• 제목/요약/키워드: ejection fraction

검색결과 346건 처리시간 0.02초

디지탈 혈관 조영장치를 이용한 실시간 영상처리와 심장파라미터의 측정 (Real time image processing and measurement of heart parameter using digital subtraction angiography)

  • 신동익;구본호;박광석;민병구;한만청
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 1990년도 한국자동제어학술회의논문집(국내학술편); KOEX, Seoul; 26-27 Oct. 1990
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    • pp.570-574
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    • 1990
  • Detection of left ventricular boundary for the functional analysis of LV(left ventricle)is obtained using automatic boundary detection algorithm based on dynamic programming method. This scheme reduces the edge searching time and ensures connective edge detection, since it does not require general edge operator, edge thresholding and linking process of other edge. detection methods. The left ventricular diastolic volume and systolic volume and systolic volume were computed after this automatic boundary detection, and these Volume data wm applied to analyze LV ejection fraction.

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심에코를 이용한 승모판막이식환자의 예후결정요소에 관한 임상적 고찰 (The echocardiographic analysis of the prognostic factors in mitral valvular replacement)

  • 안재호;서경필
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.55-64
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    • 1983
  • A hundred and eleven patients of mitral valvular heart disease, who were operated at Seoul National University Hospital, were analysed with echocardiogram before and after operation during the period from November 1979 to February 1982. Twenty-eight patients had mitral stenosis and eighty-three mitral regurgitation. In patients with mitral stenosis, right ventricular end-diastolic volume was in normal range at preoperative and postoperative period. But the left ventricular end-systolic volume was slightly increased preoperatively to 35.4mm and decreased to 33.5mm on immediate postoperative period and 32.5mm after a year later. The left ventricular end-diastolic volume was 50.5mm preoperatively and fell to 46.8mm postoperatively. Ejection fraction was normal preoperatively and postoperatively without changes. Left atrial size fell significantly from 50ram to 37.6mm at the time of late follow-up study. With mitral regurgitation, right ventricular end-diastolic volume was also normal preoperatively and postoperatively. The left ventricular end-systolic volume was increased to 41.9mm and decreased to 31.6mm postoperatively with statistic significance. Left ventricular end-diastolic volume fell from 58.5mm to 45.7mm significantly at the time of late follow-up period. Ejection fraction was also within normal range and had no changes postoperatively. Left atrial size fell from 54.8mm to 45.5mm on a year later [ p value less than 0.01 ]. When atrial fibrillation, the left atrial dimension was increased as 54.9mm compared with 46.8mm of no atrial fibrillation patients.

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유방확대술 중 발생한 Takotsubo 심근병 1례 (A Case Report of Takotsubo Cardiomyopathy During Breast Augmentation)

  • 이경묵;김연환;김정태;황원중;신진호
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.85-88
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    • 2011
  • Purpose: Takotsubo cardiomyopathy is a relatively uncommon type of stress-induced cardiomyopathy characterized by transient left ventricular regional wall motion abnormalities. Emotional and physical stresses play a key role in this type of cardiomyopathy in postmenopausal women. The current hypothesis is that the syndrome represents a form of catecholamine surge due to stress or epinephrine-mediated acute myocardial stunning. Methods: A 44-year-old woman had suffered premature ventricular contraction following a cardiogenic shock during a breast augmentation surgery under enflurane anesthesia and tumescent solution infiltration. She was treated with cardiopulmonary resuscitation at a local clinic. Then she was brought to the Emergency Department of the authors' hospital. Results: The woman's echocardiogram showed an ejection fraction of 20~25% with associated basal hyperkinesis and left ventricular apical ballooning. The patient was admitted to the ICU and required inotropic support for two weeks. The patient's condition dramatically improved, and her ejection fraction returned to 70%. Conclusion: It is believed that there were multiple triggering factors of the onset of Takotsubo cardiomyopathy in the woman's social and family history, including infiltration of a large volume of the tumescent solution and VPCs induced by enflurane anesthesia without premedication. The importance of careful history-taking, careful pre-operative consultation on psychological suffering especially for breast surgery, premedication before surgery, patient reassurance, and post-operative psychosocial and emotional assistance was again seen in this case.

승모판 수술환자에 있어서 심방세동과 색전증에 영향을 주는 요소 (Factors Influencing Atrial Fibrillation & Embolization in Mitral Valve Surgery)

  • 조광조;김종원;정황규
    • Journal of Chest Surgery
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    • 제25권12호
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    • pp.1404-1415
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    • 1992
  • To understand the factors influencing Atrial fibrillation and embolism in mitral valve surgery and prevent their risk, we have reviewed our 324 patients who underwent mitral valve surgery from Fev. 1982 to May 1992. Age, disease duration, lesion type, left ventricular function and left atrial dimension were chosen as preoperative factors influencing the incidence of atrial fibrillation and embolism and their postoperative course, The number and type of replaced valve, site of atriotmy, LA obliteration, ACT and use of Defibrillator were chaser. as operative factors influencing postoperative rhythm change and postop emb-olization. The results of analyses were as follows 1. The incidence of preoperative atrial fibrillation, systemic embolism and LA throbmus was 63. 6%, 10.56% and 19.8% relatively. 2. The preoperative factors of atrial fibrillation onset was old age, prolonged symptom duration, stenotic lesion, lager LAD and lower ejection fraction. In the preoperative systemic embolism preoperative factors were old age, female, stenotic lesion. The left atrial thrombus found more commonly in patients with atrial fibrillation, old age, prolonged symptom duration, stenotic lesion and low ejection fraction. 3. The preoperative atrial fibriation persisted postoperatively in 165[50.9%] and converted to normal sinus rhythm in 50[15.4%]. The preoperative normal sinus rhythm per-eisted in 100[31%] and atrial fibrillation was occured postoperatively in 9[2.7%]. The prolonged symptom duration was the preoperative factor of persist atrial fibrillation. 4. Among 95 long term follow-up patients, atiral fibrillation was continued in 59[60%]. Conversion to normal sinus rhythm was more common significantly in left atriotomy and bileaflet valve replacement. 5. There were 12 patients who had postoperative embolism. Female, persist atrial fibrillation, no LA olbiteration and tilting disc monocusp valve were considered as possible factors influencing postoperative embolism but was impossible to analyse their statistical significance due to small sample size. So we have concluded that the patients with above risk factors need anticoagulant and early surgical intervention. Left atriotomy with minimal atrial injury, left auricular obliteration and bileaflet valve replacement may be needed to reduce postoperative atrial fibrillation persist and embolism.

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관상동맥 우회로 이식술후의 심근경색 -심전도에 의한 진단 및 위험인자 분석- (Perioperative Myocardial Infarction after Coronary Artery Bypass Grafting - Detection by serial electrocardiograms and analysis of risk factors -)

  • 김성완;이응배;서강석;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • 제31권1호
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    • pp.7-12
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    • 1998
  • 1994년 1월부터 1996년 7월까지 관상동맥 우회로 이식술을 받았던 87명을 대상으로 수술후 심근경색의 진단에 있어서 심전도 검사의 가치를 평가해 보았고 심전도에 의해 진단된 심근경색의 위험인자에 대해 조사하였다. CK-MB 최고치의 평균과 LDH1/LDH2의 비가 1이상인 경우의 빈도는 new Q파군, ST변화군 및 심전도상 변화가 없는군 간에 유의한 차이가 있었다. 심전도상 new Q파 또는 48시간이상 지속되는 ST절 변화가 있을 때 심근경색으로 진단하였다. 병원 사망률은 3.3%이며, 술후 심근경색 발생률은 17.2%였다. 술후 심근경색의 중요한 위험인자들은 1) 관상동맥 내막절제술, 2) 좌심실 박출계수의 저하(ejection fraction 40%이하), 3) 대동맥 차단시간의 연장이었고, 좌주관상동맥 질환, 3혈관 질환, 이식혈관이 3개이상인 경우, 불안정형협심증 및 고혈압 등은 술후 심근경색 발생과 연관성이 없었다. 이상에서 관상동맥 우회로 이식술후에 발생하는 심근경색의 진단에 심전도 검사는 유용한 방법이 될 수 있다고 생각된다.

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Surgical Outcomes of Cox-maze IV Procedure Using Bipolar Irrigated Radiofrequency Ablation and Cryothermy in Valvular Heart Disease

  • Kim, Jun-Sung;Lee, Jae-Hang;Chang, Hyoung-Woo;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • 제44권1호
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    • pp.18-24
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    • 2011
  • Background: We evaluated the efficacy of Cox-maze IV procedure using bipolar irrigated radiofrequency ablation and cryothermy in chronic atrial fibrillation associated with valvular heart disease. Material and Methods: From November 2005 to June 2009, ninety four patients have undergone valvular heart surgery with Cox-maze IV procedure. Preoperative duration of atrial fibrillation was $7.6{\pm}6.5$ years and follow-up duration was $22.7{\pm}12.3$ months. Results: There were two (2.1%) postoperative deaths not related to maze procedure. Two cerebrovascular accidents, five low cardiac output syndromes and two permanent pacemaker implantations have occurred after surgery. Preoperative ejection fraction on echocardiography was $55.3{\pm}8.1%$ and ejection fraction of postoperative six month was $54.7{\pm}6.5%$. Left atrial size of preoperative and postoperative were $61.5{\pm}11.6\;mm$ and $53.1{\pm}8.4\;mm$ at each. Freedom from atrial fibrillation rate at postoperative six-month was 80.7% and the cases of recurrence of atrial fibrillation after six months were three (3.3%). Risk factors for failure or recurrence of maze procedure were old age (p=.010) and preoperative moderate or severe tricuspid regurgitation (p=.033). Conclusion: The Cox-maze IV procedure using RFBP2 and cryothermy is quite safe and freedom from atrial fibrillation at postoperative 6 month was 82.5%. Risk factors for failure or recurrence of atrial fibrillation after Cox-maze IV were old age and preoperative over moderate tricuspid regurgitation.

방사성핵종 요류역학검사를 이용한 하부요로폐색의 평가 (Radionuclide Urodynamic Studies in Patients with Bladder Outlet Obstruction)

  • 이재태;김광원;손상균;정진홍;이규보;황기석;윤여득;손형규;정성광
    • 대한핵의학회지
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    • 제24권1호
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    • pp.24-28
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    • 1990
  • Various urodynamic studies have been used in patients with bladder outlet obstruction in order to evaluate the degree of obstruction, the results of therapy and postprostatectomy conditions. Radionuclide urodynamic study was performed in 27 patients with bladder outlet obstruction and 30 normal controls. The parameters evaluated were voiding time, 50% voiding time, average flow rate, peak flow rate, corrected peak flow rate, ejection fraction of the bladder and residual urine. Voiding time, 50% voiding time and residual urine of patients were significantly larger than controls and average flow rate, Peak flow rate, peak corrected flow rate and ejection fraction were significantly lower in patients. This method was noninvasive procedure for determining of voiding parameters and it avoids the extraexamination needs to determine the residual urine.

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심근경색에 의한 심정지 후 치료적 저체온증으로 호전된 쥐의 심폐소생술 모델 (Hypothermia Improves Outcomes of Cardiopulmonary Resuscitation After Cardiac Arrest In a Rat Model of Myocardial Infarction)

  • 노상균;김지희;문태영;박정현
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2011년도 추계학술논문집 1부
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    • pp.170-173
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    • 2011
  • Therapeutic hypothermia(TH) improves neurological outcomes and reduces mortality among survivors of out-of-hospital cardiac arrest. Animal and human studies have shown that TH results in improved salvage of the myocardium, reduced infarct size, reduced left ventricular remodeling and better long-term left ventricular function in settings of regional myocardial ischemia. This study is to investigate the effect of TH on post-resuscitation myocardial dysfunction and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction (MI). Thoracotomies were performed in 10 Male Sprague-Dawley rats weighing 450-550 g. MI was induced by ligation of the left anterior descending coronary artery (LAD). Ninety min after LAD ligation, ventricular fibrillation induction and subsequent cardiopulmonary resuscitation was performed before defibrillation attempts. Animals were randomized to two groups: a) Acute MI-Normothermia b) Acute MI-Hypothermia ($32^{\circ}C$ for 4 h). Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured echocardiographically together with duration of survival. Ejection fraction, cardiac output and myocardial performance index were $54.74{\pm}9.16$, $89.00{\pm}8.89$, $1.30{\pm}0.09$ respectively and significantly better in the TH group than those of the normothermic group at the first 4 h after resuscitation($32.20{\pm}1.85$,$41.60{\pm}8.62$,$1.77{\pm}0.19$)(p=0.00). The survival time of the hypothermic group ($31.8{\pm}14.8$ h) was greater than that of the normothermic group($12.3{\pm}6.5$ h, p<0.05). This study suggested that TH attenuated post resuscitation myocardial dysfunction in acute MI and would be a potential strategy in post resuscitation care.

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The Influence of Maximal Aerobic Capacity on the Two Years Cardiac Related Re-Hospitalization in Patients with Heart Failure with Reduced Ejection Fraction in Korean Society

  • Ryu, Ho Youl;Hong, Do Sun;Kim, Tack Hoon
    • The Journal of Korean Physical Therapy
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    • 제31권5호
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    • pp.322-327
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    • 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.