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1.
Yonsei Medical Journal ; : 57-62, 2018.
Artículo en Inglés | WPRIM | ID: wpr-742504

RESUMEN

PURPOSE: Obesity is often associated with better clinical outcomes in heart failure (HF). This so-called obesity paradox remains controversial. The aim of present study was to investigate the prognostic value of obesity in patients hospitalized for systolic HF. MATERIALS AND METHODS: We performed a pooled analysis of data from two multicenter, observational HF studies. Patients hospitalized for systolic HF were eligible for the present study. We divided the subjects into two groups, a normal body mass index (BMI) group and a high BMI group. Study endpoints included all-cause mortality and any re-hospitalization within 1 year. RESULTS: We enrolled 3145 patients (male, 1824; female, 1321). The high BMI group was significantly associated with lower 1-year mortality rate [odds ratio (OR), 0.543; 95% confidence interval (CI), 0.355−0.832] after adjusting for age, hypertension, diabetes, ischemic HF, previous myocardial infarction, serum creatinine level, anemia, and ejection fraction in men. After adjustment for clinical characteristics, high BMI was not significantly associated with 1-year mortality (OR, 0.739; 95% CI, 0.450−1.216) or 1-year re-hospitalization (OR, 0.958; 95% CI, 0.696−1.319) in women. CONCLUSION: In pooled analysis of data from two Korean HF registries, the high BMI group was independently associated with lower 1-year mortality rate from systolic HF, especially in men.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Masa Corporal , Demografía , Determinación de Punto Final , Insuficiencia Cardíaca Sistólica/complicaciones , Insuficiencia Cardíaca Sistólica/epidemiología , Incidencia , Estimación de Kaplan-Meier , Obesidad/complicaciones , Obesidad/epidemiología , Caracteres Sexuales , Resultado del Tratamiento
2.
Gut and Liver ; : 555-561, 2018.
Artículo en Inglés | WPRIM | ID: wpr-716830

RESUMEN

BACKGROUND/AIMS: Acute hepatic dysfunction combined with alcoholic hepatitis (AH) in alcoholic cirrhosis is related to hepatic hypo-perfusion secondary to intrahepatic necroinflammation, neoangiogenesis, and shunt. The hepatic vein arrival time (HVAT) assessed by microbubble contrast-enhanced ultrasonography (CEUS) is closely correlated with the severity of intrahepatic changes. We investigated the usefulness of HVAT to predict short-term mortality of AH in cirrhosis. METHODS: Thirty-nine patients with alcoholic cirrhosis (27 males) and AH were prospectively enrolled. HVAT study was performed within 3 days after admission using ultrasonic contrast (SonoVue®). The primary outcome was 12-week mortality. RESULTS: Twelve-week mortality developed in nine patients. HVAT was significantly different between the mortality and survival groups (9.3±2.0 seconds vs 12.6±3.5 seconds, p=0.002). The odds ratio of a shortened HVAT for 12-week mortality was 1.481 (95% confidence interval, 1.050–2.090; p=0.025). The area under the receiver operating characteristic curve of HVAT for 12-week mortality was 0.787 (p=0.010). The combination of MDF and HVAT ≥11.0 seconds resulted in an 87.5% survival rate even if the MDF score ≥32; however, HVAT < 11.0 seconds was related with mortality despite a MDF score < 32. CONCLUSIONS: HVAT using microbubble CEUS could be a useful additional index to predict short-term mortality in patients with AH and cirrhosis.


Asunto(s)
Humanos , Alcohólicos , Fibrosis , Venas Hepáticas , Hepatitis Alcohólica , Cirrosis Hepática Alcohólica , Microburbujas , Mortalidad , Oportunidad Relativa , Proyectos Piloto , Pronóstico , Estudios Prospectivos , Curva ROC , Tasa de Supervivencia , Ultrasonido , Ultrasonografía
3.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 474-476, 2017.
Artículo en Inglés | WPRIM | ID: wpr-175179

RESUMEN

A 56-year-old woman, who underwent cardiac surgery 3 months previously, presented to the emergency room with pulmonary artery rupture due to the cytotoxic effects of BioGlue (CryoLife Inc., Kennesaw, GA, USA). She was successfully treated with surgical management. Although surgical glue can be effectively used for hemostasis, it can induce delayed vascular complications. Therefore, surgical glue should be used cautiously.


Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Adhesivos , Servicio de Urgencia en Hospital , Hemostasis , Arteria Pulmonar , Rotura , Cirugía Torácica
4.
Journal of Korean Medical Science ; : 153-159, 2012.
Artículo en Inglés | WPRIM | ID: wpr-156440

RESUMEN

There is no consensus as to which acute myocardial infarction subtype poses a greater risk after coronary artery bypass grafting (CABG). We compared the early and the long term results of off-pump coronary artery bypass grafting (OPCAB) between patients with STEMI (group I, n = 83), and NSTEMI (group II, n = 237). Group I had higher EuroSCORE, prevalence of emergency surgery, preoperative intra-aortic balloon pump use, preoperative emergency percutaneous transluminal coronary angioplasty, and preoperative thrombolytic use than group II. There were no significant differences in 30-day mortality and major adverse cardiac and cerebrovascular event (MACCE) between groups. Overall 8-yr survival was 93% and 87% in groups I and II, respectively. Freedom from MACCE after 8 yr was 92% and 93% in groups I and II, respectively. After propensity score matching analysis, there were no significant differences in preoperative parameters, postoperative in-hospital outcomes, and long-term clinical outcomes. Surgical results of OPCAB in patients with acute myocardial infarction show good results in terms of long-term survival and freedom from MACCE, with no significant differences in clinical outcomes between STEMI and NSTEMI groups.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Aguda , Angioplastia Coronaria con Balón , Puente de Arteria Coronaria Off-Pump , Supervivencia sin Enfermedad , Electrocardiografía , Fibrinolíticos/uso terapéutico , Infarto del Miocardio/tratamiento farmacológico , Oportunidad Relativa , Periodo Preoperatorio , Puntaje de Propensión
5.
Journal of Korean Medical Science ; : 444-446, 2011.
Artículo en Inglés | WPRIM | ID: wpr-52126

RESUMEN

Endovascular repair of inflammatory aortic aneurysms has been reported as an alternative to open surgical treatment. In selective cases, adjunctive bypass surgery may be required to provide an adequate landing zone. We report a case of endovascular repair of an inflammatory aortic aneurysm in a patient with Behcet's disease using a carotid-carotid bypass graft to provide an adequate landing zone. A 45-yr-old man with a voice change was referred to our hospital with the diagnosis of saccular aneurysm of the distal aortic arch resulting from vasculitis. Computed tomography showed a thoracic aortic aneurysm with thrombosis. Right to left carotid-carotid bypass grafting was performed. After 8 days, the patient underwent an endovascular stent graft placement distal to the origin of the innominate artery. The patient was discharged with medication and without postoperative complications after 5 days. Hybrid endovascular treatment may be suitable a complementary modality for repairing inflammatory aortic aneurysms.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Aneurisma de la Aorta Torácica/complicaciones , Síndrome de Behçet/complicaciones , Implantación de Prótesis Vascular/métodos , Arterias Carótidas/fisiopatología , Puente de Arteria Coronaria , Procedimientos Endovasculares , Stents , Trombosis/complicaciones , Tomógrafos Computarizados por Rayos X , Vasculitis/complicaciones
6.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 758-763, 2010.
Artículo en Coreano | WPRIM | ID: wpr-126394

RESUMEN

In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.


Asunto(s)
Rotura de la Aorta , Endofuga , Stents , Trasplantes , Insuficiencia del Tratamiento , Ursidae
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