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1.
Journal of Stroke ; : 113-123, 2021.
Article in English | WPRIM | ID: wpr-874951

ABSTRACT

Background@#and Purpose To evaluate the outcome events and bleeding complications of the European Society of Cardiology (ESC) guideline-matched oral anticoagulant therapy for patients with acute ischemic stroke and atrial fibrillation (AF). @*Methods@#Patients with acute ischemic stroke and AF from a nationwide multicenter registry (Korean ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts [K-ATTENTION]) between January 2013 and December 2015 were included in the study. Patients were divided into the ESC guideline-matched and the non-matched groups. The primary outcome was recurrence of any stroke during the 90-day follow-up period. Secondary outcomes were major adverse cerebrovascular and cardiovascular events, ischemic stroke, intracranial hemorrhage, acute coronary syndrome, allcause mortality, and major hemorrhage. Propensity score matching and logistic regression analyses were performed to assess the effect of the treatments administered. @*Results@#Among 2,321 eligible patients, 1,126 patients were 1:1 matched to the ESC guidelinematched and the non-matched groups. As compared with the non-matched group, the ESC guideline-matched group had a lower risk of any recurrent stroke (1.4% vs. 3.4%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.18 to 0.95). The risk of recurrent ischemic stroke was lower in the ESC guideline-matched group than in the non-matched group (0.9% vs. 2.7%; OR, 0.32; 95% CI, 0.11 to 0.88). There was no significant difference in the other secondary outcomes between the two groups. @*Conclusions@#ESC guideline-matched oral anticoagulant therapy was associated with reduced risks of any stroke and ischemic stroke as compared with the non-matched therapy.

2.
Article in English | WPRIM | ID: wpr-764361

ABSTRACT

BACKGROUND AND PURPOSE: The clinical implications of echocardiography findings for long-term outcomes in atrial fibrillation (AF)-related stroke patients are unknown. METHODS: This was a substudy of the Korean ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts (K-ATTENTION), which is a multicenter-based cohort comprising prospective stroke registries from 11 tertiary centers. Stroke survivors who underwent two-dimensional transthoracic echocardiography during hospitalization were enrolled. Echocardiography markers included the left-ventricle (LV) ejection fraction (LVEF), the left atrium diameter, and the ratio of the peak transmitral filling velocity to the mean mitral annular velocity during early diastole (E/e′ ratio). LVEF was categorized into normal (≥55%), mildly decreased (>40% and <55%), and severely decreased (≤40%). The E/e′ ratio associated with the LV filling pressure was categorized into normal (<8), borderline (≥8 and <15), and elevated (≥15). Kaplan-Meier and Cox regression analyses were performed for recurrent stroke, major adverse cardiac events, and all-cause death. RESULTS: This study finally included 1,947 patients. Over a median follow-up of 1.65 years (interquartile range, 0.42–2.87 years), the rates of recurrent stroke, major adverse cardiac events, and all-cause death were 35.1, 10.8, and 69.6 cases per 1,000 person-years, respectively. Multivariable analyses demonstrated that severely decreased LVEF was associated with a higher risks of major adverse cardiac events [hazard ratio (HR), 3.91; 95% confidence interval (CI), 1.58–9.69] and all-cause death (HR, 1.95; 95% CI, 1.23–3.10). The multivariable fractional polynomial plot indicated that recurrent stroke might be associated with a lower LVEF. CONCLUSIONS: Severe LV systolic dysfunction could be a determinant of long-term outcomes in AF-related stroke.


Subject(s)
Atrial Fibrillation , Cohort Studies , Diastole , Echocardiography , Follow-Up Studies , Heart Atria , Hospitalization , Humans , Prospective Studies , Registries , Stroke , Survivors
3.
Article in English | WPRIM | ID: wpr-67124

ABSTRACT

Fulminant hepatic failure (FHF) is often accompanied by a myriad of neurologic complications, which are associated with high morbidity and mortality. Although appropriate neuromonitoring is recommended for early diagnosis and to minimize secondary brain injury, individuals with FHF usually have a high chance of coagulopathy, which limits the ability to use invasive neuromonitoring. Jugular bulb venous oxygen saturation (JvO₂) monitoring is well known as a surrogate direct measures of global brain oxygen use. We report the case of a patient with increased intracranial pressure due to FHF, in which JvO₂ was used for appropriate brain oxygen monitoring.


Subject(s)
Brain Edema , Brain Injuries , Brain , Early Diagnosis , Hepatic Encephalopathy , Humans , Intracranial Pressure , Jugular Veins , Liver Failure, Acute , Mortality , Oxygen Consumption , Oxygen
4.
Article in English | WPRIM | ID: wpr-770945

ABSTRACT

Fulminant hepatic failure (FHF) is often accompanied by a myriad of neurologic complications, which are associated with high morbidity and mortality. Although appropriate neuromonitoring is recommended for early diagnosis and to minimize secondary brain injury, individuals with FHF usually have a high chance of coagulopathy, which limits the ability to use invasive neuromonitoring. Jugular bulb venous oxygen saturation (JvO₂) monitoring is well known as a surrogate direct measures of global brain oxygen use. We report the case of a patient with increased intracranial pressure due to FHF, in which JvO₂ was used for appropriate brain oxygen monitoring.


Subject(s)
Brain Edema , Brain Injuries , Brain , Early Diagnosis , Hepatic Encephalopathy , Humans , Intracranial Pressure , Jugular Veins , Liver Failure, Acute , Mortality , Oxygen Consumption , Oxygen
5.
Journal of Stroke ; : 199-209, 2015.
Article in English | WPRIM | ID: wpr-24741

ABSTRACT

BACKGROUND AND PURPOSE: Thrombolysis is underused in acute ischemic stroke, mainly due to the reluctance of physicians to treat thrombolysis patients. However, a computerized clinical decision support system can help physicians to develop individualized stroke treatments. METHODS: A consecutive series of 958 patients, hospitalized within 12 hours of ischemic stroke onset from a representative clinical center in Korea, was used to establish a prognostic model. Multivariable logistic regression was used to develop the model for global and safety outcomes. An external validation of developed model was performed using 954 patients data obtained from 5 university hospitals or regional stroke centers. RESULTS: Final global outcome predictors were age; previous modified Rankin scale score; initial National Institutes of Health Stroke Scale (NIHSS) score; previous stroke; diabetes; prior use of antiplatelet treatment, antihypertensive drugs, and statins; lacunae; thrombolysis; onset to treatment time; and systolic blood pressure. Final safety outcome predictors were age, initial NIHSS score, thrombolysis, onset to treatment time, systolic blood pressure, and glucose level. The discriminative ability of the prognostic model showed a C-statistic of 0.89 and 0.84 for the global and safety outcomes, respectively. Internal and external validation showed similar C-statistic results. After updating the model, calibration slopes were corrected from 0.68 to 1.0 and from 0.96 to 1.0 for the global and safety outcome models, respectively. CONCLUSIONS: A novel computerized outcome prediction model for thrombolysis after ischemic stroke was developed using large amounts of clinical information. After external validation and updating, the model's performance was deemed clinically satisfactory.


Subject(s)
Antihypertensive Agents , Blood Pressure , Calibration , Glucose , Hospitals, University , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Korea , Logistic Models , Stroke
6.
Journal of Stroke ; : 144-152, 2013.
Article in English | WPRIM | ID: wpr-206668

ABSTRACT

Stroke associated with non-valvular atrial fibrillation (NVAF) is one of the most important subtypes of ischemic stroke, and its importance is becoming even more apparent in an aging population. To assess the risk of stroke associated with NVAF, the CHADS2 and CHA2DS2-VASc scores are mainly used. Such scores can be used to predict the recurrence and prognosis of ischemic stroke. In addition, new oral anticoagulants (NOACs) and devices are being evaluated in the prevention of stroke associated with NVAF in addition to treatment with the conventional oral anticoagulant, warfarin. Since clinical experience with NOACs is not globally sufficient, a cautious approach is needed.


Subject(s)
Aging , Anticoagulants , Atrial Fibrillation , Prognosis , Recurrence , Stroke , Warfarin
7.
Article in English | WPRIM | ID: wpr-12707

ABSTRACT

BACKGROUND AND PURPOSE: The CHADS2 (an acronym for congestive heart failure, hypertension, age > or =75 years, diabetes mellitus, and prior stroke or transient ischemic attack or thromboembolism) score is a widely used system for estimating the risk of stroke in patients with atrial fibrillation. However, how the CHADS2 score is related to stroke severity and outcome in patients with strokes due to atrial fibrillation has not yet been elucidated. METHODS: We enrolled patients with atrial fibrillation who visited our stroke center within 7 days after the onset of acute ischemic stroke between October 2002 and September 2008. CHADS2 scores were categorized into three groups: 0 points, low risk; 1 or 2 points, intermediate risk; and 3-6 points, high risk. Poor neurological state was defined as follows: a National Institutes of Health Stroke Scale (NIHSS) score of > or =2, and a modified Rankin Scale (mRS) score of > or =3 at discharge. Mortality information was ascertained as at December 2008. RESULTS: A cohort of 298 patients with atrial-fibrillation-related stroke was included in this study. A high-risk CHADS2 score at admission was a powerful predictor of poor neurological outcome [for NIHSS: odds ratio (OR), 4.17; 95% confidence interval (CI), 1.76-9.87; for mRS: OR, 2.97; 95% CI, 1.23-7.16] after controlling for all possible confounders. In addition, a high-risk CHADS2 score was an independent predictor of all causes of death during the follow-up [hazard ratio (HR), 3.01; 95% CI, 1.18-7.65] and vascular death (HR, 12.25; 95% CI, 1.50-99.90). CONCLUSIONS: Although the CHADS2 score was originally designed to distinguish patients with a future risk of stroke, our study shows that it may also be used to predict poor neurological outcome after atrial-fibrillation-related stroke.


Subject(s)
Atrial Fibrillation , Cause of Death , Cohort Studies , Diabetes Mellitus , Follow-Up Studies , Heart Failure , Humans , Hypertension , Ischemic Attack, Transient , Odds Ratio , Stroke
8.
Article in English | WPRIM | ID: wpr-12706

ABSTRACT

BACKGROUND AND PURPOSE: The vertebral artery (VA) is important for the development of the transverse foramen (TF). Most studies of these structures have focused on anatomical anomalies. Therefore, we investigated quantitatively the association between the relative sizes of the TF and VA. METHODS: We recruited a consecutive series of subjects who underwent CT angiography to estimate the relative sizes of the VA and TF in axial source images. Two neurologists independently reviewed the axial CT images of 208 patients who had no history of transient ischemic attack or stroke. Averaged areas of the VA and TF were defined by the sum of the areas at each level from C3 to C6, divided by 4. Correlation analyses were adjusted for age, sex, and vascular risk factors. RESULTS: The mean age of the subjects was 53 years. The interobserver and intraobserver reliabilities of TF size were good. There was a linear relationship between the sizes of the VA and TF on each side (right side: r2=0.58, p<0.001; left side: r2=0.62, p<0.001). The area of the VA was significantly associated with that of the TF after adjusting for vascular risk factors. CONCLUSIONS: The size of the VA is strongly and linearly correlated with the size of the TF. These findings suggest that measurement of the TF and VA with CT angiography is a reliable method for evaluating VA diseases, and may provide new insight into the differentiation between VA hypoplasia and atherosclerosis of the VA.


Subject(s)
Angiography , Atherosclerosis , Humans , Ischemic Attack, Transient , Stroke , Vertebral Artery
9.
Article in English | WPRIM | ID: wpr-82459

ABSTRACT

BACKGROUND: Carotid cavernous fistula (CCF) is an abnormal communication between the carotid artery and the cavernous sinus. The pathogenesis of spontaneous CCF remains unclear, although sinus thrombosis is known to be a predisposing factor for dural arteriovenous fistula. Because spontaneous CCFs are mainly of the dural type, we considered that thrombogenic conditions, such as, protein S deficiency might be associated with CCF. CASE REPORT: A 42-year-old woman complained of conjunctival injection and retro-orbital pain that first appeared 1-month before visiting our hospital. She had no history of head trauma or intracranial surgery. Exophthalmos and chemosis were observed in her left eye, which also had lower visual acuity and higher intraocular pressure than the right eye. Magnetic resonance images and cerebral angiography revealed a left dural CCF. Her protein S was low, at 41% (normal range: 70-140%), but other hematologic values related to coagulation were normal. Her symptoms were relieved after initial transvenous coil embolization. However, a newly developed sixth-nerve palsy was detected 4 days after initial embolization. Follow-up angiography revealed a minimal shunt, and thus transvenous coil embolization was repeated. Two days later, the ophthalmoplegia started reducing, and 1-month later it had almost disappeared. CONCLUSIONS: To the best of our knowledge, this is the first report of spontaneous dural CCF in a Korean patient with concurrent protein S deficiency. Interestingly, transient sixth-nerve palsy developed after transvenous coil embolization in this patient. This additional symptom caused by the residual fistula was relieved after additional transarterial embolization.


Subject(s)
Adult , Angiography , Carotid Arteries , Cavernous Sinus , Caves , Central Nervous System Vascular Malformations , Cerebral Angiography , Craniocerebral Trauma , Exophthalmos , Eye , Female , Fistula , Follow-Up Studies , Humans , Intraocular Pressure , Magnetic Resonance Spectroscopy , Ophthalmoplegia , Paralysis , Protein S , Protein S Deficiency , Sinus Thrombosis, Intracranial , Visual Acuity
10.
Article in Korean | WPRIM | ID: wpr-217005

ABSTRACT

BACKGROUND: Connexin 43-mediated gap junctional communication plays an important role in atherosclerosis. Numerous studies have demonstrated a correlation between mitral valve annular calcification and atherosclerotic disease. However, the relevance of connexin 43 to mitral valve disease remains unclear. We hypothesized that the mechanism contributing to mitral valve disease is associated with alterations in cell-to-cell communication mediated by changes in Connexin 43 expression. MATERIAL AND METHOD: Twenty male New Zealand rabbits were divided into two groups: animals in group 1 (n=10) were fed a normal chow diet, whilst those in group 2 (n=10) received a diet containing 1% cholesterol for 12 weeks. After sacrificing the animals, the mitral valves were excised and analyzed with immunohistochemical staining and Real-time Reverse Transcriptase polymerase chain reaction (real time RT-PCR). RESULT: Myofibroblasts and macrophages were found concentrated within the endothelial layer on the ventricular side of the leaflet in the cholesterol diet group. Immunohistochemial staining showed elevated expression of connexin43 in the cholesterol diet group. Real-time RT-PCR revealed increased connexin43 mRNA levels in mitral valves from hypercholesterolemic animals. CONCLUSION: Our finding that connexin43 expression is increased in mitral valves of hypercholesterolemic rabbits suggests that alterations in cell-to-cell communication via connexin43 containing gap junctions play a role in the development of mitral valve disease in hypercholesterolemia.


Subject(s)
Animals , Atherosclerosis , Cholesterol , Connexin 43 , Diet , Gap Junctions , Humans , Hypercholesterolemia , Macrophages , Male , Mitral Valve , Myofibroblasts , Rabbits , Reverse Transcriptase Polymerase Chain Reaction , RNA, Messenger , Up-Regulation
11.
Article in Korean | WPRIM | ID: wpr-85643

ABSTRACT

BACKGROUND: Postoperative atrial fibrillation (AF) is a common complication after coronary artery bypass graft (CABG) surgery. Although postoperative AF is regarded as benign, transient and self-limited, it has been associated with increased morbidity, thromboembolic events and an increased duration and cost of hospitalization. MATERIAL AND METHOD: From January 1994 to December 2007, 190 patients that had isolated CABG surgery were divided into two groups. Group 1 (n=139) involved those who had postoperative atrial fibrillation, and group 2 (n=51) did not have any such events. We reviewed the medical records retrospectively including the incidence of postoperative AF, patient characteristics, surgery related factors and the outcome of the patients with postoperative AF. RESULT: The frequency of postoperative AF was 26.8%, the conversion rate to regular sinus rhythm before discharge was 82.4%; 82.4% of the AF developed within the first three postoperative days. Although the postoperative AF group was significantly older and had a prolonged postoperative Intensive care unit (ICU) stay, there was no difference in the aortic crossclamp time or duration of hospitalization. No spontaneous defibrillation at declamping, and longer duration of cardiopulmonary bypass were significantly related to the development of postoperative AF. However, postoperative treatment with a beta blocker was associated with a decreased incidence of postoperative AF. The multivariate analysis showed that age and ICU stay were significantly associated with the development of POAF. Spontaneous defibrillation and postoperative beta blocker treatment were significantly associated with a decreased frequency of POAF. CONCLUSION: AF after CABG surgery is a common complication associated with increased morbidity and a longer ICU stay. Therefore, various strategies aimed at reducing AF, and its complications, such as postoperative treatment with a beta blocker should be considered.


Subject(s)
Arrhythmias, Cardiac , Atrial Fibrillation , Cardiopulmonary Bypass , Coronary Artery Bypass , Coronary Vessels , Hospitalization , Humans , Incidence , Intensive Care Units , Medical Records , Multivariate Analysis , Retrospective Studies , Transplants
12.
Article in Korean | WPRIM | ID: wpr-85642

ABSTRACT

BACKGROUND: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. MATERIAL AND METHOD: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was 75.7+/-46.1 months. RESULT: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). CONCLUSION: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.


Subject(s)
Coronary Artery Bypass , Coronary Artery Disease , Coronary Vessels , Diabetes Mellitus , Follow-Up Studies , Humans , Hypertension , Korea , Mammary Arteries , Medical Records , Multivariate Analysis , Retrospective Studies , Risk Factors , Survival Analysis , Survival Rate , Ventricular Dysfunction, Left
13.
Article in Korean | WPRIM | ID: wpr-85635

ABSTRACT

BACKGROUND: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. MATERIAL AND METHOD: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. RESULT: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. CONCLUSION: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.


Subject(s)
Constriction, Pathologic , Follow-Up Studies , Humans , Logistic Models , Medical Records , Retrospective Studies , Silicones , Stents , Tracheal Stenosis , Tracheomalacia , Tracheostomy
14.
Article in Korean | WPRIM | ID: wpr-185549

ABSTRACT

We report herein a case of meningitis due to Streptococcus viridans that occurred after epidural nerve block. The low virulence of S. viridans resulted in milder clinical symptoms and signs than are usually observed for bacterial meningitis, thus mimicking viral meningitis. The infection may have originated from the oral cavity of the medical personnel, and so S. viridans infection should be included in the differential diagnosis of meningitis subsequent to spinal manipulation.


Subject(s)
Diagnosis, Differential , Manipulation, Spinal , Meningitis , Meningitis, Bacterial , Meningitis, Viral , Mouth , Nerve Block , Streptococcus , Viridans Streptococci
15.
Article in Korean | WPRIM | ID: wpr-26823

ABSTRACT

Paravalvular abscess is defined as infective necrosis of the mitral annulus and surrounding tissue that requires debridement of the necrotic tissue and patch reconstruction before valve implantation. Paravalvular abscess is associated with high operative mortality, postoperative complications, and recurrence. We report here a case of a 59-year old woman that had undergone mitral valvular replacement with a mechanical valve 13 years ago. The patient was determined to have paravalvular leakage due to paravalvular abscess as seen during follow-up. The patient underwent repeat mitral valvular replacement with annular reconstruction. However, the patient with mitral annular reconstruction and valvular replacement on the fifteenth postoperative day due to recurrence of paravalvular leakage. The patient is now receiving follow-up eight months after surgery.


Subject(s)
Abscess , Debridement , Endocarditis , Female , Follow-Up Studies , Humans , Mitral Valve , Necrosis , Postoperative Complications , Recurrence , Reoperation
16.
Article in Korean | WPRIM | ID: wpr-99824

ABSTRACT

BACKGROUND: Although aortic valve sclerosis causes no significant hemodynamic alterations, it is associated with an increased risk of cardiovascular death and myocardial infarction. However, the role of beta3 integrin in aortic valve sclerosis remains unclear. MATERIAL AND METHOD: Twenty male New Zealand rabbits were divided into two groups. Group 1 rabbits (n=10) received a normal chow diet, while group 2 (n=10) rabbits received a diet containing 1% cholesterol for 12 weeks. After the rabbits were euthanized, their aortic valves and ascending aortas were excised for analysis. RESULT: Total serum cholesterol (2,148.3+/-1,012.5 mg/dL versus 53.7+/-31.8 mg/dL, p<0.05), triglyceride (240.4+/-218.3 mg/dL versus 31.6+/-6.4 mg/dL, p<0.05), and low density lipoprotein (LDL)-cholesterol (2,065.3+/-960.9 mg/dL versus 29.1+/-30.9 mg/dL, p<0.05) levels were significantly higher in the cholesterol diet group compared with the normal diet group. Myofibroblasts and macrophages were more highly expressed in the aortic valve leaflets of rabbits in the cholesterol diet group than of those in the normal diet group. A real-time polymerase chain reaction revealed decreased beta3 integrin mRNA levels in the hypercholesterolemic aortic valves and aortas. CONCLUSION: The present study shows that hypercholesterolemia induces aortic valve sclerosis. These findings suggest that alterations in beta3 integrin may play a role in the development of aortic valve sclerosis.


Subject(s)
Aorta , Aortic Valve , Atherosclerosis , Cholesterol , Diet , Hemodynamics , Humans , Hypercholesterolemia , Integrin beta3 , Integrins , Lipoproteins , Macrophages , Male , Myocardial Infarction , Myofibroblasts , Rabbits , Real-Time Polymerase Chain Reaction , RNA, Messenger , Sclerosis
17.
Article in Korean | WPRIM | ID: wpr-119311

ABSTRACT

BACKGROUND: Although echocardiography is usually used for quantitative assessment of left ventricular function, the recently developed 16-slice multidetector computed tomography (MDCT) is not only capable of evaluating the coronary arteries but also left ventricular function. Therefore, the objective of our study was to compare the values of left ventricular function quantified by MDCT to those by echocardiography for evaluation of its regards to clinical applications. MATERIAL AND METHOD: From 49 patients who underwent MDCT in our hospital from November 1, 2003 to January 31, 2005, we enrolled 26 patients who underwent echocardiography during the same period for this study. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), left ventricular mass index (LVMI), and ejection fraction (EF) were analyzed. RESULT: Average LVEDVI (80.86+/-34.69 mL for MDCT vs 60.23+/-29.06 mL for Echocardiography, p<0.01), average LVESVI (37.96+/-24.52 mL for MDCT vs 25.68+/-16.57 mL for Echocardiography, p<0.01), average SVI (42.90+/-15.86 mL for MDCT vs 34.54+/-17.94 mL for Echocardiography, p<0.01), average LVMI (72.14+/-25.35 mL for MDCT vs 130.35+/-53.10 mL for Echocardiography, p<0.01), and average EF (55.63+/-12.91 mL for MDCT vs 59.95+/-12.75 mL for Echocardiography, p<0.05) showed significant difference between both groups. Average LVEDVI, average LVESVI, and average SVI were higher in MDCT, and average LVMI and average EF were higher in echocardiogram. Comparing correlation for each parameters between both groups, LVEDVI (r(2)=0.74, p<0.0001), LVESVI (r(2)=0.69, p<0.0001) and SVI (r(2)=0.55, p<0.0001) showed high relevance, LVMI (r(2)=0.84, p<0.0001) showed very high relevance, and EF (r(2)=0.45, p=0.0002) showed relatively high relevance. CONCLUSION: Quantitative assessment of left ventricular volume and function using 16-slice MDCT showed high relevance compared with echocardiography, therefore may be a feasible assessment method. However, because the average of each parameters showed significant difference, the absolute values between both studies may not be appropriate for clinical applications. Furthermore, considering the future development of MDCT, we expect to be able to easily evaluate the assessment of coronary artery stenosis along with left ventricular function in coronary artery disease patients.


Subject(s)
Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Echocardiography , Humans , Multidetector Computed Tomography , Stroke Volume , Ventricular Function, Left
18.
Article in English | WPRIM | ID: wpr-92868

ABSTRACT

The incidence of primary cardiac tumor is rare, furthermore the cardiac tumor which cause arrhythmia is very rare. We presesent a case of cardiac lipoma combined with paroxysmal atrial tachycardia.


Subject(s)
Incidence
19.
Article in Korean | WPRIM | ID: wpr-166022

ABSTRACT

Anomalous origin of right coronary artery from left sinus of valsalva is associated with sudden unexpected death, syncope, arrhythmia and myocardial ischemia. The mechanism that explains the restriction of coronary flow in the anomalous coronary artery is unclear but several surgical methods have been proposed, such as coronary artery bypass graft, coronary reimplantation, translocation of pulmonary artery, and unroofing procedure. We reported the surgical correction of the anomalous origin of right coronary artery from left sinus of valsalva between the aorta and pulmonary trunk using the unroofing procedure.


Subject(s)
Aorta , Arrhythmias, Cardiac , Coronary Artery Bypass , Coronary Vessels , Myocardial Ischemia , Pulmonary Artery , Replantation , Sinus of Valsalva , Syncope , Transplants
20.
Article in English | WPRIM | ID: wpr-166021

ABSTRACT

The quadricuspid aortic valve is a rare congenital cardiac morphology. In regard to the hemodynamics of the quadricuspid aortic valve, the regurgitation is most common, the regurgitation accompanying the stenosis or pure stenosis are rare. We report hear a case with quadricuspid aortic valve disease which has been known to be extremely rare.


Subject(s)
Aortic Valve , Constriction, Pathologic , Heart Defects, Congenital , Hemodynamics
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