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1.
Yeungnam University Journal of Medicine ; : 85-89, 2016.
Article in Korean | WPRIM | ID: wpr-90951

ABSTRACT

BACKGROUND: Formaldehyde is used to preserve cadaver in medical schools, and students are exposed to formaldehyde during cadaver dissection classes. When humans are exposed to formaldehyde, it induces mucosal inflammation, skin inflammation, and declining of neurobehavioral function including attention and memory executive functions. The purpose of this study is to identify the effects of formaldehyde exposure on student's neurobehavioral performance during cadaver dissection classes. METHODS: The level of formaldehyde was measured in a cadaver dissection class. A total of 16 students were randomly divided into two groups. One group wore respiratory protection masks, while the other group did not. Among many subtests in Korean Computerized Neurobehavioral test, backward digit span was tested on all subjects before and after the class. RESULTS: The length of memorized digit span between the two groups was not significant; however there was a greater decrease in neurobehavioral function after formaldehyde exposure in the non-mask group than the mask group. CONCLUSION: Formaldehyde exposure during cadaver dissection may likely decrease neurobehavioral performance of students. Therefore, proper ventilation system and respiratory protective equipment are necessary to protect medical school students from adverse effects of formaldehyde exposure.


Subject(s)
Humans , Cadaver , Executive Function , Formaldehyde , Inflammation , Masks , Memory , Schools, Medical , Skin , Ventilation
2.
Journal of Cardiovascular Ultrasound ; : 42-48, 2012.
Article in English | WPRIM | ID: wpr-144953

ABSTRACT

BACKGROUND: Right ventricular apical (RVA) pacing induces left ventricular (LV) dyssynchrony, increases the risk of persistent atrial fibrillation in the long term. The aim was to investigate the effects of RVA pacing on left atrial (LA) function, which are unknown. METHODS: Echocardiographic evaluation including LV dyssynchrony based on conventional Doppler, tissue Doppler imaging and speckle tracking strain echocardiography was done before and after (12 months) single-chamber ventricular pacemaker implantation in 40 patients with sick sinus syndrome. Patients were divided to 2 groups, according to the RVA pacing frequency (group I had higher pacing rate of more than 50% and group II, less than 50%). RESULTS: There was no significant difference in LV ejection fraction, however, mean global LV strain, myocardial performance index, and parameters of LV dyssynchrony had shown significant changes after 12 months of RVA pacing. There were also significant increase in the LA volume index and the reduction of peak systolic LA strain and strain rate (SR), peak early and late diastolic SR after RVA pacing. Moreover, there was significant deterioration of LV dyssynchrony and both LA and LV longitudinal function in even group II. LA functional deterioration and LA volume was significantly correlated with the frequency of RVA pacing. CONCLUSION: LV dyssynchrony, induced by RVA pacing, significantly impaired active LA contraction and passive stretching, and these findings were shown in the patients with even less than 50% of RVA pacing. Impairment of LA strain/SR was significantly correlated with the frequency of RVA pacing.


Subject(s)
Humans , Atrial Fibrillation , Atrial Function , Atrial Function, Left , Contracts , Echocardiography , Muscle Stretching Exercises , Sick Sinus Syndrome , Sprains and Strains , Track and Field
3.
Journal of Cardiovascular Ultrasound ; : 42-48, 2012.
Article in English | WPRIM | ID: wpr-144940

ABSTRACT

BACKGROUND: Right ventricular apical (RVA) pacing induces left ventricular (LV) dyssynchrony, increases the risk of persistent atrial fibrillation in the long term. The aim was to investigate the effects of RVA pacing on left atrial (LA) function, which are unknown. METHODS: Echocardiographic evaluation including LV dyssynchrony based on conventional Doppler, tissue Doppler imaging and speckle tracking strain echocardiography was done before and after (12 months) single-chamber ventricular pacemaker implantation in 40 patients with sick sinus syndrome. Patients were divided to 2 groups, according to the RVA pacing frequency (group I had higher pacing rate of more than 50% and group II, less than 50%). RESULTS: There was no significant difference in LV ejection fraction, however, mean global LV strain, myocardial performance index, and parameters of LV dyssynchrony had shown significant changes after 12 months of RVA pacing. There were also significant increase in the LA volume index and the reduction of peak systolic LA strain and strain rate (SR), peak early and late diastolic SR after RVA pacing. Moreover, there was significant deterioration of LV dyssynchrony and both LA and LV longitudinal function in even group II. LA functional deterioration and LA volume was significantly correlated with the frequency of RVA pacing. CONCLUSION: LV dyssynchrony, induced by RVA pacing, significantly impaired active LA contraction and passive stretching, and these findings were shown in the patients with even less than 50% of RVA pacing. Impairment of LA strain/SR was significantly correlated with the frequency of RVA pacing.


Subject(s)
Humans , Atrial Fibrillation , Atrial Function , Atrial Function, Left , Contracts , Echocardiography , Muscle Stretching Exercises , Sick Sinus Syndrome , Sprains and Strains , Track and Field
4.
Journal of Cardiovascular Ultrasound ; : 100-102, 2012.
Article in English | WPRIM | ID: wpr-210079

ABSTRACT

Aneurysm of the mitral valve, although uncommon, occurs most commonly in association with infective endocarditis of the aortic valve and true mitral valve aneurysm is a rare cause of mitral regurgitation. We report a case with perforated mitral valve aneurysm in the posterior leaflet without concurrent infective endocarditis initially mistaken diagnosis of cystic mass, which was confirmed at operation with successful mitral valve annuloplasty.


Subject(s)
Aneurysm , Aortic Valve , Echocardiography , Endocarditis , Heart Aneurysm , Mitral Valve , Mitral Valve Annuloplasty , Mitral Valve Insufficiency
5.
Journal of Cardiovascular Ultrasound ; : 126-133, 2012.
Article in English | WPRIM | ID: wpr-207513

ABSTRACT

BACKGROUND: The objective of this study was to investigate the association between nonalcoholic fatty liver disease (NAFLD) and carotid artery atherosclerosis beyond metabolic disorders. METHODS: We studied 320 non-diabetic patients with ultrasonographically diagnosed NAFLD and 313 non-diabetic patients without NAFLD who have less than 40 g alcohol/week drinking history. Carotid atherosclerotic burden was assessed by carotid intima-media thickness (IMT) and plaque. All subjects were divided to the metabolic syndrome (MetS) according to International Diabetes Federation criteria. RESULTS: NAFLD patients had a significantly increased mean carotid IMT (0.79 +/- 0.18 vs. 0.73 +/- 0.13 mm; p or = 1 mm, and carotid plaque were 52.5% and 34.1% in the patients with NAFLD vs. 35.8% and 18.8% in the patients without this condition (p < 0.001). The difference in IMT and prevalence of plaque was also significant even in patients without MetS as well as those with MetS (all p < 0.05). NAFLD-associated adjusted odds ratio for increased IMT was 1.236 [95% confidence interval (CI), 1.023-1.467, p = 0.016] without MetS and 1.178 (95% CI, 1.059-1.311, p = 0.003) with MetS. NAFLD-associated adjusted odds ratio of carotid plaque was 1.583 (95% CI, 1.309-1.857, p = 0.024) without MetS and 1.536 (95% CI, 0.512-4.604, p = 0.444) with MetS. CONCLUSION: NAFLD is significantly associated with carotid atherosclerosis in non-diabetic outpatients even without MetS. Carotid screening for NAFLD might be beneficial for assessment of future atherosclerotic complications.


Subject(s)
Humans , Atherosclerosis , Carotid Arteries , Carotid Artery Diseases , Carotid Intima-Media Thickness , Drinking , Fatty Liver , Mass Screening , Odds Ratio , Outpatients , Prevalence
6.
Korean Circulation Journal ; : 213-216, 2011.
Article in English | WPRIM | ID: wpr-91753

ABSTRACT

Coronary artery fistula to pulmonary artery is common. However, to the best of our knowledge, a case of coronary artery fistula to pulmonary artery associated with aortopulmonary fistula remains unreported. We herein report a 64-year-old female with a left anterior descending coronary artery and ascending aorta to pulmonary artery fistulas, and conduct a brief review of the literature.


Subject(s)
Female , Humans , Middle Aged , Aorta , Arterio-Arterial Fistula , Coronary Vessels , Echocardiography , Fistula , Pulmonary Artery
7.
The Korean Journal of Internal Medicine ; : 410-420, 2011.
Article in English | WPRIM | ID: wpr-46542

ABSTRACT

BACKGROUND/AIMS: The aim of this study was to identify changes in left ventricular (LV) performance in patients with a myocardial bridge (MB) in the left anterior descending coronary artery during resting and in an inotropic state. METHODS: Myocardial strain measurement by speckle-tracking echocardiography and conventional LV wall-motion scoring was performed in 18 patients with MB (mean age, 48.1 +/- 1.7 years, eight female) during resting and intravenous dobutamine challenge (10 and 20 microg/kg/min). RESULTS: Conventional LV wall-motion scoring was normal in all patients during resting and in an inotropic state. Peak regional circumferential strain increased dose dependently upon dobutamine challenge. Longitudinal strains of the anterior and anteroseptal segments were, however, reduced at 20 microg/kg/min and showed a dyssynchronous pattern at 20 microg/kg/min. Although there were no significant differences in radial strain and displacement of all segments at rest compared with under 10 microg/kg/min challenge, radial strain and displacement of anterior segments at 20 microg/kg/min were significantly reduced compared with posterior segments at the papillary muscle level (44.8 +/- 14.9% vs. 78.4 +/- 20.1% and 5.3 +/- 2.3 mm vs. 8.5 +/- 1.8 mm, respectively; all p < 0.001), and showed plateau (40%) or biphasic (62%) patterns. CONCLUSIONS: Reduced LV strain of patients with MB after inotropic stimulation was identified. Speckle-tracking strain echocardiography identified a LV myocardial dyssynchrony that was not demonstrated by conventional echocardiography in patients with MB.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adrenergic beta-1 Receptor Agonists , Chest Pain , Coronary Angiography , Diastole , Dobutamine , Echocardiography, Stress/instrumentation , Myocardial Contraction , Myocardium , Physical Exertion , Systole , Ventricular Dysfunction, Left , Ventricular Function, Left/drug effects
8.
Korean Circulation Journal ; : 596-602, 2011.
Article in English | WPRIM | ID: wpr-181353

ABSTRACT

BACKGROUND AND OBJECTIVES: In patients with fibromyalgia (FM) syndrome, stress and pain may chronically enhance sympathetic activity, altering cardiovascular responses and inducing the arterial wall-stiffening process. We investigated arterial stiffness in FM patients using pulse wave velocity (PWV) and analyzed whether arterial stiffness was affected by the clinical parameters of FM. SUBJECTS AND METHODS: This study included 108 female FM patients (51.5+/-8.9 years) without any known cardiovascular diseases and 76 healthy female controls (50.1+/-8.9 years). FM patients underwent a manual tender point survey for tender point counts, and completed the visual analogue scale (VAS) of pain and fibromyalgia impact questionnaire (FIQ), which were composed of a physical and feel score. Brachial-ankle pulse-wave velocity (baPWV) was measured with an automated device. The study participants were subdivided into 2 groups based on the sum of the FIQ score (group A: FIQ > or =50, group B: <50). RESULTS: Patients with FM had significantly higher baPWV than the controls, and significant increase were noted in baPWV values of group A compared with those of group B. BaPWV showed a significant positive correlation (correlation coefficient=6.83, p=0.022) with severity of disease assessed by FIQ. CONCLUSION: The patients with FM showed significantly increased arterial stiffness, suggesting a pathophysiologic link between FM and endothelial dysfunction. This study provides a basis for clarifying the mechanism by which chronic pain syndrome is associated with an increased risk of vascular stiffness.


Subject(s)
Female , Humans , Aluminum Hydroxide , Carbonates , Cardiovascular Diseases , Chronic Pain , Compliance , Fibromyalgia , Pulse Wave Analysis , Vascular Stiffness , Surveys and Questionnaires
9.
Korean Circulation Journal ; : 74-80, 2010.
Article in English | WPRIM | ID: wpr-27396

ABSTRACT

BACKGROUND AND OBJECTIVES: An association between emotional or physical stressful triggers and adverse cardiovascular events, such as death and myocardial infarction, has been recognized for many years. The clinical features of transient left apical ballooning syndrome have been clearly described, but the effect of chronic stress on the myocardium is unknown. Our objective was to assess left ventricular (LV) function in patients with fibromyalgia (FM) with chronic emotional and physical stress. SUBJECTS AND METHODS: We investigated 30 consecutive postmenopausal women (mean age, 48+/-8 years) satisfying the criteria for FM with atypical chest pain and 20 age-matched healthy controls by means of standard and 2-dimensional strain (2DS) echocardiography. Patients with hypertension, coronary heart disease, or diabetes were excluded. Global and segmental longitudinal deformation parameters of LV function from 3 apical views were analyzed, and patients underwent a manual tender point survey for the number of tender points and tender point counts, and completed the Fibromyalgia Impact Questionnaire (FIQ), which was comprised of physical and feel scores, the Brief Fatigue Inventory (BFI), and the Beck Depression Inventory (BDI). RESULTS: Both global and segmental longitudinal LV strains were significantly reduced in FM patients with high FIQ scores (>50) compared to FM patients with low FIQ scores (-18.98% vs. -22.72%). Various emotional and physical stress indexes were significantly correlated with global LV strain. CONCLUSION: Global and segmental LV strains were negatively associated with fatigue, tender point count, and FIQ score. However, there was no significant association between depression and LV strain. This study demonstrated that chronic emotional or physical stress in FM patients might reduce myocardial longitudinal deformation.


Subject(s)
Female , Humans , Chest Pain , Coronary Disease , Depression , Echocardiography , Fatigue , Fibromyalgia , Hypertension , Myocardial Infarction , Myocardium , Sprains and Strains , Stress, Psychological , Takotsubo Cardiomyopathy , Surveys and Questionnaires
10.
Journal of Cardiovascular Ultrasound ; : 104-107, 2010.
Article in English | WPRIM | ID: wpr-207085

ABSTRACT

A primary pericardial tumor is very rare. A 77-year-old woman was admitted to our hospital with chief complaint of exertional dyspnea due to large amount of pericardial effusion. She was finally diagnosed as pericardial undifferentiated carcinoma without definite histopathologial, immunochemistry feature. Despite palliative radiation therapy, the patient died of multiple organ failure. The prognosis of primary pericardial undifferentiated carcinoma is known to be very poor, especially in old people.


Subject(s)
Aged , Female , Humans , Carcinoma , Dyspnea , Echocardiography , Immunochemistry , Multiple Organ Failure , Pericardial Effusion , Pericardium , Prognosis
11.
Korean Circulation Journal ; : 538-544, 2009.
Article in English | WPRIM | ID: wpr-53256

ABSTRACT

BACKGROUND AND OBJECTIVES: Several recent studies have shown that there is an inverse relationship between plasma B-type natriuretic peptide (BNP) and body mass index (BMI) in subjects with and without heart failure. Obesity frequently coexists with diabetes, so it is important to consider the relationship between diabetes and natriuretic peptide levels. We evaluated the influence of diabetes on the correlation of BNP and BMI. SUBJECTS AND METHODS: We examined 933 patients with chest pain and/or dyspnea undergoing cardiac catheterization between Feb. 2006 and Nov. 2007 in the Maryknoll cardiac center who had creatinine levels or =25 kg/m2) showed a significant negative correlation with increasing BMI (856.39+/-237.3 pg/mL, 601.69+/-159.6 pg/mL, 289.62+/-164.9 pg/mL, respectively, p<0.0001). However, in 200 diabetic patients, the correlation between BMI and NT-proBNP was not significant (r=-0.21, p=0.19), and NT-proBNP did not correlate with mitral E/Ea in obese diabetic patients (r=0.14, p=0.56). NT-proBNP was significantly correlated with mitral E/Ea in the non-obese (r=0.24, p=0.008) and non diabetic (r=0.32, p=0.003) groups. Left ventricular (LV) mass index was significantly correlated with NT-proBNP in all BMI groups (r=0.61, p<0.001), and patients with concentric cardiac hypertrophy showed the highest NT-proBNP levels. CONCLUSION: The present study demonstrates that obese patients have reduced concentrations of NT-proBNP compared to non obese patients despite having higher LV filling pressures. However, NT-proBNP is not suppressed in obese patients with diabetes. This suggests that factors other than cardiac status affect NT-proBNP concentrations.


Subject(s)
Humans , Body Mass Index , Cardiac Catheterization , Cardiac Catheters , Cardiomegaly , Chest Pain , Creatinine , Dyspnea , Echocardiography , Heart , Heart Failure , Natriuretic Peptide, Brain , Obesity , Overweight , Peptide Fragments , Plasma
12.
Journal of the Korean Medical Association ; : 1141-1147, 2009.
Article in Korean | WPRIM | ID: wpr-150752

ABSTRACT

u-Health based on ubiquitous information and communication network is being considered as an alternative to the mainstream face-to-face healthcare services in addition to its supportive functions. Traditional healthcare system has inherent problems such as limited accessibility and inadequate fulfillment of service needs to the underserved populations. Proponents of u-Health suggest that it will provide solutions to those problems. There have been many trials and pilot projects for telemedicine since 1988 in Korea, and the system is now called "u-Health". After legislation of clause regarding telehealth in the Korean medical law in 2002, local governments have made several attempts to utilize u-Health system to the patients with chronic disease living in rural under-served area. Recently, Korean government has implemented u-Health trial projects about tehemedicine, monitoring chronic disease, and providing homecare in the three underserved rural and many-islands area. Patients' perceived level of satisfaction, preference, attitude, and usability of u-Health was significantly high. Patient's compliance to u-Health has improved over time. A strategic approach based on the innovative and proactive mindset to the u-Health is strongly needed. At the time of u-Health implementation in the medically underserved area, utilization of both u-Health center and mobile clinic is recommended to achieve operational efficiency, and ensure high quality of service. Although u-Health is effective and supportive method to the mainstream face-to-face healthcare, we should be cautious, since u-Health model needs more development and more rigorous experiments.


Subject(s)
Humans , Chronic Disease , Compliance , Delivery of Health Care , Dietary Sucrose , Jurisprudence , Korea , Medically Underserved Area , Pilot Projects , Telemedicine , Vulnerable Populations
13.
Korean Journal of Medicine ; : S82-S86, 2009.
Article in Korean | WPRIM | ID: wpr-197366

ABSTRACT

The 12-lead electrocardiogram (ECG) is an inexpensive bedside tool that most physicians use to make rapid diagnoses such as acute myocardial infarction (AMI), arrhythmia, and conduction abnormalities. Although each lead in the ECG represents electronic information from specific portions of the heart, lead aVR, an augmented unipolar limb lead, is frequently ignored. The aVR lead provides excellent information from the right portion of the heart, including the outflow tract of the right ventricle and basal portion of the septum. In this report, we discuss ST segment elevation changes in lead aVR of serial ECGs in emergency room patients with chief complaints of syncope and chest discomfort.


Subject(s)
Humans , Acute Coronary Syndrome , Arrhythmias, Cardiac , Coronary Vessels , Electrocardiography , Electronics , Electrons , Emergencies , Extremities , Heart , Heart Ventricles , Myocardial Infarction , Syncope , Thorax
14.
Korean Journal of Blood Transfusion ; : 67-73, 2008.
Article in Korean | WPRIM | ID: wpr-57124

ABSTRACT

We reported a case of hemolytic transfusion reaction that was related to multiple RBC antibodies such as anti-E, anti-M, anti-Jkb and anti-Lea after serial RBC transfusions. A forty-nine year old female visited the emergency room (ER) with hematochezia. She had previously received 16 units of packed RBCs from 2003 to Jan 2007 for her intermittent esophageal varix bleeding. No specific antibodies were identified before this visiting. At the ER, under the request for packed RBCs, we identified anti-E antibody within her serum. Her blood type was AB, RhD+ with the phenotype of CcDe. She received 5 units of E antigen negative RBCs. However, she showed hemolytic transfusion reactions such as mild fever with a decrease of hemoglobin from 11.4 g/dL to 6.8 g/dL after the transfusion. From the 8th to the 10th hospital day, another 3 units of E-antigen negative with the least incompatible RBCs were transfused to the patient, but the level of hemoglobin was not definitely increased. At the 14th hospital day, she received a final 2 units of leuko-reduced RBCs without E, M and Jkb antigens. Her hemoglobin was increased right after the final transfusion. We found that the patient's serum reacted with multiple RBC antibodies such as anti-E, anti-M, anti-Jkb and anti-Lea antibodies. She finally recovered from acute varix bleeding and was discharged on the 26th hospital day with the level of hemoglobin being 8.3 g/dL.


Subject(s)
Female , Humans , Antibodies , Blood Group Incompatibility , Emergencies , Esophageal and Gastric Varices , Fever , Gastrointestinal Hemorrhage , Hemoglobins , Hemorrhage , Phenotype , Varicose Veins
15.
Korean Circulation Journal ; : 305-312, 2008.
Article in English | WPRIM | ID: wpr-121059

ABSTRACT

BACKGROUND AND OBJECTIVES: Renin-angiotensin system (RAS) inhibitors are likely to reduce the development of atrial fibrillation (AF) by preventing atrial fibrosis. We attempted to assess the relevance of strain echocardiography for quantitative assessment of the left atrial (LA) status in AF, its modification by RAS inhibitors and changes of biochemical markers during cardiac remodeling in AF. SUBJECTS AND METHODS: Strain echocardiography is performed 2 times (baseline and 12 month) in 60 patients with AF (RAS inhibitors-used group: 30, non-used group: 30). In an apical 4-chamber view, the regional analysis consisted of placing the region of interest cursor at the basal segments of the septal and lateral wall of LA. Mean peak systolic and early diastolic strain/rate are measured with LA end-systolic antero-posterior, longitudinal and transverse dimensions. RESULTS: Six patients of RAS inhibitors-used group (group A, 20%) and three patients of non-used group (group B, 10%) were converted to normal sinus rhythm during the study. LA size, E wave velocity, E/E', strain parameters showed no significant differences between groups at the baseline. There were no significant differences in LA size and E wave velocity between groups at the 12 months, however, peak systolic strain/rate were significantly higher in group A (36.71+/-13.63% and 2.98+/-0.59s(-1), p<0.05, respectively) than group B (27.21+/-10.49% and 2.21+/-0.47s(-1)). In addition, peak early diastolic strain/rate were significantly higher in group A (-1.89+/-3.30% and -2.32 +/-0.77s-1 p<0.05, respectively) than group B (-0.83+/-2.79% and -1.77+/-0.25s(-1)). There were no significant differences in C-reactive protein (CRP) and B-type natriuretic peptide (BNP) at the baseline, but BNP were significantly reduced in group A (822.9+/-798.3 pg/mL, p<0.05) than group B (1481.9+/-209.97 pg/mL) at the 12-month follow-up. CONCLUSION: The increased values of atrial peak systolic and diastolic strain/rate after treatment with RAS inhibitors revealed that passive stretching and shortening of LA wall might improve in some patients with AF even before LA size change possibly because of reduced atrial fibrosis and increased compliance. Our results indicated that strain echocardiography provides clinically useful information of LA function and remodeling and treatment with RAS inhibitors appears to preserve LA reservoir function in AF patients without visible LA structural change.


Subject(s)
Humans , Atrial Fibrillation , Atrial Function, Left , Biomarkers , C-Reactive Protein , Compliance , Echocardiography , Fibrosis , Muscle Stretching Exercises , Natriuretic Peptide, Brain , Prospective Studies , Renin-Angiotensin System , Sprains and Strains
16.
Korean Circulation Journal ; : 612-617, 2008.
Article in Korean | WPRIM | ID: wpr-192088

ABSTRACT

BACKGROUND AND OBJECTIVES: In the era of stents, lesion length remains an important predictor of restenosis. Drug-eluting stents (DESs) have significantly reduced in-stent restenosis (ISR), but results in long lesions are still lacking. Therefore, we investigated the impact of DESs on clinical outcomes in patients with diffuse coronary lesions. SUBJECTS AND METHODS: Between January 2004 and January 2005, 80 patients (94 lesions) with lesions >20 mm in length were treated with one or more DESs and underwent follow-up coronary angiography. The patients were divided into three groups: Group 1 was composed of those with lesions 21 to 35 mm in length, Group 2 was composed of those with lesions 36 to 50 mm in length, and Group 3 was composed of those with lesions > or =51 mm in length. RESULTS: The mean clinical follow-up duration was 9 months. On the 6-month follow-up angiogram, 6.4% of the lesions had binary ISR (5.0% in group 1, 8.7% in group 2, and 9.1% in group 3). The percent diameter stenosis was 6.0+/-18.15% in Group 1, 12.61+/-21.99% in Group 2, and 19.81+/-31.26% in Group 3(p< 0.05). Late lumen loss was 0.17+/-0.50 mm in Group 1, 0.39+/-0.66 mm in Group 2, and 0.59+/-0.93 mm in Group 3 (p<0.05). Lesion length was associated with an increase in percent diameter stenosis and late lumen loss (of 6.9% and 0.21 mm per 15 mm). CONCLUSION: DES implantation is considered safe and effective in the treatment of diffuse lesions. However, lesion length may be associated with an increase in percent diameter stenosis and late lumen loss at 6-month follow-up.


Subject(s)
Humans , Constriction, Pathologic , Coronary Angiography , Coronary Restenosis , Coronary Stenosis , Drug-Eluting Stents , Follow-Up Studies , Stents
17.
Journal of Cardiovascular Ultrasound ; : 116-122, 2008.
Article in Korean | WPRIM | ID: wpr-124719

ABSTRACT

BACKGROUND: The measurement of carotid intima-media thickness (IMT) is useful for detection of early atherosclerotic disease. But, IMT are influenced by various factors including hypertension, age, diabetes, etc. We tried to estimate the correlation between carotid IMT and coronary artery disease in diabetics. METHODS: The B-mode ultrasonography and coronary angiography was perfomed in 50 as type 2 diabetes and 226 as nondiabetes. Carotid IMT was measured at around carotid bulb. Coronary artery lesions was evaluated based on quantitative coronary analysis (QCA) from coronary angiogram. RESULTS: Type 2 diabetic group (mean age 64.5+/-8.9 years old) included 21 patients without coronary artery disease and 29 patients with coronary artery disease. Non-diabetic group (mean age 61.0+/-10.1) included 138 patients without coronary artery disease and 88 patients with coronary artery disease. In type 2 diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was similar to that of subjects without coronary disease (mean Rt. IMT, 1.26+/-0.62 mm vs. 1.03+/-0.29 mm, respectively, p=0.11, mean Lt IMT, 1.30+/-0.70 mm vs. 1.17+/-0.43 mm, respectively, p=0.46). But in non-diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was more than that of subjects without coronary disease, and it is statistically significant (mean Rt. IMT, 1.09+/-0.32 mm vs. 0.96+/-0.25 mm, respectively, p=0.01, mean Lt IMT, 1.19+/-0.47 mm vs. 1.01+/-0.32 mm, respectively, p=0.01). CONCLUSION: This study shows weak correlation power between carotid IMT and coronary artery diseases in diabetics, contrast to non-diabetes.


Subject(s)
Humans , Carotid Arteries , Carotid Intima-Media Thickness , Coronary Angiography , Coronary Artery Disease , Coronary Disease , Coronary Vessels , Hypertension
18.
Korean Circulation Journal ; : 398-404, 2008.
Article in English | WPRIM | ID: wpr-203738

ABSTRACT

BACKGROUND AND OBJECTIVES: Strain imaging has already been shown to quantify regional myocardial function in both acute ischemic myocardium and infarcted myocardium. We proposed that strain imaging could differentiate deformation of normal and ischemic myocardium that are without regional wall motion abnormality, as assessed by conventional echocardiography. The aim of this study is to determine the diagnostic value of strain imaging for the detection and localization of coronary lesions in patients with chest pain, but they are without apparent wall motion abnormalities. SUBJECTS AND METHODS: Strain imaging for advanced wall motion analysis was performed in 179 patients with suspicious stable angina (SA) and in 94 patients with suspicious acute coronary syndrome (ACS) prior to coronary angiography. All the patients had normal conventional wall motion scoring based on the standards of the American Society of Echocardiography. Longitudinal strain was measured in 3 apical views, and assessments of the strain value for individual segments with using an 18-segment division of the left ventricle were performed to determine the average strain value. Marked heterogeneity of strain was considered abnormal, and significant coronary artery disease was considered present if stenosis above 70% was noted on the quantitative angiography. RESULTS: Eighty (78%) of the 103 patients with SA and 18 (56%) of the 32 patients with ACS and who showed constant systolic strain throughout the left ventricular wall had normal or minimal coronary lesions. Fifty-one (67%) of the 76 patients with SA and 53 (85%) of the 62 patients with ACS and marked heterogeneity of strain had angiographically significant coronary stenosis. The receiver-operating characteristic (ROC) analysis of the peak systolic strain yielded that the ROC-area of peak systolic strain for the left anterior descending artery territory was 0.79 (95% CI 0.72-0.84), this was 0.87 (95% CI 0.79-0.91) for the left circumflex artery territory and 0.89 (95% CI 0.79-0.93) for the right coronary artery territory. CONCLUSION: Ultrasound-based strain imaging demonstrates a strong correlation with coronary angiography and it has potential as a noninvasive diagnostic tool for detecting coronary artery stenosis in patients with chest pain, but who are without apparent wall motion abnormalities on conventional echocardiography.


Subject(s)
Humans , Acute Coronary Syndrome , Angina, Stable , Arteries , Chest Pain , Constriction, Pathologic , Coronary Angiography , Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Echocardiography , Heart Ventricles , Myocardium , Population Characteristics , Sprains and Strains
19.
Journal of Cardiovascular Ultrasound ; : 59-62, 2007.
Article in Korean | WPRIM | ID: wpr-192423

ABSTRACT

Cancer is a major risk factor for pulmonary thromboembolism. Occasionally, the thromboembolic event occurs before the diagnosis of cancer. We report a rare case of massive pulmonary thromboembolism with multiple myeloma diagnosed by transthoracic echocardiography.


Subject(s)
Diagnosis , Echocardiography , Multiple Myeloma , Pulmonary Embolism , Risk Factors
20.
Journal of Cardiovascular Ultrasound ; : 8-12, 2007.
Article in Korean | WPRIM | ID: wpr-192276

ABSTRACT

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in kidney transplantion recipients. Enhanced cardiac load by the persistence of functioning AVF in posttransplant period is associated with LV hypertrophy and may adversely influence cardiac outcome. METHODS: To investigate the impact of AVF on LV mass and function in kidney transplant recipients, 46 patients with functioning AVF were randomly assigned to surgical closure of AVF (fistular closing group, FC, n=23) or maintenance of fistula (fistular maintenance group, FM, n=23). Serum creatinine of all participants was stable(1.4+/-0.3). Mean age was 46+/-11. Mean posttransplant month was 78+/-53 (12-161). Echocardiography and determination of N-terminal pro-BNP, cTnT and CRP were done at 0, 1 and 6 months in group 1 (FC), and at 0 and 6 months in group 2 (FM). RESULTS: Baseline echocardiographic indices of systolic and diastolic LV function such as EF, E/A, E/E' and Tei index were not significantly different between groups. In patients whose AVF was surgically closed, LV mass (247.7+/-76.8 to 235.2+/-66.5, p=0.015) and LV mass index (144.0+/-10.1 to 137.1+/-8.6, p=0.02) significantly reduced at one month after closure, and no further significant change was observed at 6 months. In two groups no significant change in LV systolic and diastolic performance indices were observed. BNP, cTnT and CRP did not differ between groups in baseline value and did not change after closure. CONCLUSION: We conclude that the persistence of functioning AVF in kidney transplantation recipients is associated with LVH, and which can be reduced by closure of fistula. As LVH is one of major determinants of cardiovascular outcome in transplant patients as well as in general population, it would be prudent to close the fistula in patients with stable graft function.


Subject(s)
Humans , Arteriovenous Fistula , Cardiovascular Diseases , Creatinine , Echocardiography , Fistula , Hypertrophy , Hypertrophy, Left Ventricular , Kidney Transplantation , Kidney , Mortality , Transplantation , Transplants
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