Non-Dipper Pattern is a Determinant of the Inappropriateness of Left Ventricular Mass in Essential Hypertensive Patients

BACKGROUND AND OBJECTIVES: Inappropriately high left ventricular mass (iLVM) is known to be related to cardiovascular prognosis. A non-dipper pattern has a greater mean left ventricular (LV) mass than the dipper pattern in hypertensive patients. However, the appropriateness of LV mass in dipper or non-dipper patterns has not been adequately investigated. The aim of this study was to define the relationship between nocturnal dipping and the appropriateness of LV mass. SUBJECTS AND METHODS: Using the ambulatory blood pressure monitoring (ABPM) database, the data of 361 patients who underwent ABPM and echocardiography was analyzed retrospectively. Appropriateness of LV mass was calculated as observed/predicted ratio of LV mass (OPR) using a Korean-specified equation. Nocturnal dipping was expressed as percent fall in systolic blood pressure (BP) during the night compared to the day. RESULTS: Daytime, nighttime and 24 hours BP in hypertensive patients was 140.4+/-14.8 mmHg, 143.7+/-15.2 mmHg and 129.4+/-20.0 mmHg, respectively. OPR was 106.3+/-19.9% and nocturnal dipping was 10.2+/-10.9 mmHg. In a multiple linear regression model, 24 hours systolic BP (beta=0.097, p=0.043) and nocturnal dipping (beta=-0.098, p=0.046) were independent determinants of OPR as well as age (beta=0.130, p=0.025) and body mass index (BMI) (beta=0.363, p25 kg/m2). CONCLUSION: The non-dipper pattern is independently associated with iLVM in hypertensive patients as well as obesity.

The Relationship Between Ambulatory Arterial Stiffness Index and Blood Pressure Variability in Hypertensive Patients

BACKGROUND AND OBJECTIVES: Ambulatory arterial stiffness index (AASI) is well known as a predictor of cardiovascular mortality in hypertensive patients. Mathematically, AASI reflect the standard deviation (SD) of blood pressure (BP) variation. AASI is measured higher levels in non-dipper than dipper. Thus, AASI has a possibility of not only reflecting arterial stiffness but also BP variability and/or autonomic nervous dysfunction. SUBJECTS AND METHODS: Consecutive data from 418 untreated hypertensive patients were analyzed retrospectively. We examined the association between the 24-hour ambulatory BP monitoring (ABPM) parameters and AASI. RESULTS: AASI had a simple correlation with age (R=0.189, p<0.001), relative wall thickness (RWT) (R=0.115, p=0.019), left ventricular mass index (LVMI) (R=0.192, p<0.001), average systolic BP (SBP) (R=0.232, p<0.001), average pulse pressure (PP) (R=0.363, p<0.001), SD of diastolic BP (DBP) (R=-0.352, p<0.001), SD of PP (R=0.330, p<0.001), SD of heart rate (HR) (R=-0.268, p<0.001), and nocturnal dipping (R=-0.137, p=0.005). In multiple linear regression analysis model including clinical parameters and 24 hour-ABPM parameters, independent predictors of AASI were SD of PP (beta=1.246, p<0.001), SD of DBP (beta=-1.067, p<0.001), SD of SBP (beta=-0.197, p<0.001), and non-dipper (beta=0.054, p=0.033). CONCLUSION: AASI is closely correlated with BP variability. The result of this study shows that AASI is not only a parameter for arterial stiffness, but also a parameter for BP variability.

Recurrent Infective Endocarditis Associated With Pyogenic Spondylodiskitis

Infective endocarditis is a life-threatening condition caused by microbial infection of the heart's endocardial surface. This condition can also be associated with bacterial infections of other organs. We experienced an unusual case of recurrent infective endocarditis associated with pyogenic spondylodiskitis. A 70-year-old man presented with persistent fever and lower back pain visited our hospital. The patient had a past history of recurrent infective endocarditis. He was diagnosed with infective endocarditis again based on clinical symptoms and echocardiographic findings. Magnetic resonance imaging was used to evaluate lower back pain, which showed acute spondylodiskitis on L3 and L4 vertebrae. The patient completely recovered following four weeks of antibiotic therapy.

Type 2 Myocardial Infarction Following Generalized Tonic-Clonic Seizure

Myocardial infarction is diagnosed when blood levels of biomarkers are increased in the clinical setting of acute myocardial ischemia. Among the biomarkers, troponin I is the preferred biomarker indicative of myocardial necrosis. It is tissue specific for the heart. Myocardial infarction is rarely reported following seizure. We report a case of elevated troponin I in a patient after an episode of generalized tonic-clonic seizure. The diagnosis was type 2 myocardial infarction.

Bone Mineral Density is an Independent Determinant of Left Ventricular Mass Index in the General Female Population

BACKGROUND AND OBJECTIVES: Left ventricular hypertrophy (LVH) is a well known cardiovascular prognostic predictor. Osteoporosis has been suggested to be associated with cardiovascular disease. According to studies of primary hyperparathyroidism, a pathophysiological association between calcium metabolism and LVH has been suggested but is not yet fully understood. This study was performed to investigate the association between bone mineral density (BMD) and left ventricular mass index (LVMI) in a general population. SUBJECTS AND METHODS: Data from 460 subjects among 543 subjects sampled from a general population in a rural area in Korea were analyzed. BMD, echocardiography, brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (IMT) measurement as well as the measurements of blood pressure, blood chemistry and metabolic parameters were analyzed. BMD was measured using the Sahara Clinical Bone Sonometer (Hologic Inc., Mass., USA). RESULTS: Age of the subjects was 59.4+/-12.4 years. Males were 42.2% (n=194). In a simple correlation analysis on female subjects, age and waist circumference showed negative correlation, and body mass index (BMI) showed positive correlation with BMD. However, only age showed negative correlation with BMD in male subjects. After adjusting baPWV and carotid IMT, we found that BMD was an independent determinant of LVMI in female subjects (beta=-13.703, p=0.016), but not in male subjects (beta=-1.235, p=0.841). CONCLUSION: BMD is a consistent and independent determining factor of LVMI, BMI and carotid IMT in postmenopausal women.

Left main coronary artery dissection during the transcatheter coil closure of multiple congenital coronary fistulas / 대한내과학회지

A congenital coronary fistula is a rare defect. Many congenital fistulas drain into the pulmonary artery and may be an incidental finding; however, some fistulas can cause a coronary 'steal' phenomenon resulting in angina. The transcatheter closure of coronary fistulas is an accepted, effective, and safe alternative to surgery in adults. In comparison, left main coronary artery (LMCA) dissection is rare and can lead to life-threatening complications during percutaneous coronary intervention. The optimal treatment for patients with LMCA dissection during catheter-based procedures is uncertain. Some studies suggest that bail-out LMCA stenting provides good acute and long-term results. Here, we present a case of LMCA dissection during the transcatheter coil closure of multiple congenital coronary fistulas with subsequent successful stent implantation in the LMCA.

Development of acute myocardial infarction in a young female patient with essential thrombocythemia treated with anagrelide: a case report

Essential thrombocythemia (ET) is a chronic myeloproliferative disorder with a prolonged clinical course. Since this disorder is considered to be at increased risk of thromboembolism, therapy is mainly focused on the decreased risk of thrombohemorrhagic events by use of cytotoxic agents. Anagrelide is a phosphodiesterase III inhibitor which is utilized in the treatment of ET for the reduction of platelets. However, patients treated with anagrelide might experience cardiovascular adverse effects including myocardial infarction (MI), although these events are rare. Herein, we report a case of a 30-year-old female with well controlled ET by anagrelide, who eventually developed an acute non-ST elevation myocardial infarction (MI). There has no found any cardiovascular risk factors in this ET patient, strongly suggesting that anagrelide might be the cause of MI. Therefore, cardiovascular function should be monitored in those patients prescribed with anagrelide.

Association Between Inappropriateness of Left Ventricular Mass and Left Ventricular Diastolic Dysfunction: A Study Using the Tissue Doppler Parameter, E/E'

BACKGROUND AND OBJECTIVES: The structural significance of the inappropriateness of left ventricular mass (iLVM) is known to be an important prognostic factor for cardiovascular events; however, the functional changes associated with iLVM have not been established. This study was performed to determine if diastolic dysfunction is associated with iLVM using a tissue Doppler technique. SUBJECTS AND METHODS: Three hundred sixty consecutive subjects, including 221 hypertension patients from the echocardiography database, were analyzed. Regarding the appropriateness of left ventricular (LV) mass, an observed/predicted ratio of LV mass (OPR) >130% was defined as inappropriate. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), isovolumetric relaxation time (IVRT), and E/early mitral annulus velocity (E'), were compared between the appropriate LV mass (aLVM) group and the iLVM group. RESULTS: Among transmitral flow parameters, only the E velocity was negatively correlated with the OPR when adjusted for age (adjusted r=-0.107, p=0.04). Based on multiple regression analysis, the OPR (beta=0.163, p=0.003), as well as age (beta=0.286, p=0.0001), systolic blood pressure (beta=0.120, p=0.019), fasting blood glucose (beta=0.098, p=0.042), and male gender (beta=0.157, p=0.002) were independent factors determining E/E'. The cholesterol level was not an independent factor (beta=-0.059, p=0.355). In the iLVM group (n=105), the adjusted E/E' was higher than in the aLVM group (n=255; 11.7+/-3.4 vs. 10.8+/-3.1, p=0.02), while the peak E flow velocity was significantly lower than in the aLVM group (70.9+/-15.1 vs. 75.5+/-17.6, p=0.03). CONCLUSION: Inappropriateness of LV mass is independently associated with increased E/E'. Thus, E/E' may be a useful parameter for the evaluation of diastolic dysfunction.

A Case of Aortic Root Abscess Causing Fatal Myocardial Infarction

Despite the major advances in diagnostic technology and improvements in antimicrobial selection and monitoring accompanied by parallel advances in surgical techniques, the morbidity and mortality of infective endocarditis(IE) still remain high. Because of this high mortality rate, it is worthy of investigating the clinical features of IE and it's complications thoroughly. The main causes of mortality in IE are congestive heart failure and septic embolization. In 9% of active IE, acute myocardial infarction(AMI) developed. AMI caused by coronary artery obliteration by occlusion or embolization is a rare but recognized complication of aortic valve endocarditis with annular abscess. We reported a case of aortic valve endocarditis with aortic root abscess which was complicated by AMI and death.

Aterial Stiffness and Abdominal Obesity are Associated with the Relaxation Abnormality of Left Ventricle in Human Hypertension

BACKGROUND AND OBJECTIVES: Aging is a major factor related to a relaxation abnormality of the left ventricle. Increased arterial stiffness and central distribution of body fat are common physiologic changes observed in the elderly. To further elucidate the relationship between aging and a relaxation abnormality of the left ventricle, we investigate the relationship between the pulse wave velocity, abdominal obesity and diastolic function parameters of the left ventricle. SUBJECTS AND METHODS: In 490 subjects (153 normotensive, 128 prehypertensive, 120 untreated hypertensive and 89 hypertensive on anti-hypertensive drugs, aged 59.8+/-12.6 (21-88) years), the brachial-ankle pulse wave velocity (baPWV) and echocardiographic indices for a relaxation abnormality, i.e. transmitral E, A, E/A, DT, IVRT, were measured. A relaxation abnormality was defined by an E/A 240 ms in the young (240 ms in the old ( or =90 cm in male, > or =80 cm in female, OR: 2.34), a high baPWV (> or =1,600 cm/sec, OR: 3.96) and a high BMI (> or =25 kg/m2, OR: 0.60) to be independent deter-minants of a relaxation abnormality. The age adjusted mean baPWV (1526.9+/-119.4 vs. 1577.1+/-106.9 cm/sec, p< 0.0001) and AC (86.2+/-9.8 vs. 88.5+/-7.7 cm, p=0.005) were higher in group II than group I. CONCLUSION: Arterial stiffness is the major determinant of a relaxation abnormality of the left ventricle. Abdominal obesity and a high BMI were found to be independent of each other, and an inverse relationship was found with respect to a relaxation abnormality of the left ventricle in a rural Korean population, including hypertensive patients.

A Case of Coronary Artery-Left Ventricular Microfistulae Demonstrated by Transthoracic Doppler Echocardiography

The coronary artery-left ventricular microfistula is an extremely rare congenital anomaly. Little is known about their epidemiologic and clinical features. Moreover, to our knowledge, only two cases of coronary artery-left ventricular microfistulae demonstrated by transthoracic doppler echocardiography have been reported in the literature. Recently we experienced a case of coronary artery-left ventricular microfistulae demonstrated by transthoracic doppler echocardiography, who was a 63 year old woman and visited for evaluation of chest pain. Herein, along with a review of the pertinent literature regarding this disorder, we report a case of coronary artery-left ventricular microfistulae demonstrated by transthoracic doppler echocardiography.

Comparison of Endothelium-Dependent Vasodilation According to the Presence of Diabetes in Coronary Artery Disease

BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate endothelium dependent vasodilation in the diabetic patients suffering with coronary artery disease (CAD). SUBJECTS AND METHODS: 43 patients who presented with typical chest pain and who underwent coronary angiography were enrolled in this study. They were classified into diabetic patients with CAD (n=13), non-diabetic patients with CAD (n=13), diabetic patients without CAD (n=7), and non-diabetic patients without CAD (n=10), according to the presence of CAD and diabetes mellitus. Endothelium-dependent vasodilation of the brachial artery was measured in all the subjects by performing 7.5 MHz high-resolution ultrasound sonography. RESULTS: The endothelium-dependent vasodilation in the diabetic patients with CAD was 1.30+/-2.13% and it was 5.72+/-3.70% in the non-diabetic patients with CAD. There was a significant difference between the two groups (p=0.001). The endothelium-dependent vasodilation in diabetic patients without CAD was 2.28+/-1.88% and it was 10.70+/-10.19% in the non-diabetic patients without CAD. There was a significant difference between the two groups (p=0.029). The endothelium-dependent vasodilations in the diabetic group was 2.28+/-1.88% and it was 10.70+/-10.19% in the non-diabetic group for all the patients. There was a significant difference between the two groups (p=0.029). There was correlation between the endothelium-dependent vasodilation and the fasting blood sugar. There was negative correlation between the endothelium-dependent vasodilation and the fasting blood sugar (FBS) in the patients with CAD (r=-0.59, p=0.002). However, there was no correlation between the endothelium-dependent vasodilation and the FBS in the patients without CAD (r=-0.327, p=0.201). There was negative correlation between the endothelium-dependent vasodilation and the FBS in all subjects (r=-0.352, p=0.021). CONCLUSION: The endothelium-dependent vasodilation was decreased in the diabetic patients with CAD as compared to the non-diabetic patients with CAD. There was also was negative correlation between the endothelium-dependent vasodilation and the FBS in the patients with CAD.

The Relationship between the Pulse Wave Velocity(PWV) and the Left Ventricular Geometry: A Community-Based Cross-Sectional Study

BACKGROUND AND OBJECTIVES: Arterial compliance is a well-known factor affecting the left ventricular structure and function. Pulse wave velocity (PWV) is a reliable indicator of arterial compliance. To elucidate the role of arterial stiffness on the geometric adaptation of LV, the relationship between the pulse wave velocity and geometric patterns of the LV were investigated in subject living in a rural area of Korea. SUBJECTS AND METHODS: The brachial-ankle pulse wave velocity (baPWV) and echocardiographic indices, i.e. left ventricular mass index (LVMI), relative wall thickness (RWT), were measured in 217 (59 hypertensive, 158 normotensive, and age of 57.7+/-12.8 (21-86)) subjects. The relationship between the baPWV and RWT was analyzed according to the presence of LVH, which was defined by >52.0 g/m2.7. Group I was defined as having a RWT0.35. RESULTS: In a multiple regression model for the relative wall thickness, the stroke volume (beta=-0.261), PWVright (beta=0.177), total peripheral resistance (beta=0.227), abdominal circumference (beta=0.317) and body mass index (beta=-0.214) were found to be independent determinants (R2=0.265, SEE=0.043, constant=0.258+/-0.043, p=0.0001). In subjects without LVH, those in group II (n=42) were older (59.3+/-13.4 vs. 52.0+/-13.0, p=0.005) and had a higher meanPWV (1590.7+/-407.3 vs. 1711.3+/-407.3 cm/sec, p=0.02) than those in group I (n=65). In subjects with LVH, those in group II (n=66) were older (62.5+/-10.9 vs. 57.5+/-11.4, p=0.03) and had a higher meanPWV (1623.7+/-385.3 vs. 1488.5+/-266.3 cm/sec, p=0.03) than those in group I (n=44). In group II, the total peripheral resistance was higher (1858.7+/-447.7 vs. 1608.0+/-347.4 dynes-sec-cm-5, p=0.0001) and the stroke volume lower (67.0+/-14.2 vs. 79.4+/-15.7 ml, p=0.0001) than in group I. CONCLUSION: Pulse wave velocity is independently associated with the concentric geometry of the left ventricle in the rural Korean population used in this study.

Influences of Body Size and Cardiac Workload on the Left Ventricular Mass in Healthy Korean Adults with Normal Body Weight and Blood Pressure

BACKGROUND AND OBJECTIVES: The left ventricular mass is known to be influenced by both hemodynamic and non-hemodynamic factors. Body size and gender are the most representative non-hemodynamic factors. This study was performed to establish the influences of these variables on the variation of the left ventricular mass in healthy Korean adults. SUBJECTS AND METHODS: 368 subjects (male=184, female=184), with a normal body mass index and blood pressure, were included in the echocardiographic analysis from the echocardiography database of the Hanyang University Hospital and of the Yangpyung Epidemiologic Survey 2004. The left ventricular mass was calculated using the equation: 1.04x(IVSd+LVDd+PWTd)3-LDVs3)x0.8+0.6. The stroke volume was calculated (mL/beat) using Teichholz's formula. The stroke work (SW in gram-meters/beat [g-m/beat]) was computed as the cuff systolic BPxstroke volumex0.0144. RESULTS: The stroke work (SW) was the most important factor associated with the LV mass (adjusted R2=0.501, p<0.001), and body weight, age and gender were independent factors (adjusted R2=0.642). In a regression model, including stroke work, gender and height2.7, the LV mass was predicted by the equation: 54.9+7.62xheight (m2.7)+0.67xSW (g-m/beat)-13.2xgender (male=1, female=2)(constant=54.9+/-14.7 g, adjusted R2=0.576, SEE=21.67, p=0.001). CONCLUSION: As with the studies in the western countries, the stroke work, gender and height2.7 were important determinants of the left ventricular mass in Korean adults with a normal weight and normal blood pressure.

Significance of QT Dispersion as a Prognostic Factor in Hyperkalemia

PURPOSE: To date, it has been impossible to relate the occurrence of ventricular arrhythmia to survival in hyperkalemia. QT dispersion is thought to reflect the inhomogeneity of ventricular repolarization and to be related to ventricular-arrhythmia-induced sudden cardiac death in various medical conditions. Therefore, the purpose of this study was to investigate to use QT dispersion as a prognostic marker in hyperkalemia and to suggest treatment guidelines for hyperkalemia by analyzing the correlations between the QT dispersion on the initial ECG and the treatment outcomes. METHODS: This study's population was comprised of 104 patients with serum potassium concentrations > or =5.5 mEq/L, who were divided into 2 groups; group 1 was the survival group (n=81), group 2 was the death group (n=23). We reviewed retrospectively the underlying diseases, electrolytes, treatment outcomes and the clinical and ECG findings during the initial and the recovery states. The QT interval for each lead was measured manually on an enlarged (X1.5) ECG. The QT interval was measured from the first deflection of the QRS complex to the point of the T wave offset, and the corrected QT interval was obtained by using B a z e t t's formula. The QT dispersion and the corrected QT dispersion were defined as the differences between the minimal and the maximal QT values and between the corresponding corrected QT values for each of the 12 leads, respectively. RESULTS: The treatment outcomes were not related to the initial serum potassium and the hourly serum potassium change rates. For hyperkalemia > or =7.0 mEq/L, the death group had significantly larger QT dispersion than the survival group (death group = 95.6+/-15.4 msec, survival group = 51.8+/-17.5 msec, p or =7.0mEq/L, QT dispersion above 65 msec had a 93.8% sensitivity, a 79.4% specificity, and a 68.2% positive predictive value for death. CONCLUSION: For hyperkalemia > or =7.0 mEq/L, QT dispersion above 65 msec should be considered to be a prognostic marker for prediction of the treatment outcome.

Coronary Heart Disease in Air Travelers / 항공우주의학회지

The air medical transport of coronary patients is a rapidly expanding practice. From time to time, the physician is called on to assess risk or advise coronary patients. Commericial aircraft flight presents a highly variable altitude exposure that may result in significant hypoxia for patients with coronary heart disease. When considering elective long-distance air travel of coronary patients, it is necessary to weigh the benefits against the potential risks of flight. Strong contraindications to air travel by coronary patients would appear to be new-onset angina and unstable angina. And myocardial infarction within several weeks or months constitutes a relative contraindication, with persistent angina, ventricular ectopy, and poor ventricular function. These patients and those coronary patients with obstructive lung disease maybe candidates for in-flight oxygen treatment.

The Effect on Age, Body Weight, Height, Body Mass Index and Smoking to Coagulation Factor VII, VIII and Fibrinogen in Pilots

BACKGROUND: The pilots with cardiovascular events have a possibility for a risk of suffering from sudden incapacitation which is closely related to flying safety. The coagulation factors such as fibrinogen, factor VII, and factor VIII are possibly related to cardiovascular events. Several studies for general population have shown that an increase of those coagulation factors with age, a correlation of Factor VII and fibrinogen with BMI, and of fibrinogen with smoking. However, this study is to find out whether pilots' age, body weight, body mass index (BMI) and smoking are related to the baseline measurement of coagulation factor VII, factor VIII and fibrinogen. METHOD: Samples were taken from 21 pilots from Asiana Airlines: 11 smokers and 10 non-smokers. In order to measure the relationship between age, body weight, BMI, and the coagulation factors, Pearson correlation was used in this analysis. Independent two sampled t-test was used to analyze the correlation between smoking and the coagulation factors. RESULTS: Mean age, mean height, mean body weight and mean BMI of pilots were examined: 38 years, 171.81 cm, 70.67 Kg and 23.94 Kg/m(2). Mean fibrinogen, mean factor VII, and mean factor VIII were also obtained: 236.0 mg/dl, 92.93%, and 60.16%. The coagulation factor VII, factor VIII and fibrinogen were not significant related to age, body weight, BMI, smoking of pilots. CONCLUSION: This study has no correlation between age, body weight, BMI, smoking and the coagulation factors because the age of this study does not have pilots with over 60 years old and healthy behaviors (e.g., exercise, smoking, drinking, etc.) of most pilots are relatively well.

Relationship between Body Weight and Pulmonary Function in Pilots from a Airlines: The Comparison of Data from 1996 with 2002

BACKGROUND: Obesity increases the risk of cardiovascular disease, hypertension, diabetes, and other disorders. Several studies have shown that excess weight or weight gain was related to the decline of pulmonary function. This study is to find out whether pilot's age, height, body weight, body mass index(BMI) and smoking are related to the baseline measurement of pulmonary function in order to promote the healthy behavior of pilots. METHOD: The analysis was based on data from the annual physical examination of pilots which was conducted in one airlines company of Korea. This study compared the data obtained from 73 pilots in 1996 with the data in 2002. Pulmonary function(forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal mid expiratory flow (MMEF), peak expiratory flow (PEF)), age, height, body weight and body mass index were measured in both surveys. Multivariate analysis of variance (MANOVA) was used to examine the relationship weight gain, smoking and pulmonary function. RESULTS: According to the data from 2002, mean age, mean height, mean body weight and mean BMI of pilots were examined: 47.62 years, 171.60 cm, 70.6 Kg and 24.03 Kg/m(2). Age was significantly related to FVC, FEV1 and MMEF. Height was significantly related to FVC and FEV1. However, body weight was significantly related to PEF and MMEF. The effect of smoking on pulmonary function was not significant. Pilots who gained body weight and BMI after 7 years were not related significantly to the pulmonary function. CONCLUSION: This study shows that age, height, weight are significantly related to pulmonary function. And other studies show that weight gain is significantly related to the decline of pulmonary function, but the relationship from this study is not significant because the number of sample is not enough and healthy behaviors of most pilots are relatively well.

The Relationship between Sick Leave and Pilot's Depression & Anxiety Tendency Using BDI & STAI

BACKGROUND: It is known that depression and anxiety tendency causes physical or social dysfunction. Nowadays, the air travel is increasing as the life condition has been improved so the health of pilots who are in charge of passengers become a very important issue. However, few studies have been done on this issue, especially the relationship between depression & anxiety and medical diseases among them. This study was performed to know the factors affection pilots' sick leave and the correlation between depression & anxiety and sick leave. METHODS: Self administered questionaires were obtained from 123 pilots of one of the airline companies at Seoul from 1st April to 30th may 2003. Depression tendency was measured based upon BDI, the level of anxiety was measured by the standardised STAI and obesity was diagnosed if a BMI is over 25 kg/m2. The data on the subjects' age, position, airlines and the days of sick leave were obtained from personal record. RESULTS: All the study subjects were male with the average age of 40.23+/-7.48 (ranging from 30 to 60). The average age for those who had sick leave was 34.58+/-3.50 and that for those who had not was 40.48+/-7.55 and these two average ages showed difference with statistical significance (P value 0.05). CONCLUSION: This study shows that the average age of sick leave group was lower than that of non-sick leave group (P<0.001). The level of depression and anxiety were not related to the sick leave. The reasons for this seems to be the fact that pilots are healthier than general population and also they pay more attention to their own health. The younger pilots tended to have more days of sick leave, which might be explain that the older pilots were more cautious about the disadvantages of having sick leave but, the younger pilots tend to have strong individualistic personalities.

Characteristics of QT Dispersion during Recovery Phase after Treadmill Exercise in Airlines Pilots

BACKGROUND: QT dispersion (QTD) represents the inhomogeneity of ventricular repolarization and has been suggested to predict ventricular arrhythmia in patients with coronary artery disease. The purpose of this article is to study the characteristics of QTD during recovery phase after maximal treadmill exercise in airlines pilots. METHODS: The study population included 45 healthy airlines pilots. QTpeak D (QTpD) was defined as the difference between maximum and minimum QTp interval measured on 12 lead ECG at single cardiac beat. Paired t test was used between QTpD at rest and QTpD during recovery phase after maximal treadmill exercise. RESULTS: The QTpD at early recovery phase (1 minute) after maxial treadmill exercise was significantly decreased compared to QTpD at rest (22+/-11 msec. vs 27+/-12 msec., P<0.05), but there was no significant difference between QTpD at rest and QTpD at late recovery phases (3 minutes, 5 minutes and 7 minutes). CONCLUSION: This finding suggests that antiarrhythmogenic effect is present at early recovery phase (1 minute) after maxial treadmill exercise in healthy airlines pilots.