• The Journal of Korean Physical Therapy
• /
• v.31 no.5
• /
• pp.322-327
• /
• 2019

Purpose: This study examined the influence of the maximal aerobic capacity on the two-year cardiac-related re-hospitalization in patients with heart failure with a reduced ejection fraction (HFrEF) in Korean society. Methods: The maximal aerobic capacity of the study population (n=95, male 63%) was evaluated using a cardiopulmonary exercise (CPX) testing system. Each patient was followed up for two years to divide the HFrEF patients into two groups according to cardiac-related re-hospitalization: re-hospitalization (RH) group (n=29, 30%) and no re-hospitalization (NRH) group (n=66, 70%). Results: The relative peak $VO_2$ (mL/kg/min, p<0.001), exercise duration (p<0.001), respiratory exchange ratio ($VCO_2/VO_2$, p=0.001), systolic blood pressure (SBP) reserve (p=0.004), heart rate (HR) reserve (p=0.007), SBP max (p=0.02), and HR max (p=0.039) were significantly lower in the RH group than the NRH group during the CPX test. On the other hand, the ventilatory efficiency (VE/VCO2 slope, p=0.02) and age (p=0.022) were significantly higher in the RH group than in the NRH group. In binary logistic regression analysis, the relative peak $VO_2$ (p=0.001, Wald Chi-square 10.137) was the strongest predictive factor on cardiac-related re-hospitalization, which was followed by $VCO_2/VO_2$ (p=0.019, Wald Chi-square 5.54). On the other hand, age (p=0.063, Wald Chi-square 3.445) did not have a significant influence on cardiac related re-hospitalization. Conclusion: The maximal aerobic capacity, especially the relative peak $VO_2$, is the strongest factor on cardiac-related re-hospitalization within two years in patients with HFrEF in Korean society.

• Tuberculosis and Respiratory Diseases
• /
• v.84 no.1
• /
• pp.35-45
• /
• 2021

Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

• Journal of Chest Surgery
• /
• v.56 no.6
• /
• pp.456-459
• /
• 2023

Penetrating chest trauma may result in significant intracardiac injury. A traumatic ventricular septal defect is a rare complication that requires surgical management, particularly if heart failure ensues. We report a case of delayed repair of an outlet-type ventricular septal defect and perforation of the aortic and pulmonary valve leaflets following a stab wound. This report highlights diagnostic and surgical considerations and also presents an opportunity to review the conotruncal anatomy, which may be relatively unfamiliar to many adult cardiac surgeons.

• Journal of Chest Surgery
• /
• v.26 no.11
• /
• pp.886-889
• /
• 1993

The DiGeorge syndrome is a rare congenital anomaly of absent or hypoplastic thymus and parathyroid glands. Authors experienced a case of DiGeorge syndrome with complex cardiac anomaly. The complex cardiac anomaly was tetralogy of Fallot with origin of the right pulmonaly artery from the posterolateral ascending aorta.His face showed hypertelorism,short philtrum,"fish-like"mouth and micrognathia. This patient underwent total correction of tetralogy of Fallot and end-to-side anastomosis between right pulmonaly artery and side of main pulmonaly artery. He expired on postoperative second day due to right heart failure and hypoxia.d hypoxia.

• Korean Journal of Adult Nursing
• /
• v.26 no.5
• /
• pp.573-583
• /
• 2014

Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

• Journal of Chest Surgery
• /
• v.42 no.1
• /
• pp.92-95
• /
• 2009

Sarcoidosis is a systemic inflammatory disease with granulomatous lesions, and cardiac involvement occurs in 20~60% of patients. Isolated cardiac sarcoidosis is extremely rare, and heart transplantation can be performed, if indicated, contingent upon the absence of systemic manifestations of the disease. We present a case of isolated cardiac sarcoidosis with progressive heart failure, which was successfully managed by heart transplantation.

• Journal of Chest Surgery
• /
• v.10 no.1
• /
• pp.173-178
• /
• 1977

A 51 year old man was admitted to the Thoracic and Cardiovascular Department of Kyungpook University Hospital on April 7, 1976, with chief complaints of orthopnea and the chest pain for about 3 months. Physical examination showed narrow pulse pressure, puffy face, engorged neck veins at sitting position, distant heart sound, enlarged liver and edematous upper extremities. The chest roentgenogram demonstrated markedly enlarged cardiac silhouette. Low voltage and the low to diphagic T`s were noted on the electrocardiogram. Paroxysmal ventricular tachycardia was developed intermittently and was subsided spontaneously. Repeated pericardiocentesis were performed each of which yielded from 100 to 300ml. but intractable cardiac failure was progressed. The bacteriology and cytology of the pericardial fluid were not revealed any specific findings. The pericardiectomy was performed to release the intractable cardiac tamponade. Pericardium was found to be thickened and cardiac constriction was noted. The thickened pericardium was easily removed. A large hen`s egg sized dark blue tumor mass occupied the anterior wall of the right atrium and two thumb tip sized pearl gray tumors were placed at the just below portion of the main pulmonary artery. The biopsy report revealed primary fibrosarcoma of the heart. The patient was improved from the symptoms of the cardiac failure during the postoperative course.

• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.275-284
• /
• 1990

A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

• Journal of Chest Surgery
• /
• v.20 no.3
• /
• pp.512-519
• /
• 1987

In the department of chest surgery of Pusan National University hospital cardiac valve surgery was done in 118 cases from March, 1982, to June, 1986. Among these, 90 were mitral valve replacement, 9 mitral commissurotomy, 5 mitral valvuloplasty, 4 aortic valve replacement, 4 double valve replacement, 4 mitral annuloplasty, one mitral annuloplasty with commissurotomy and valvuloplasty. 48 were male and 70 were female and age distribution ranged from 6 to 57 years [mean 30.6 years]. Early death within 30 days after operation was 14 cases: 10 had mitral valve replacement, 2 double valve replacement and 2 mitral annuloplasty respectively. Confirmed causes of death were low cardiac output syndrome in 9 cases, congestive heart failure in one case, cardiac tamponade in one case, malfunction of valve in one case, cardiac rupture in one case and renal failure in one case. The 104 cases were followed up for a total 190 years and range was from 2 to 54 months [Mean*SD: 21.9*16.5 months]. During follow-up period, 2 late deaths were developed: one was due to subdural hematoma and the other was congestive heart failure combined with fulminant hepatitis. Anticoagulation therapy was done with warfarin to the level of 20 to 40% of normal prothrombin time in 53 cases, dipyridamole and aspirin in 18 cases, or ticlopidine hcl in 15 cases. The frequency of bleeding due to anticoagulation therapy was 1.0% episodes per patient-years: one was in warfarin group and another was in dipyridamole and aspirin group. Among the studied 102 cases, 93 cases [91.2%] of patients were in NYHA class I or II during follow up period.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.20 no.3
• /
• pp.730-734
• /
• 2006

Aqueous extracts of medicinal plants traditionally used in the East Asia such as China, Korea, and Japan were screened for inotropic activity using isolated rabbit atria. Among the twenty-one aqueous-extracts from medicinal plants, the aqueous extracts of Convallaria keiskei(ACK) and rhizome of Coptis chinesis (ACC) were found to exhibit distinctive positive inotropic activity. The aqueous extracts of C. keiskei and rhizome of C. chinensis significantly increased atrial stroke volume and pulse pressure in beating rabbit atria. These findings suggest that the aqueous extracts of C. keiskei and rhizome of C. chinensis enhance the cardiac muscle contractility and then could be useful for the treatment of cardiac failure.