RESUMEN
Beyond statin therapy for reducing low density lipoprotein cholesterol (LDL-C), additional therapeutic strategies are required to achieve more optimal reduction in cardiovascular risk among diabetic patients with dyslipidemia. To evaluate the effects and the safety of combined treatment with omega-3 fatty acids and statin in dyslipidemic patients with type 2 diabetes, we conducted a randomized, open-label study in Korea. Patients with persistent hypertriglyceridemia (> or =200 mg/dL) while taking statin for at least 6 weeks were eligible. Fifty-one patients were randomized to receive either omega-3 fatty acid 4, 2 g, or no drug for 8 weeks while continuing statin therapy. After 8 weeks of treatment, the mean percentage change of low density lipoprotein (LDL) particle size and triglyceride (TG) level was greater in patients who were prescribed 4 g of omega-3 fatty acid with statin than in patients receiving statin monotherapy (2.8%+/-3.1% vs. 2.3%+/-3.6%, P=0.024; -41.0%+/-24.1% vs. -24.2%+/-31.9%, P=0.049). Coadministration of omega-3 fatty acids with statin increased LDL particle size and decreased TG level in dyslipidemic patients with type 2 diabetes. The therapy was well tolerated without significant adverse effects.
Asunto(s)
Humanos , Colesterol , LDL-Colesterol , Diabetes Mellitus Tipo 2 , Dislipidemias , Ácidos Grasos Omega-3 , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Hipertrigliceridemia , Corea (Geográfico) , Lipoproteínas , Tamaño de la PartículaRESUMEN
From a young age, males are at higher cardiovascular risk than females. Dyslipidemia, including a higher burden related to small low-density lipoproteins (LDL), plays an important role in precipitating atherosclerosis in both males and females. We investigated sex differences in atherogenic lipoprotein burden and the independent predictors of LDL particle size in children and adolescents. We measured the concentrations of total testosterone, sex hormone-binding globulin, estradiol, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, and LDL particle size in 135 children and adolescents (67 boys, 68 girls). The free androgen index was significantly and negatively correlated with LDL particle size (r = -0.273, P = 0.026) in boys, but estrogen and LDL particle size were not related. In a stepwise multiple regression analysis adjusted for body mass index, age, and homeostasis model assessment for insulin resistance, free androgen index was still an independent predictor of LDL particle size in boys (R2 = 0.075, P = 0.026). The prominent decrease in LDL particle size along with increased testosterone concentrations in males might explain why they are more likely to display atherogenic dyslipidemia from adolescence.
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Adolescente , Femenino , Humanos , Masculino , Factores de Edad , Aterosclerosis/sangre , Índice de Masa Corporal , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estradiol/sangre , Lipoproteínas LDL/sangre , Tamaño de la Partícula , Pubertad/sangre , Análisis de Regresión , Riesgo , Factores Sexuales , Globulina de Unión a Hormona Sexual/análisis , Testosterona/sangre , Triglicéridos/sangreRESUMEN
BACKGROUND: Previous studies showed 'treatment gap' phenomenon in the treatment of hyperlipidemia, meaning failure to adhere to the recommendation in the treatment guideline. In Korea, systematic research on this issue has never been done. This investigation was to estimate the hypercholesterolemia treatment gap in coronary artery disease (CAD) patients in tertiary care centers according to NCEP ATP-III guideline. METHODS: Ten Korean educational hospital participated in the survey, reviewing medical record of 1,048 patients. Patients were enrolled when they were documented as having coronary artery disease by coronary angiography or stress tests or medical history of myocardial infarction, percutaneous coronary intervention or bypass surgery. Thirty or more medical records per each of 3 or more cardiologists were reviewed in each hospital. Sampling was done sequentially based on outpatient or inpatient list. Pharmacological treatment for hyperlipidemia included the first and last records of prescription. Baseline and the most recent lipid profiles were collected. RESULTS: Findings from the survey was summarized as '10 to 50% rule': 10%: mean LDL-cholesterol reduction without lipid-lowering drug, 20%: LDL-cholesterol level at the treatment goal before any treatment, 30%: mean LDL-cholesterol reduction with lipid-lowering drug treatment, 40%: proportion of CAD patients without lipid-lowering drug, 50%: treatment goal achievement after treatment. CONCLUSIONS: Significant treatment gap exists in Korean cardiology practice in tertiary care centers. Systematic approach to reduce this gap is warranted.
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Humanos , Cardiología , Angiografía Coronaria , Enfermedad de la Arteria Coronaria , Vasos Coronarios , Prueba de Esfuerzo , Adhesión a Directriz , Hipercolesterolemia , Hiperlipidemias , Pacientes Internos , Corea (Geográfico) , Registros Médicos , Infarto del Miocardio , Pacientes Ambulatorios , Intervención Coronaria Percutánea , Prescripciones , Centros de Atención TerciariaRESUMEN
A myriad of the retrospective studies have shown the benefit of hormone replacement therapy (HRT) on cardiovascular disease. It has been consistently shown that estrogen decreases total and LDL cholesterol, but increases the HDL cholesterol, resulting in a favorable cardiovascular outcome. In addition, it has been reported that estrogen has a beneficial role toward vascular function. The benefit of HRT on cardiovascular disease did not become a matter for suspicion or skepticism until the arrival of primary and secondary prevention clinical trial data. A large body of evidence from secondary prevention trials, such as HERS, EVA and WAVE, revealed that HRT has no beneficial effect at all toward cardiovascular disease protection; conversely, it was revealed to even be harmful. HRT increased the risk of CHD, DVT and strokes, as well as of cancers in postmenopausal women with CHD, with the worst evidence coming from a primary prevention trial. The Women's Health Initiative (WHI) study, the largest of the HRT trials, revealed the same findings as those of secondary prevention trials. In this trial, HRT significantly increased the risks of CHD, DVT, strokes and cancers, further confirming the previous findings. The lack of benefit of HRT in those trials can not be explained by the beneficial influence of HRT on the lipid profile and vascular function. Many researchers that still regard HRT as cardioprotective argue that the route, combination of drugs or even the dose of the drug administered would make differences. However, it is the increased VLDL synthesis and risk of thrombosis that make HRT harmful. HRT increase, VLDL synthesis that results in the generation of atherogenic small dense LDL and thrombus formation. In addition, HRT increases the risk of thrombosis by activating the coagulation pathway independently of VLDL synthesis. It has been reported that transdermal estrogen therapy does not increase VLDL synthesis or thrombus formation, being allegedly beneficial. However, it should not be forgotten that even the present data is not decisive and not confirmative for performing another new clinical trial of HRT being potentially harmful
Asunto(s)
Femenino , Humanos , Enfermedades Cardiovasculares , HDL-Colesterol , LDL-Colesterol , VLDL-Colesterol , Estrógenos , Actividad Extravehicular , Terapia de Reemplazo de Hormonas , Prevención Primaria , Estudios Retrospectivos , Prevención Secundaria , Accidente Cerebrovascular , Trombosis , Salud de la MujerRESUMEN
BACKGROUND AND OBJECTIVES: Cholesteryl ester transfer protein (CETP) plays a key role in the reverse cholesterol transport pathway. The purpose of this study was to investigate the association of CETP gene polymorphism with the plasma lipid levels and coronary artery disease (CAD) in Korean men. SUBJECTS AND METHODS: Two hundred and sixteen healthy control subjects (46.8+/-10.6 y) and 95 patients with CAD (58.2+/-8.8 y) were examined. The genotypes of C-629A, Taq1B and I405V were determined by the SNP-IT assay. RESULTS: The allele frequencies of the C:A in the C-629A, B1:B2 in the Taq1B and I:V in the I405V in the control group were 0.51:0.49, 0.63:0.37 and 0.55:0.45, respectively. The genotype distributions of the C-629 A and Taq1B polymorphisms in the CAD patients did not differ from those in the control group. No variation in the CETP genotype was associated with disease progression in the CAD group. The HDL cholesterol in -629A homozygous and Taq1B B2 homozygous were higher than those of the other genotypes. The Taq1B B2 carrier was an independent determinant for HDL cholesterol in the control group. However, I405V polymorphism was not associated with HDL cholesterol. The V allele in the I405V polymorphism was associated with reduced CAD events after controlling the age, BMI and other risk factors (OR:0.4, p<0.01). CONCLUSION: The frequencies of Taq1B and C-629A variants between the healthy and CAD groups did not differ. The B2 carrier in the Taq1B polymorphism was associated with a higher HDL cholesterol concentration. The V variation in the I405V polymorphism had a protective effect against the development of CAD in Korean men.
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Humanos , Masculino , Alelos , Colesterol , Proteínas de Transferencia de Ésteres de Colesterol , HDL-Colesterol , Enfermedad de la Arteria Coronaria , Enfermedad Coronaria , Vasos Coronarios , Progresión de la Enfermedad , Frecuencia de los Genes , Genotipo , Plasma , Factores de RiesgoRESUMEN
BACKGROUND AND OBJECT: Transradial percutaneous coronary intervention enables early ambulation and caused less complications at the puncture site. This study was performed to evaluate the safety of transradial coronary intervention with early discharge in selected patients. MATERIALS AND METHOD: Thirty patients were studied retrospectively. Twenty five patients had transradial percutaneous coronary intervention with next morning discharge and 5 patients had transradial percutaneous coronary intervention on an outpatient basis. Each patient was checked for cardiovascular complication and any other problems at the puncture site immediately after, 2 weeks after and 1 month after the procedure. RESULTS: This study group consisted of 30 patients with a mean age of 60+/-10 years. The indication for intervention were unstable angina (63.3%), stable angina (20.0%), and restenosis at 6-month follow-up after intervention. A total of 21 stents were implanted at 40 lesions. No major cardiovascular complication nor puncture site complication was reported at 1 month follow-up. CONCLUSION: Early discharge is supposed to be safe for those with optimal angiographic results and no clinical problems for at least 5 hours after intervention.
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Humanos , Angina Estable , Angina Inestable , Ambulación Precoz , Estudios de Seguimiento , Pacientes Ambulatorios , Intervención Coronaria Percutánea , Punciones , Arteria Radial , Estudios Retrospectivos , StentsRESUMEN
BACKGROUND: Hypertension, diabetes, hyperlipidemia and coronary heart disease are closely related to obesity. Recently incidence of such diseases are remarkably increased. Many researches have been done to find out to implement prevention and treatment of such diseases. Abdominal obesity is one of the most important contributing factors of metabolic complications. This study was done to compare indicators of obesity with abdominal fat amount which was measured by anthropometric parameters and computed tomogram, and to find correlation between the risk factors of atherosclerosis and the indicators of obesity. METHODS: Fifty nine healthy premenopausal women without diabetes, coronary heart disease or history of other chronic disease were enrolled. Blood pressure and simple anthropometric parameter were measured. Computed tomograms in umbilical and femoral regions were performed. From serial blood samples, plasma fasting glucose and insulin, cholesterol and triglyceride were measured and atherogenic index was calculated. RESULTS: The ratio of visceral fat area and skeletal muscle area at the mid-thigh level was found to be highly correlated(R=0.965, p<0.001) and atherogenic index showed similar patterns to the waist circumference, the waist/height ratio and the waist/hip ratio. Especially, the waist/height ratio was found to be the most reliable indicator of obesity to predict atherogenic index. CONCLUSION: Although the ratio of visceral fat and skeletal muscle areas at the mid-thigh level which is measured by computed tomogram was the best indicator of visceral fat, these results proved that waist circumference and the waist/height ratio were also good indicators of the risk factors of atherosclerosis. By simple anthropometric measurements, it can help to find the remedy and preventiono of obesity in primary practices.
Asunto(s)
Femenino , Humanos , Grasa Abdominal , Aterosclerosis , Presión Sanguínea , Colesterol , Enfermedad Crónica , Enfermedad Coronaria , Ayuno , Glucosa , Hiperlipidemias , Hipertensión , Incidencia , Insulina , Grasa Intraabdominal , Músculo Esquelético , Obesidad , Obesidad Abdominal , Plasma , Factores de Riesgo , Triglicéridos , Circunferencia de la CinturaRESUMEN
BACKGROUND AND OBJECTIVES: Thrombin and its interaction with platelets play a pivotal role in arterial thrombus formation. Hirudin, an anticoagulant agent derived from medicinal leeches(Hirudo medicinalis), is a unique and specific thrombin inhibitor with no effect on other serine protease. We investigated the inhibitory effect of hirudin on platelet deposition in a rabbit carotid artery eversion model of acute arterial thrombosis. MATERIALS AND METHODS: The everted arterial segments were perfused with 111 Indium-labeled human platelets only(control, n=8), and a mixed solution of 111 Indium-labeled human platelets and hirudin(30, 45, 60, 90 microgram/ml, n=3, respectively). Platelet deposition was calculated by a gamma-counter and confirmed by scanning electron microscopy. RESULTS: 1) Indium-111 labeling efficiency of platelets was 87.0+/-6.6%, and the aggregation of platelets was not changed after labeling. The number of platelets perfused through each arterial segment was 4.3 +/-0.2x10(8) platelets/ml. 2) The control group showed a platelet deposition rate of 23.9+/-7.0 % and a number of platelet deposition of 9.8+/-2.5x10(8) platelets/cm2 . 3) Platelet deposition of arteries perfused with hirudin(60 microgram/ml) was significantly decreased compared with that of the control group(2.9+/-0.6 vs 9.8+/-2.5x10(8)/cm2 , p<0.05). 4) The number of deposited platelets in hirudin-perfused arteries was dose-dependently decreased(30 microgram/ml:6.7+/-1.4x10(8) /cm2 , 45 microgram/ml: 4.8+/-1.7x10(8) /cm2 , 60 microgram/ml: 2.9+/-1.8x10(8)/cm2, 90 microgram/ml:2.9+/-1.4x10(8)/cm2: p<0.05 vs. control, respectively). 5) Scanning electron microscopic examination revealed significantly reduced platelet deposition in hirudin-perfused groups compared with control group. CONCLUSION: Hirudin inhibits effectively platelet deposition and arterial thrombus formation in a rabbit carotid artery eversion model. The antiplatelet effect of hirudin in this model suggests that hirudin may be an useful antithrombotic agent therapeutically useful in the prevention of acute arterial thrombus formation.
Asunto(s)
Humanos , Arterias , Plaquetas , Arterias Carótidas , Hirudinas , Microscopía Electrónica de Rastreo , Serina Proteasas , Trombina , TrombosisRESUMEN
Congenital coronary arteriovenous fistula is a rare condition which is an abnormal communication of the coronary artery with the right ventricle, right atrium, left atrium or left ventricle. Coronary artery aneurysm is an uncommon disease which is defined as coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. In young ages, symptoms are unusual, but significant symptoms and complications such as congestive heart failure, subacute bacterial endocarditis, coronary steal syndrome, aneurysm formation, rupture, and pulmonary hypertension may appear among the older age group. We report a case of giant aneurysm of a congenital coronary arteriovenous fistula between left co-ronary artery and right ventricular outflow tract with significant left to right shunt confirmed in a 84-year old female with a brief review of literature.
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Anciano de 80 o más Años , Femenino , Humanos , Aneurisma , Arterias , Fístula Arteriovenosa , Aneurisma Coronario , Vasos Coronarios , Dilatación , Endocarditis Bacteriana Subaguda , Atrios Cardíacos , Insuficiencia Cardíaca , Ventrículos Cardíacos , Hipertensión Pulmonar , RoturaRESUMEN
Malignant fibrous histiocytoma (MFH) of the heart is a very rare disease. It is difficult to distinguish from myxoma which is most common benign cardiac tumor. Prognosis of malignant fibrous histiocytoma (MFH) of the heart is known to be fatal despite of medical and surgical treatment in contrast to benign tumors. A primary myxoid malignant fibrous histiocytoma of the left atrium was diagnosed in a 58 years old woman. The mass was removed incompletely by operation. The patient did not receive either chemotherapy or radiotherapy. However, the patient is still alive for more than fifteen months after the initial presentation. We report a case of malignant fi brous histiocytoma (MFH) with reviewing the current references.
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Femenino , Humanos , Persona de Mediana Edad , Quimioterapia , Ecocardiografía , Atrios Cardíacos , Neoplasias Cardíacas , Corazón , Histiocitoma , Histiocitoma Fibroso Maligno , Mixoma , Pronóstico , Radioterapia , Enfermedades RarasRESUMEN
BACKGROUND AND OBJECTIVES: Insulin resistance is associated with hyperlipidemia. Recently, visceral fat adiposity is reported to be associated with insulin resistance and hyperlipidemia. We investigated insulin resistance and visceral fat adiposity in hyperlipidemic patients. MATERIALS AND METHOD: Hyperlipidemic group included 14 hyperlipidemic patients (total cholesterol > or = 220 mg/dl and triglyceride < or = 400 mg/dl) without hypertension, angina, impaired glucose tolerance and diabetes mellitus (DM). Control group included age, sex and body mass index (BMI) matched 25 healthy volunteers. We measured plasma lipid profiles and the insulin and glucose during the oral glucose tolerance test. We measured visceral fat area and abdominal subcutaneous fat area with computed tomography (CT). RESULTS: There were no differences of age, sex and BMI in both group. Total cholesterol, LDL cholesterol and triglyceride increased significantly in hyperlipidemic group. Fasting plasma glucose, insulin, area under curve (AUC) of the glucose and insulin and the Insulin / Glucose (IG) ratio increased significantly in hyperlipidemic group. Significant positive correlations were demonstrated between visceral fat area and the fasting plasma glucose, AUC of glucose and insulin at 120 minutes after glucose load. However, there was no difference in visceral fat area between both groups. After adjustment of visceral fat area, fasting plasma glucose, insulin, area under curve (AUC) of the glucose and insulin and the Insulin / Glucose (IG) ratio still remained increased significantly in hyperlipidemic group. CONCLUSION: We observed significantly increased insulin resistance in hyperlipidemic group. There was partial relationship between visceral fat area and the glucose and insulin profile. However, we did not find increased visceral fat area in hyperlipidemic group.
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Humanos , Adiposidad , Área Bajo la Curva , Glucemia , Índice de Masa Corporal , Colesterol , LDL-Colesterol , Diabetes Mellitus , Ayuno , Glucosa , Prueba de Tolerancia a la Glucosa , Voluntarios Sanos , Hiperlipidemias , Hipertensión , Resistencia a la Insulina , Insulina , Grasa Intraabdominal , Obesidad , Plasma , Grasa Subcutánea Abdominal , TriglicéridosRESUMEN
Aortic saddle embolus accounts for approximately 10% of all peripheral arterial emboli. The most common sources of emboli are left atrial thrombi associated with atrial fibrillation and vegetation. A 22-year-old male patient was admitted due to acute onset of orthopnea, tachypea and cough. Transthoracic and transeophageal echocardiography showed huge vegetation (3X2cm) of the posterior mitral valve leaflet which was associated with severe mitral regurgitation. On 14th hospital day, he suffered from sudden onset of weakness, pain, and coldness on both lower extremities. Follow-up echocardiography showed marked size reduction of the original mitral valve vegetation. Angiography showed aortic saddle embolus. The embolectomy of aortic saddle embolus was performed through the transfemoral approach with a Forgarty catheter. At the same time, removal of the infected mitral valve and mitral valve replacement were performed.
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Humanos , Masculino , Adulto Joven , Angiografía , Fibrilación Atrial , Catéteres , Tos , Ecocardiografía , Embolectomía , Embolia , Estudios de Seguimiento , Extremidad Inferior , Insuficiencia de la Válvula Mitral , Válvula MitralRESUMEN
Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
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Biopsia , Edema , Eosinofilia , Eosinófilos , Corazón , Síndrome Hipereosinofílico , Mortalidad , Miocarditis , Sistema Nervioso , TrombosisRESUMEN
Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
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Biopsia , Edema , Eosinofilia , Eosinófilos , Corazón , Síndrome Hipereosinofílico , Mortalidad , Miocarditis , Sistema Nervioso , TrombosisRESUMEN
The pathophysiology, clinical presentation and prognosis of left ventricular obstruction present an important cardiological problem. Various anatomical and functional abnormality can cause this phenomenon. Rarely, left ventricular outflow obstruction can result after mitral valve surgery. We experienced a case of left ventricular outflow obdtruction 13 years after mitral valve replavement. The diagnosis was made using two-dimensinal Doppler echocardiography and confirmed by cardiac catheterization. The pressure gradient across the left ventricular outflow obstruction was 96mmHg. A second mitral valve replacement was performed. Because severe fibrosis, pannis around the prosthetic mitral valve and a subaortic web were detected during the operation, the subaortic web was removes.
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Cateterismo Cardíaco , Catéteres Cardíacos , Diagnóstico , Ecocardiografía Doppler , Fibrosis , Válvula Mitral , Pronóstico , Obstrucción del Flujo Ventricular ExternoRESUMEN
BACKGROUND: Left ventricular hypertrophy is one of the major cardiovascular risk factors. So it is generally thought to be a predictor of complication and prognosis of hypertension. The 24-hour noninvasive ambulatory blood pressure monitoring (ABP) has been shown to be superior to office BP inpredicting target organ involvement in patients with hypertension and assessing antihypertensivve therapy. To determine the correlation between blood pressure and left ventricular hypertrophy in patients with newly diaggnosed systemic hypertension, we evaluate blood pressure by 24-hour ABP, office BP and echocardiiographic parameters of left ventricular hypertrophy. METHODS: From january 1995 to September 1995, in 22 patients with untreated essential hypertension who were diagnosed recently (within 1 month). They were studied by 24-hour noninvasive ambulatory blood pressure monitoring and cross sectional, M-mode and pulsed Doppler echocardiography for examining the relation between ABP and echocardiographic parameters. In the present study, we divided the oatuebts by two groups; white-coat hypertensive group and sustained hypertensive group. RESULTS: 1) Among the 22 patients who were diagnosed by office blood pressure, the white-coat hypertension was in 7 cases (31.8%) and sustained hypertension was 15 cases (68.2%). 2) In sustained hypertensive group, LV mass, LV mass index and relative posterior septal wall thickness were significantly increased compared with white-cost hypertensive group. 3) 24-hour ABP and systolic BP and loading % were significantly correlated with relative posterior septal wall thickness (p<0.05). CONCLUSION: In patients with newly diagnosed hypertension (especially with sustained hypertension), there was left ventricular hypertrophy expressed by increasing of LV mass, LV mass index, and relative posterior septal wall thickness. And, there were close correlation between 24-hour ABP monitoring-especially systolic BP and loading % of systolic BP and LVH.
Asunto(s)
Humanos , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Ecocardiografía , Ecocardiografía Doppler de Pulso , Hipertensión , Hipertrofia Ventricular Izquierda , Pronóstico , Factores de RiesgoRESUMEN
BACKGROUND: Left ventricular hypertrophy is major cardiovascular risk factor for sudden death, acute myocardial infarction and congestive heart failure. Antihypertensive treatment able to normalize blood pressure and regression of left ventricular mass would also favorabley affect coronary flow reserve and cardiovascular mortality. OBJECT: This study was designed to explore changes of left venrtricular mass, echocardiographic datas such as interventricular septal thickness in diastole, posterior wall thickness in diastole, left ventricular end diastolic dimension, relative wall thickness, mainmorphologic change of LV, and diastolic function after antihypertensive treatment. METHODS: From May 1988 to Agust 1997, in 41 patients(14 men, 27 women) with estaiblished essential hypertension aged 35 to 78(mean 56+/-13) year were studied. We obtained the basal echocardiography and follow up echocardiography after treatment. RESULT: The results were as followings: 1) Baseline blood pressure was 157/92mmHg and fell to 137/81mmHg(p<0.001), and LV mass were reduced from 133.9g/mg2 to 132.9g/m2 without statistical significance. 2) Most of the patients(48.8%) were remained increased LV mass and only 12% of the patients were revert to normal LV mass. 3) Most of the patients remained same LV morphology after antihypertensive treatment. 4) Normalization of LV diastolic dysfunction was not observed after antihypertensive treatment. CONCLUSION: Most of the patients were remained increased LV mass, same morphology, and relaxation abnormality of LV after antihypertensive treatments. For analysis of our result, follow up studies are needed about regression of LV mass, remodeling of LV, diastolic function after antihypertensive treatment.
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Humanos , Masculino , Presión Sanguínea , Muerte Súbita , Diástole , Ecocardiografía , Estudios de Seguimiento , Insuficiencia Cardíaca , Hipertensión , Hipertrofia Ventricular Izquierda , Mortalidad , Infarto del Miocardio , Relajación , Factores de RiesgoRESUMEN
Dermatomyositis is a disease of unknown etiology characterized by inflammation and degeneration of skeletal muscles and cutaneous abnormalities. Cardiac involvement in dermatomyositis-polymyositis is thought to be rare. In recent year, however, there has been an increasing number of reports on cardiac abnormalities in adult dermatomyositis and polymyositis due to development of noninvasive diagnostic techniques. Categorically, these abnormalities have included electrocardiographic changes, cardiac arrhythmias, congestive heart failure, coronary artery disease, and pericarditis. A 56-year-old woman was admittied to the Ewha womans University Hospital with dyspnea and palpitation. She was diagnosed as having dermatomyositis and followed up our department of Dermatology. Electrocardiogram showed a paroxysmal supraventricular tachycardia at as rate of 195/min. The patient was treated with 240mg/day verapamil p.o, 60mg/day prednisone p.o, there was marked improvement of symptoms. Systematic study of cardiac function utilizing echocardiography, Holter monitoring, thallium-201-scan, and gated blood pool studies were conducted in five newly diagnosed patients with dematomyositis-polymyositis. A significant elevation of serum CPK-MB is indicative of cardiac involvement. Cardiac involvement is a serious prognostic sign. We report a case with the review of the literature.