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    • 제54권9호
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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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    • 제42권3호
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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.

심장스펙트 영상에 사용되는 방사성의약품 (Radiopharmaceuticals of Cardiac SPECT Imaging)

  • 정용안
    • 대한핵의학회지
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    • 제39권2호
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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.

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

  • 정준영;이삼범;도병수;박종선;신동구;김영조
    • Journal of Yeungnam Medical Science
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    • 제16권2호
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    • pp.283-295
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    • 1999
  • 1997년 1월 1일부터 12월 31일까지 영남대학교 의과대학 부속병원 응급의료센터에 내원한 비외상성 흉통 환자에 대한 임상적 연구를 시행하여 다음과 같은 결과를 얻었다. 응급의료센터를 내원한 총환자 25,583명 중 비외상성 흉통을 주소로 내원한 경우는 488례였으며 남녀비는 1.9:1로 남자에게서 많이 발생하는 것으로 조사되었다. 흉통의 원인별 분류를 보면 심인성인 경우가 320례(65.6%)로 가장 많이 발생하였으며 심인성의 경우를 다시 나누어 보면 협심증이 140례(28.7%), 심근경색증이 128례(26.2%)였다. 흉통의 발생시간별 비교에서 심인성군이 비심인성군에 비해 오전에 더 많이 발생하는 것으로 나타났다(p<0.05). 내원 시간별 비교에서는 6시간내 도착한 경우가 심인성에서 60.0%, 비심인성에서 45.2%로 가장 많았으며, 6시간 이후에 도착한 경우는 심인성 40.0%, 비심인성 54.8%였다. 평균 소요시간은 비심인성군에서 $1,848.9{\pm}4,384.6$분, 심인성군에서 $1,454.5{\pm}3,219.1$분, 심근경색증군에서 $1,230{\pm}2780.6$분으로 심인성군, 심근경색증 환자군에서 소요시간이 짧은 것으로 나타났다. 흉통의 양상은 쥐어짜는 듯한 양상이 256(52.5%)례로 가장 많았고, 다음이 둔한 양상의 순으로 나타났으며, 심인성의 경우 쥐어짜는 듯한 양상이, 비심인성의 경우 둔한 양상이 가장 많이 나타났다. 연관된 증상의 경우, 호흡 곤란이 가장 많았으며, 증상의 평균개수는 비심인성군에서 $1.1{\pm}0.9$개, 심인성군에서 $1.4{\pm}1.1$개, 심근경색증군에서 $1.7{\pm}1.1$개로 나타나 심근경색증의 연관 개수가 의의있게 많았다(p<0.05). 심효소 검사에서 troponin-T rapid assay의 심근경색증 진단에 대한 민감도(sensitivity)는 59.2%, 특이도(specificity)가 95.0%, 양성 예측도86.0%, 음성 예측도 81.9%였으며. CK-MB 검사는 민감도 46.4%, 특이도 95.4%, 양성 예측도 84.1%, 음성 예측도 77.1%였으며 myoglobin 검사는 민감도 45.1%, 특이도 92.1%, 양성 예측도 74.3%, 음성 예측도 76.7%로 나타났다. 급성심근경색증군을 대상으로 한 경우 모두 90% 이상에서 시행되었으나 민감도는 45-59%에 불과했지만 심전도 검사의 경우 민감도가 96.1%로 나타났다. 입원율은 심인성군에서 229례(71.6%)로 비심인성군의 85례(50.6%)에 비해 높게 나타났으며 전체 응급의료센터의 입원율 35.2%에 비해서도 높았다(p<0.01). 사망률은 심인성군에서 13.8%로 전체 흉통환자의 8.8%보다 더 높았으며 비심인성군의 0.6%에 비해 20배 이상의 높은 수치를 보였다(p<0.01). 심인성군중에서도 특히 심근경색증이 원인인 경우에는 사망률이 28.1%에 달했다. 결론적으로 비외상성 흉통을 호소하는 환자의 경우 심인성 질환에 의한 경우가 가장 많고 이중 허혈성 심질환이나 심근경색증이 그 원인인 경우가 많은 것으로 나타났고, 임상양상을 비교해 볼 때 심인성질환 특히 심근경색증의 경우 연관 증상이 더 많은 것으로 나타났으며 쥐어짜는 듯한 양상이 가장 많았고 사망률 또한 가장 높았다. 그러나 정확한 진단이 되지 못한 상태에서 퇴원되는 경우도 있어 초기에 자세한 병력 청취를 통해 연관증상이 많은 경우 심질환을 의심하고, 심전도 검사를 시행하여 이를 통한 환자의 분류를 통해 조기에 심인성 질환을 감별하고 처치할 수 있는 방법이 모색되어야 할 것이며 특히 흉통진료실과 같은 특수한 제도를 도입함으로써 심근경색증 환자에 대한 집중적인 관리와 아울러 저위험군의 진료에도 좀 더 개선된 결과를 가져올 수 있도록 하는 것이 필요할 것으로 사료된다.

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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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    • 제24권3호
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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.

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

  • 박인철;강병규;손창호
    • 한국임상수의학회지
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    • 제17권1호
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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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병원전 처치에서 자동제세동기의 사용 (Defibrillator(AED) in prehospital care)

  • 고봉연
    • 한국응급구조학회지
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    • 제9권1호
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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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