• Title/Summary/Keyword: coronary risk index

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The Effect of Isoflavone Supplement on Plasma Lipids & Antioxidant Status in Hypercholesterolemic Postmenopausal Women (고지혈증인 폐경 후 여성에서 이소플라본 보충이 혈청 지질 농도 및 항산화능에 미치는 영향)

  • Lee, Jong-Ho;Kim, Eun-Mi;Chae, Ji-Sook;Jang, Yang-Soo;Lee, Jin-Hee;Lee, Geun
    • Journal of Nutrition and Health
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    • v.36 no.6
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    • pp.603-612
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    • 2003
  • Postmenopausal women are at an increased risk of developing coronary artery disease. This is due to primarily dyslipidemia accompanying the loss of estrogen secretion. Soy isoflavones are known to have weak estrogenic effects. The purpose of this study is to investigate whether isoflavone supplement improves the risk of cardiovascular disease in hypercholesterolemic postmenopausal women. Subjects consisted of 39 Korean postmenopausal women with hypercholesterolemia (total cholesterol $\geq$ 200 mg/㎗ or LDL cholesterol $\geq$ 130 mg/㎗). Subjects were divided into 2 groups; placebo group (PG), isoflavone supplement group (IG). During 12 weeks, subjects were given placebo and 80mg isoflavone daily. Anthropometric measurement, blood sample analysis and dietary intake measurement were taken at baseline and after 12 weeks. After 12 weeks, systolic blood pressure was decreased significantly (p < 0.01) and plasma HDL cholesterol level was increased significantly (p < 0.05) in IG. But there were no significant changes in plasma total cholesterol, LDL cholesterol and triglyceride levels after isoflavone supplementation. There was a negative correlation between initial plasma HDL cholesterol level and the extent of plasma HDL cholesterol reduction in IG (r=-0.572, p=0.012). Atherogenic index (AI), total-/LDL- cholesterol ratio and LDL/HDL cholesterol ratio were improved significantly after isoflavone supplementation. In subjects whose initial plasma LDL cholesterol level were above 160 mg/㎗, plasma malondialdehyde (MDA) level were decreased and total antioxidant status (TAS) were increased significantly after isoflavone supplement (p < 0.05). However there were no significant changes in flow-mediated dilator (FMD), the marker of endothelium-dependent vasodilation and nitroglycerine-mediated dilator (NMD), the marker of endothelium-independent vasodilation and the extent of DNA damage after isoflavone supplement. In conclusion, these results indicate that isoflavone supplement may decrease the risk of cardiovascular disease via improving blood pressure, HDL cholesterol level and AI in hypercholesterolemic postmenopausal women. Futhermore, in case of subjects with elevated LDL cholesterol level, isoflavone supplementation may have more antiatherogenic effects via improving antioxidant status.

Mid-Term Results of Totally Thoracoscopic Ablation in Patients with Recurrent Atrial Fibrillation after Catheter Ablation

  • Lim, Suk Kyung;Kim, Joo Yeon;On, Young Keun;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.270-276
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    • 2020
  • Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

Elevated Levels of Serum Lipids Accelerate Biological Vascular Aging evaluated by the Second Derivative of Photoplethysmogram Waveform in the Middle-Age Adults (중년 성인남녀의 혈중 지질농도가 가속도맥파에 미치는 영향)

  • Nam, Tong-Hyun;Koh, Hyung-Kyun;Park, Young-Bae
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.126-137
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    • 2002
  • Objective : There is accumulating data that cardiovascular diseases, including hypertension, cerebro-vascular accident, coronary heart disease, relate to atherosclerotic changes. Increased serum levels of lipids could play a role in these circumstances. the SDPTG(the second derivative of photoplethysmogram waveform) is noninvasive methods for evaluating the pulse wave and is correlated with age and other risk factors for atherosclerosis. Methods : To study the effects of serum lipid levels on the SDPTG in the middle-age adults, data on serum lipid levels and the SDPTG were collected in 80 healthy middle age with varying serum lipid concentrations. Biological vascular age was assessed using the SDPTG. the SDPTG consists of an a, b, c, and d wave in systole and an e wave in diastole; an SDPTG aging index(Al) was calculated as (b-c-d-e)/a. Results : Serum triglyceride, total cholesterol, total lipid, phospholipid, HDL cholesterol levels were respectively and significantly correlated with SDPTG Al. Serum lipid levels and blood pressure are age-dependent and the SDPTG is blood pressure-dependent. Restricting analysis to age and blood pressure yield strong positive correlations between serum triglyceride, total lipid levels and SDPTG Al, but no correlations between serum total cholesterol, phospholipid levels and SDPTG Al. Conclusion : The results of this study suggest that preventive acupuncture programs or herbal medications for reducing serum lipid, especially triglyceride, levels in middle-age should include a evaluation of biological vascular aging with the second derivative of photoplethysmogram waveform.

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Mass Reduction and Functional Improvement of the Left Ventricle after Aortic Valve Replacement for Degenerative Aortic Stenosis

  • Shin, Su-Min;Park, Pyo-Won;Han, Woo-Sik;Sung, Ki-Ick;Kim, Wook-Sung;Lee, Young-Tak
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.399-405
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    • 2011
  • Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

Comparisons of Food Consumption and Food Sources of Nutrients in the Diets of Postmenopausal Women with Normocholesterolemia and Hypercholesterolemia in Seoul, Korea

  • Kim, Sangyeon;Kyungah Jung;Yukyung Chang
    • Nutritional Sciences
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    • v.7 no.3
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    • pp.174-182
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    • 2004
  • Women have a greater incidence of coronary heart disease (CHD) after menopause. This relates to hormone imbalance-induced changes in known CHD risk factors, especially hyperlipidemia. The purpose of this study was to explore d1e differences in food consumption and food sources of nutrients in the Korean diet between postmenopausal women aged 50-74 years with normocholesterolemia(NC) and those with hypercholesterolemia(HC). Each subject was either classified as part of the NC group (n=39, serum total cholesterol con. <200 mg/$dl$) or the HC group (n=31, serum total cholesterol con. $\geq$240 mg/dl) based on the Guideline for Korean Hyperlipidemia.l Diet was assessed through a validated semi-quantitative food frequency questionnaire. Consumption of foods such as biscuits and/or crackers, squid and eggs was significantly (p<0.05) higher in the HC group than in the NC group. On the other hand, consumption of potatoes/starches and carrots was significantly (p<0.05) lower in the HC group than in the NC group. There was no significant difference between the two groups in terms of the consumption of legumes and legume products containing phytoestrogen and we could not find a relationship between legumes and legume products and serum cholesterol levels. Consumption of green tea tended to be lower in the HC group than in the NC group. Major sources of cholesterol, cholesterol-saturated index and vitamin A in the diets of the HC group consisted of foods high in cholesterol. Our results confirm that postmenopausal women with hypercholesterolemia in Korea tend to consume cholesterol-rich foods and dishes.

Food Intake Patterns and Blood Clinical Indices in Female College Students by HDL-cholesterol Levels (여대생의 HDL-콜레스테롤 수준에 따른 임상건강지표와 영양섭취 실태)

  • Jung, Ha-Na;Kim, Jung-Hee
    • Korean Journal of Community Nutrition
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    • v.13 no.1
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    • pp.100-110
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    • 2008
  • Recently, a lot of epidemiological studies revealed that low HDL-cholesterol level was a better predictor of risk for coronary heart disease than total cholesterol. This study investigated the anthropometric parameters, clinical blood indices, and dietary factors influencing serum HDL-cholesterol level by using a cross-sectional study for Korean female college students. The subjects were 94 female college students. They were divided into three groups according to their serum HDL-cholesterol levels, low HDL-cholesterol (<50 mg/dL, n=20), medium HDL-cholesterol (50 $\leq$, < 60 mg/dL, n=39) high serum HDL-cholesterol groups (60 $\leq$ mg/dL, n = 35). This study examined their demographic data and dietary intake throughout a questionnaire. Clinical blood indices were measured using an automatic blood chemistry analyzer (Selectra E), after 12 hours of fasting. BMI, body weight, fat mass, and waist circumferences were significantly increased according to low serum HDL-cholesterol levels. Serum lipid analysis showed a significantly higher level of TG, LDL-/HDL-Ratio, atherogenic index in the low HDL-cholesterol group. Serum levels of GPT, uric acid and alkaline phosphatase in the low HDL-cholesterol group were significantly higher than in the other group. The average consumption of energy was 1627 kcal and 77.76% of estimated energy requirement (EER). The mean ratio of calories from carbohydrate: protein: fat was 57:15:28. The low HDL-cholesterol group was significantly higher than the other groups in eggs, fat and oils consumption. Interestingly, milk and diary products consumption of low HDL-cholesterol group was half (p < 0.05) of those of the other groups. In conclusion, serum HDL-cholesterol levels appeared to be decreased by increasing BMI, fat mass, waist circumference, and serum TG level. In addition, some dietary factors seemed to be related to serum HDL-cholesterol levels. However, further research is needed to elucidate the exact relationship between serum HDL-cholesterol level and dietary factors.

Bayesian Network Model to Evaluate the Effectiveness of Continuous Positive Airway Pressure Treatment of Sleep Apnea

  • Ryynanen, Olli-Pekka;Leppanen, Timo;Kekolahti, Pekka;Mervaala, Esa;Toyras, Juha
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.346-358
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    • 2018
  • Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

Potential Risk Assessment of Cardiovascular Disease in Low Calcium-Score (낮은 칼슘 수치에서 심혈관질환의 잠재 위험도 평가)

  • Yoo, Heangsoo;Park, Jikoon;Jung, Bongjae;Noh, Sicheol;Choi, IlhHong;Jung, Hyungjn;Kang, Sangsik
    • Journal of the Korean Society of Radiology
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    • v.7 no.6
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    • pp.369-376
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    • 2013
  • Prepared her for the early detection of the risk of cardiovascular disease prevention for the various attempts being made ill through a lot of research to the criteria of coronary artery calcification, but the figure is more than 100 the progress of the flow can be expected to be was. In this study, we quantify the correlation between body composition analysis, blood lipid levels of calcium and public asymptomatic even at low calcium levels in comparison with the existing studies by analyzing potential risk of cardiovascular disease will be represented on the were evaluated. Studies, the calcium scores in the body composition analysis "1-10", and when "11-100" when there was a significant correlation in BMI and WHR look more normal frequency range of the mean values in the normal range meomulreoteuna 21% relative HDL and TG in lipid profiles, no significant correlation look more normal frequency range of risk were derived from the mean values in the normal range, 21% to 40% of the relative risk were derived. meomulreoteuna. In addition, there is no correlation between BFM and BMR Also, average increases in the frequency of a higher standard was higher relative risk derived 31 to 93%, and geological correlation test TC above 20mg/dl atherosclerotic sclerosis seems to be the value of HDL to act to remove cholesterol from atheroma already looking at the same time to suppress the occurrence of atherosclerosis, increased LDL showed higher values occurs rapidly increasing. At this time, the relative risk of 43-50% have been identified. In other words, even when calcium levels are low, that is inherent in the incidence of cardiovascular disease was unknown.

The Effect of Inulin Supplementation on Blood Lipid Levels, and Fecal Excretion of Bile Acid and Neutral Sterol in Korean Postmenopausal Women (폐경 후 한국 여성에서 이눌린 보충이 혈중 지질 농도와 변 담즙산 및 중성 스테롤 배설에 미치는 영향)

  • 이은영;김윤영;장기효;강순아;조여원
    • Journal of Nutrition and Health
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    • v.37 no.5
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    • pp.352-363
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    • 2004
  • Lipid-lowering effects of the inulin have been demonstrated in animal, yet attempts to reproduce similar effects in humans have generated conflicting results. In this study, the lipid-lowering potential of inulin and especially its effect on bile acid and neutral sterol excretion were investigated in Korean postmenopausal women. Nineteen postmenopausal women were randomly divided into two groups in a double-blind parallel design and consumed one of two supplements for 12 weeks; placebo of 8g maltodextrins/sucrose mixture (placebo group) or 8g inulin (inulin group). There were no significant changes in body weight during the supplementation period in either inulin or placebo group. Dietary consumption of animal fat in both group tended to decrease after 12 weeks of experiment. Intake of cholesterol was lower in placebo group, whereas the decrease of cholesterol intake in inulin group did not reach statistical significance after 12 weeks. The levels of serum total cholesterol (TC) and LDL-cholesterol (LDL-C) were significantly decreased in both placebo (p<0.05) and inulin group (p<0.01) after supplementation for 12 weeks compared with the baseline. The levels of serum triglyceride (TG) and HDL-cholesterol (HDL-C) were not significantly affected by inulin supplements, but atherogenic index (AI) and LDL-C/HDL-C ratio (LHR) as a predictor for coronary heart disease were improved (p<0.01) significantly after inulin supplementation. Therefore, inulin supplement may decrease the risk of cardiovascular disease via improving blood cholesterol level. Fecal weight and pH were not changed after 12 weeks of supplementation. There were no statistically significant changes for the fecal short-chain fatty acids (SCFAs). In inulin group, fecal deoxycholic acid (DCA) was significantly lowered compared with the baseline (p<0.05) whereas other bile acids were not changed. During the 12 weeks of intervention, no differences were found in fecal excretion of neutral sterol in the two groups. In summary, dietary inulin decreases serum TC, LDL-C, AI, LHR and lowers excretion of fecal DCA in the Korean postmenopausal women. These results support the use of inulin for reducing risk factors for hyperlipidemic postmenopausal women. However, the exact mechanism (s) responsible for the blood lipid lowering action of inulin including altered fecal bile acid remain to be elucidated.

Effects of Nutrition and Exercise Education on Fat Mass and Blood Lipid Profile in Postmenopausal Obese Women (폐경 후 비만 여성의 식이 및 운동 교육이 체지방향 및 혈중지질농도에 미치는 효과)

  • Kim, Nae-Hee;Kim, Ji-Myung;Kim, Hye-Sook;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.40 no.2
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    • pp.162-171
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    • 2007
  • Obesity is an independent risk factor fur coronary artery disease in the postmenopausal women, which may be mediated by alteration of blood lipid metabolism. We are aimed to evaluate the effects of low energy diet, restriction of high fat foods and exercise education on weight, fat mass and blood lipid profile. Fifteen postmenopausal obese women were studied. Subjects received detailed advice about how to achieve a reduction of weight by a low-energy diet (1,200kcal), restriction of high fat food and increased exercise in every 4 wks during 8 wk. To evaluate the effectiveness for education programs, dietary fat habit and daily nutrient intakes, exercise were tested before and after intervention. Anthropometry, computerized tomography, and blood lipid profile were assessed before and after intervention. According to the nutrition education, energy intake (from 1776.1 ${\pm}$ 28.2 kcal to 1268.7 ${\pm}$ 115.2 kcal, p < 0.001) and percent of energy from fat (21.9%, p < 0.01) were significantly decreased. However, the index of nutritional quality was over 1.0. On the contrary, exercise (from 341.3 ${\pm}$ 222.1 kcal to 569.4 ${\pm}$ 309.8 kcal, p < 0.05) was increased and dietary fat habit scores (from 30.8 ${\pm}$ 5.2 to 36.1 ${\pm}$ 3.0, p < 0.01) were improved. Also, body weight (4.2%, p < 0.001), BMI (4.5%, p < 0.001), body fat mass (3.4%, p < 0.05) and waist to hip ratio (1.1%, p < 0.05) were decreased. Among abdominal fat, visceral fat (26.1%, p < 0.05) and subcutaneous fat (14.8%, p < 0.01) were decreased. But there was no difference in visceral fat to subcutaneous fat ratio. We observed HDL-cholesterol increase (11.7%, p < 0.05), triglyceride reduction(14.8%, p < 0.05) and atherogenic index improvement (from 2.7 ${\pm}$ 0.7 to 2.3 ${\pm}$ 0.7, p < 0.05) However, there was no change in LDL-cholesterol and total cholesterol. Theses results showed that low energy diet, restriction of high fat foods and exercise education could result in reduction of body weight, fat mass, visceral and subcutaneous fat, and in improvement of blood lipid profile in the postmenopausal obese women.