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Jo SH, Kang SM, Yoo BS, Lee YS, Youn HJ, Min K, Yu JM, Yoon HJ, Kim WS, Kim GH, Park JH, Kim SY, Kim CH. A Prospective Randomized, Double-Blind, Multi-Center, Phase III Clinical Trial Evaluating the Efficacy and Safety of Olmesartan/Amlodipine plus Rosuvastatin Combination Treatment in Patients with Concomitant Hypertension and Dyslipidemia: A LEISURE Study. J Clin Med 2022; 11:jcm11020350. [PMID: 35054044 PMCID: PMC8779537 DOI: 10.3390/jcm11020350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/30/2021] [Accepted: 01/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study was a multicenter, randomized, double-blinded, placebo-controlled phase III clinical trial to investigate the efficacy and safety of an olmesartan/amlodipine single pill plus rosuvastatin combination treatment for patients with concomitant hypertension and dyslipidemia. METHODS Patients with both hypertension and dyslipidemia aged 20-80 were enrolled from 36 tertiary hospitals in Korea from January 2017 to April 2018. Patients were randomized to three groups in a 1:1:0.5 ratio, olmesartan/amlodipine single pill plus rosuvastatin (olme/amlo/rosu) or olmesartan plus rosuvastatin (olme/rosu) or olmesartan/amlodipine single pill (olme/amlo) combination. The primary endpoints were change of sitting systolic blood pressure (sitSBP) from baseline in the olme/amlo/rosu vs. olme/rosu groups and the percentage change of low-density lipoprotein cholesterol (LDL-C) from baseline in the olme/amlo/rosu vs. olme/amlo groups after 8 weeks of treatment. RESULTS A total of 265 patients were randomized, 106 to olme/amlo/rosu, 106 to olme/rosu and 53 to olme/amlo groups. Baseline characteristics among the three groups did not differ. The mean sitSBP change was significantly larger in the olme/amlo/rosu group with -24.30 ± 12.62 mmHg (from 153.58 ± 10.90 to 129.28 ± 13.58) as compared to the olme/rosu group, -9.72 ± 16.27 mmHg (from 153.71 ± 11.10 to 144.00 ± 18.44 mmHg). The difference in change of sitSBP between the two groups was -14.62± 1.98 mmHg with significance (95% CI -18.51 to -10.73, p < 0.0001). The mean LDL-C reduced significantly in the olme/amlo/rosu group, -52.31 ± 16.63% (from 154.52 ± 30.84 to 72.72 ± 26.08 mg/dL) as compared to the olme/amlo group with no change, -2.98 ± 16.16% (from 160.42 ± 32.05 to 153.81 ± 31.57 mg/dL). Significant difference in change was found in LDL-C between the two groups with -50.10 ± 2.73% (95% CI -55.49 to -44.71, p < 0.0001). Total adverse drug reaction rates were 10.48%, 5.66% and 3.7% in the olme/amlo/rosu, olme/rosu and olme/amlo groups, respectively with no statistical significance among the three groups. Serious adverse drug reactions did not occur. CONCLUSIONS Olmesartan/amlodipine single pill plus rosuvastatin combination treatment for patients with both hypertension and dyslipidemia is effective and safe as compared to either olmesartan plus rosuvastatin or olmesartan plus amlodipine treatment.
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Affiliation(s)
- Sang-Ho Jo
- Department of Internal Medicine, Division of Cardiology, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Seok Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Byung Su Yoo
- Department of Internal Medicine, Division of Cardiology, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea;
| | - Young Soo Lee
- Department of Internal Medicine, Division of Cardiology, Daegu Catholic University Medical Center, Daegu 42472, Korea;
| | - Ho Joong Youn
- Department of Internal Medicine, Division of Cardiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea;
| | - Kyungwan Min
- Nowon Eulji Medical Center, Department of Internal Medicine, Division of Endocrinology, Eulji University, Seoul 01830, Korea;
| | - Jae Myung Yu
- Department of Internal Medicine, Division of Endocrinology, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea;
| | - Hyun Ju Yoon
- Department of Internal Medicine, Division of Cardiology, Chonnam National University Hospital, Gwangju KS018, Korea;
| | - Woo Shik Kim
- Department of Cardiology, Kyunghee Medical Center, Seoul 02447, Korea;
| | - Gee Hee Kim
- Department of Internal Medicine, Division of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Jae Hyoung Park
- Department of Internal Medicine, Division of Cardiology, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Seok Yeon Kim
- Department of Internal Medicine, Division of Cardiology, Seoul Medical Center, Seoul 02053, Korea;
| | - Cheol Ho Kim
- Department of Internal Medicine, Division of Cardiology, Seoul National University Bundang Hospital, Seongnam 13620, Korea
- Correspondence: ; Tel.: +82-31-380-3722; Fax: +82-31-386-2269
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Cho Y, Cho SY, Oh IY, Lee JH, Park JJ, Lee HY, Kim KH, Yoo BS, Kang SM, Baek SH, Jeon ES, Kim JJ, Cho MC, Chae SC, Oh BH, Choi DJ. Implantable Cardioverter-defibrillator Utilization and Its Outcomes in Korea: Data from Korean Acute Heart Failure Registry. J Korean Med Sci 2020; 35:e397. [PMID: 33258331 PMCID: PMC7707927 DOI: 10.3346/jkms.2020.35.e397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/14/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There are sparse data on the utilization rate of implantable cardioverter-defibrillator (ICD) and its beneficial effects in Korean patients with heart failure with reduced left ventricular ejection fraction (LVEF). METHODS Among 5,625 acute heart failure (AHF) patients from 10 tertiary university hospitals across Korea, 485 patients with reassessed LVEF ≤ 35% at least 3 months after the index admission were enrolled in this study. The ICD implantation during the follow-up was evaluated. Mortality was compared between patients with ICDs and age-, sex-, and follow-up duration matched control patients. RESULTS Among 485 patients potentially indicated for an ICD for primary prevention, only 56 patients (11.5%) underwent ICD implantation during the follow-up. Patients with ICD showed a significantly lower all-cause mortality compared with their matched control population: adjusted hazard ratio (HR) (95% confidence interval [CI]) = 0.39 (0.16-0.92), P = 0.032. The mortality rate was still lower in the ICD group after excluding patients with cardiac resynchronization therapy (adjusted HR [95% CI] = 0.09 [0.01-0.63], P = 0.015). According to the subgroup analysis for ischemic heart failure, there was a significantly lower all-cause mortality in the ICD group than in the no-ICD group (HR [95% CI] = 0.20 [0.06-0.72], P = 0.013), with a borderline statistical significance (interaction P = 0.069). CONCLUSION Follow-up data of this large, multicenter registry suggests a significant under-utilization of ICD in Korean heart failure patients with reduced LVEF. Survival analysis implies that previously proven survival benefit of ICD in clinical trials could be extrapolated to Korean patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01389843.
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Affiliation(s)
- Youngjin Cho
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Yeong Cho
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Il Young Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hyun Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin Joo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hae Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kye Hun Kim
- Department of Internal Medicine, Heart Research Center, Chonnam National University, Gwangju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seok Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hong Baek
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Seok Jeon
- Department of Internal Medicine, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Jae Joong Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Byung Hee Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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Jin X, Kim MH, Han KH, Hong SJ, Ahn JC, Sung JH, Cho JM, Lee HC, Choi SY, Lee K, Kim WS, Rhee MY, Kim JH, Hong SP, Yoo BS, Cho EJ, Lee JH, Kim PJ, Park CG, Hyon MS, Shin JH, Lee SH, Sung KC, Hwang J, Kwon K, Chae IH, Seo JS, Kim H, Lee H, Cho Y, Kim HS. Efficacy and safety of co-administered telmisartan/amlodipine and rosuvastatin in subjects with hypertension and dyslipidemia. J Clin Hypertens (Greenwich) 2020; 22:1835-1845. [PMID: 32937023 PMCID: PMC7692919 DOI: 10.1111/jch.13893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/13/2022]
Abstract
Single risk factors, such as hypertension and dyslipidemia, can combine to exacerbate the development and severity of cardiovascular disease. Treatment goals may be more effectively achieved if multiple disease factors are targeted with combination treatment. We enrolled 202 patients who were randomly divided into the following three groups: telmisartan/amlodipine 80/5 mg + rosuvastatin 20 mg, telmisartan 80 mg + rosuvastatin 20 mg, and telmisartan/amlodipine 80/5 mg. The primary efficacy variables were changes from baseline in mean sitting systolic blood pressure (MSSBP) between telmisartan/amlodipine 80/5 mg + rosuvastatin 20 mg and telmisartan 80 mg + rosuvastatin 20 mg at 8 weeks, and the percent changes from baseline in low‐density lipoprotein (LDL) cholesterol between telmisartan/amlodipine 80/5 mg + rosuvastatin 20 mg and telmisartan/amlodipine 80/5 mg at 8 weeks. The secondary efficacy variables were changes in MSSBP, mean sitting diastolic blood pressure (MSDBP), LDL cholesterol and other lipid levels at 4 weeks and 8 weeks, as well as observed adverse events during follow‐up. There were no significant differences between the three groups in demographic characteristics and no significant difference among the three groups in terms of baseline characteristics for the validity evaluation variables. The mean overall treatment compliance in the three groups was, respectively, 98.42%, 96.68%, and 98.12%, indicating strong compliance for all patients. The Least‐Square (LS) mean (SE) for changes in MSSBP in the two (telmisartan/amlodipine 80/5 mg + rosuvastatin 20 mg and telmisartan 80 mg + rosuvastatin 20 mg) groups were −19.3 (2.68) mm Hg and −6.69 (2.76) mm Hg. The difference between the two groups was significant (−12.60 (2.77) mm Hg, 95% CI −18.06 to −7.14, P < .0001). The LS Mean for the percent changes from baseline in LDL cholesterol in the two (telmisartan/amlodipine 80/5 mg + rosuvastatin 20 mg and telmisartan/amlodipine 80/5 mg) groups were −52.45 (3.23) % and 2.68 (3.15) %. The difference between the two groups was significant (−55.13 (3.20) %, 95% CI −61.45 to −48.81, P < .0001). There were no adverse events leading to discontinuation or death. Combined administration of telmisartan/amlodipine 80/5 mg and rosuvastatin 20 mg for the treatment of hypertensive patients with dyslipidemia significantly reduces blood pressure and improves lipid control. ClinicalTrials.gov identifier: NCT03067688.
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Affiliation(s)
- Xuan Jin
- Department of Cardiology, Dong-A University Hospital, Busan, Korea
| | - Moo Hyun Kim
- Department of Cardiology, Dong-A University Hospital, Busan, Korea
| | - Ki Hoon Han
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Soon Jun Hong
- Division of Cardiology, Department of Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea
| | - Jeong-Cheon Ahn
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jung-Hoon Sung
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Jin-Man Cho
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Han Cheol Lee
- Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - So-Yeon Choi
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
| | - Kyounghoon Lee
- Division of Cardiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Woo-Shik Kim
- Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Moo-Yong Rhee
- Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Ju Han Kim
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Seung Pyo Hong
- Division of Cardiology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Eun Joo Cho
- Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae-Hwan Lee
- Department of Cardiology in Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Pum-Joon Kim
- Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chang-Gyu Park
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Min Su Hyon
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jin Ho Shin
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Hyun Lee
- Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ki Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Korea
| | - Jinyong Hwang
- Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea
| | - Kihwan Kwon
- Department of Cardiology, Ewha Womans University College of Medicine, Seoul, Korea
| | - In-Ho Chae
- Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Sook Seo
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyungseop Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hana Lee
- Yuhan Research Institute, Yuhan Corporation, Yongin, Korea
| | - Yoonhwa Cho
- Yuhan Research Institute, Yuhan Corporation, Yongin, Korea
| | - Hyo-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Ahn MS, Yoo BS, Son JW, Yu MH, Kang DR, Lee HY, Jeon ES, Kim JJ, Chae SC, Baek SH, Kang SM, Choi DJ, Kim KH, Cho MC, Kim SY. Beta-blocker Therapy at Discharge in Patients with Acute Heart Failure and Atrial Fibrillation. J Korean Med Sci 2020; 35:e278. [PMID: 32830467 PMCID: PMC7445305 DOI: 10.3346/jkms.2020.35.e278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 07/03/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND β-blockers (BBs) are considered primary therapy in stable heart failure (HF) with reduced ejection fraction (HFrEF) without atrial fibrillation (AF); evidence-based benefits of BB on outcome have been documented. However, BBs have not been shown to improve mortality or reduce hospital admissions in HF patients with AF. This study assessed the relationship between BBs at discharge and relevant clinical outcomes in acute heart failure (AHF) patients with AF. METHODS From the Korean Acute Heart Failure Registry, 936 HFrEF and 639 HF patients with preserved ejection fraction (HFpEF) and AF were selected. Propensity score (PS) matching accounted for BB selection bias when assessing associations. RESULTS BB-untreated patients in the overall cohort of HFrEF and HFpEF had greater deteriorated clinical and laboratory characteristics. In the 670 PS-matched cohort of HFrEF patients, incidences of all clinical events at 60 days and 1 year were not different according to use of BBs. In the 470 PS-matched cohort of HFpEF, rehospitalization and composite outcome at 6 months and 1 year more frequently occurred in non-users of BBs. After adjusting for covariates in the multivariable Cox model of matched cohorts, BB was not associated with clinical outcomes at 60 days and 1 year in HFrEF with AF patients. In HFpEF patients with AF, BB use was associated with reduced 6-month (hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20-0.74) and 1-year rehospitalization (HR, 0.53; 95% CI, 0.34-0.82). CONCLUSION In the HFrEF with AF PS-matched cohort, the use of BBs at discharge was not associated with clinical outcome. However, in HFpEF with AF, the use of BB was associated with reduced rehospitalization during the 6-month and 1-year follow up.
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Affiliation(s)
- Min Soo Ahn
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Jung Woo Son
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min Heui Yu
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hae Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eun Seok Jeon
- Department of Internal Medicine, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Jae Joong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sang Hong Baek
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kye Hun Kim
- Department of Internal Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
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Yoo BS, Ahn MS, Lee SJ, Son JW, Kim JY, Park SW. P783Guideline-directed therapy at discharge is important in patients with heart failure and atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are limited and conflicting data regarding the prognostic implication of guideline-directed therapy, especially in heart failure (HF) patients with atrial fibrillation (AF). Thus, this study evaluated the relationship between guideline adherence to recommended therapy at discharge and relevant 60-day clinical outcomes in acute HF patients with AF having reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF).
Methods and results
Of 5,625 acute HF patients in the Korean Acute Heart Failure Registry, 2,071 with documented AF (HFrEF, n=986; HFpEF, n=1,085) were separately analysed. A guideline adherence score was calculated for the prescription of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, mineralocorticoid receptor antagonists, and anticoagulants. In HFrEF patients with AF, there was significant trend of increase in mortality (p for trend <0.001) and composite endpoint (p for trend = 0.002) according to guideline adherence. Poor adherence was associated with a significantly high risk of mortality (hazard ratio [HR], 4.75; 95% confidence interval [95% CI], 1.77–12.74) and composite endpoint (HR, 2.36; 95% CI, 1.33–4.18). In HFpEF patients with AF, there was a significant increasing trend for rehospitalization (p for trend = 0.04) and composite endpoint (p for trend = 0.03). However, the beneficial effect of good guideline adherence was statistically non-significant for all clinical outcomes
Conclusion
Better adherence to guidelines was associated with a better 60-day prognosis in both HFrEF and HFpEF patients with AF. However, the beneficial effect of guideline adherence was more pronounced in HFrEF patients with AF.
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Affiliation(s)
- B S Yoo
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - M S Ahn
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - S J Lee
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - J W Son
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - J Y Kim
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
| | - S W Park
- Wonju College of Medicine, Yonsei University, Division of Cardiology, Department of Internal Medicin, Wonju, Korea (Republic of)
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Cho JY, Kim KH, Lee SE, Lee HY, Choi JO, Jeon ES, Kim MS, Kim JJ, Hwang KK, Chae SC, Kang SM, Choi DJ, Yoo BS, Cho MC, Oh BH. P3520Admission hyperglycemia is a predictor of mortality of acute heart failure: comparison between patients with and without diabetes mellitus. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Regardless of diabetes mellitus (DM), admission hyperglycemia is not uncommon in patients with acute heart failure (AHF). Although DM is a well-known predictor of mortality in AHF, the impacts of admission hyperglycemia on clinical outcomes in non-DM patients with AHF have been poorly studied. The aim of this study, therefore, was to compare the impact of admission hyperglycemia on long-term clinical outcomes in AHF patients with or without DM.
Methods
Among 5,625 AHF patients enrolled in a nationwide registry, a total of 5,541 patients were enrolled and divided into 2 groups; DM group (n=2,125, 70.4±11.4 years) vs. non-DM group (n=3,416, 67.3±16.0 years). Each group were further divided into 2 groups according to the presence of admission hyperglycemia (admission serum glucose level >200mg/dl); admission hyperglycemia (n=248) and no hyperglycemia (n=3,168) in non-DM; admission hyperglycemia (n=799) and no hyperglycemia (n=1,326) in DM. All-cause death and hospitalization due to HF (HHF) during 1-year follow-up were compared.
Results
Death was developed in 1,220 patients (22.2%) including 269 inhospital deaths (4.9%) during 1-year of follow-up. Death rate were significantly higher in DM than in non-DM group (24.8% vs 20.5%, p<0.001), however there was no difference in inhospital death (5.1% vs 4.7%, p=0.534). Both inhospital death (7.6% vs. 4.2%, p<0.001) and 1-year death (26.2% vs. 21.3%, p=0.001) were more frequent in AHF patients with hyperglycemia. On Kaplan-Meier survival curve analysis, however, admission hyperglycemia was associated with significantly higher death (p<0.001 by log-rank test) and rehospitalization (p=0.006 by log-rank test) in non-DM group, but not in DM group. In non-DM group, admission hyperglycemia was an independent predictor of 1-year mortality (HR 1.46, 95% CI 1.10–1.93, p=0.009).
Conclusion
DM was a significant predictor of long-term mortality in patients with AHF. Admission hyperglycemia was associated with both higher inhospital and 1-year mortality. The present study also demonstrated that admission hyperglycemia is an independent predictor of mortality in non-DM patients with AHF, but not in DM patients. In addition to the presence of DM, admission hyperglycemia would be a useful marker in the risk stratification of AHF, especially in non-DM patients.
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Affiliation(s)
- J Y Cho
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - K H Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - S E Lee
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - H Y Lee
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - J O Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - E S Jeon
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M S Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - J J Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - K K Hwang
- Chungbuk National University Hospital, Cheongju, Korea (Republic of)
| | - S C Chae
- Chungbuk National University Hospital, Cheongju, Korea (Republic of)
| | - S M Kang
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - D J Choi
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - B S Yoo
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - M C Cho
- Chungbuk National University Hospital, Cheongju, Korea (Republic of)
| | - B H Oh
- Seoul National University Hospital, Seoul, Korea (Republic of)
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Kim HJ, Kim MA, Lee DI, Kim HL, Choi DJ, Han S, Cho MC, Jeon ES, Kim JJ, Yoo BS, Shin MS, Chae SC, Ryu KH, Kang SM. P3453Gender difference in impact of ischemic heart disease on long-term outcome in patients with heart failure reduced ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Ischemic heart disease (IHD) is a major underlying etiology in patients with heart failure (HF). Although the impact of IHD on HF is evolving, there is a lack of understanding of how IHD affects long-term clinical outcomes and uncertainty about the role of IHD in determining the risk of clinical outcomes by gender.
Purpose
This study aims to evaluate the gender difference in impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).
Methods
Study data were obtained from the nationwide registry which is a prospective multicenter cohort and included patients who were hospitalized for HF composed of 3,200 patients. A total of 1,638 patients with HFrEF were classified into gender (women 704 and men 934). The primary outcome was all-cause death during follow-up and the composite clinical events of all-cause death and HF readmission during follow-up were also obtained. HF readmission was defined as re-hospitalization because of HF exacerbation.
Results
133 women (18.9%) were died and 168 men (18.0%) were died during follow-up (median 489 days; inter-quartile range, 162–947 days). As underlying cause of HF, IHD did not show significant difference between genders. Women with HFrEF combined with IHD had significantly lower cumulative survival rate than women without IHD at long-term follow-up (74.8% vs. 84.9%, Log Rank p=0.001, Figure 1). However, men with HFrEF combined with IHD had no significant difference in survival rate compared with men without IHD (79.3% vs. 83.8%, Log Rank p=0.067). After adjustment for confounding factors, Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently only in women. (odds ratio 1.43, 95% confidence interval 1.058–1.929, p=0.020). On the contrary to the death-free survival rates, there were significant differences in composite clinical events-free survival rates between patients with HFrEF combined with IHD and HFrEF without IHD in both genders.
Figure 1
Conclusions
IHD as predisposing cause of HF was an important risk factor for long-term mortality in women with HFrEF. Clinician need to aware of gender-based characteristics in patients with HF and should manage and monitor them appropriately and gender-specifically. Women with HF caused by IHD also should be treated more meticulously to avoid a poor prognosis.
Acknowledgement/Funding
None
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Affiliation(s)
- H J Kim
- Chungbuk National University Hospital, Cardiology, Cheongju, Korea (Republic of)
| | - M A Kim
- Boramae Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D I Lee
- Chungbuk National University Hospital, Cardiology, Cheongju, Korea (Republic of)
| | - H L Kim
- Boramae Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D J Choi
- Seoul National University Bun-Dang Hospital, Department of Internal medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - S Han
- Dongtan Sacred Heart Hospital, Cardiology, Hwaseong, Korea (Republic of)
| | - M C Cho
- Chungbuk National University Hospital, Cardiology, Cheongju, Korea (Republic of)
| | - E S Jeon
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - J J Kim
- Asan Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - B S Yoo
- Wonju Christian Hospital, Cardiology, Wonju, Korea (Republic of)
| | - M S Shin
- Inha University Hospital, Cardiology, Incheon, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Cardiology, Daegu, Korea (Republic of)
| | - K H Ryu
- Dongtan Sacred Heart Hospital, Cardiology, Hwaseong, Korea (Republic of)
| | - S M Kang
- Severance Hospital, Cardiology, Seoul, Korea (Republic of)
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8
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Cho EJ, Lee HY, Sung KC, Park S, Sohn IS, Park CG, Choi DJ, Ha JW, Ahn YK, Shin J, Hong SJ, Kim SK, Chung WJ, Yoo BS, Hong TJ, Youn HJ, Cho MC, Chae SC, Kim YJ, Kim CJ. Comparison of 24-Hour Ambulatory Central Blood Pressure Reduction Efficacy Between Fixed Amlodipine or Up-Titrated Hydrochlorothiazide Plus Losartan: The K-Central Study. Am J Hypertens 2019; 32:992-1002. [PMID: 31099387 PMCID: PMC6758941 DOI: 10.1093/ajh/hpz050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/18/2019] [Accepted: 05/10/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The main objective of this study was to evaluate non-inferiority of office mean systolic blood pressure (BP) reduction efficacy and superiority of 24-hour ambulatory central BP reduction efficacy between losartan combined with fixed dose amlodipine (L/A group) and dose up-titrated hydrochlorothiazide (L/H group) according to office BP. METHODS We conducted a prospective, randomized, double-blind multicenter trial in 231 patients with hypertensive (mean age = 59.2 ± 12.2 years). Patients received losartan 50 mg monotherapy for 4 weeks, followed by additional use of amlodipine 5 mg or hydrochlorothiazide 12.5 mg for 20 weeks after randomization. The patients who did not achieve the BP goal after 4 weeks' randomization received an increased dose of 100 mg/5 mg for the L/A group and 100 mg/25 mg for L/H group, respectively. The 24-hour ambulatory central BP was measured at baseline and after 20 weeks' treatment. RESULTS Office mean systolic BP reduction of L/A group was not inferior to L/H group after 4 weeks' treatment (-17.6 ± 13.3 vs. -14.4 ± 12.6 mm Hg, P = 0.0863) and was not significantly different after 20 weeks' treatment. (-15.7 ± 14.0 vs. -14.7 ± 15.1 mm Hg, P = 0.6130) The 24-hour ambulatory central systolic BP was significantly more reduced in the L/A group compared with that in the L/H group after 20 weeks' treatment (-9.37 ± 10.67 vs. -6.28 ± 10.50 mm Hg, P = 0.0407). The 24-hour ambulatory central systolic BP at the completion of the study and its reduction magnitude were independently associated with reductions in aortic pulse wave velocity, pulse pressure, and wave reflection magnitude. CONCLUSION Office systolic BP reduction with L/A was not inferior to L/H after 4 week's treatment. The combination of losartan and amlodipine was more favorable in 24-hour ambulatory central hemodynamics beyond BP-lowering efficacy than the combination of losartan and hydrochlorothiazide, regardless of office BP. CLINICAL TRIALS REGISTRATION NCT02294539.
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Affiliation(s)
- Eun Joo Cho
- Division of Cardiology, Department of Internal Medicine, St. Paul’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hae Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ki Chul Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Korea
| | - Sungha Park
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University, Seoul, Korea
| | - Il-Suk Sohn
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Chang Gyu Park
- Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Dong-Ju Choi
- Division of Cardiology, Department of Internal Medicine, Bundang Seoul National University Hospital, Seongnam, Korea
| | - Jong Won Ha
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University, Seoul, Korea
| | - Young Keun Ahn
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea
| | - Soon-Jun Hong
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Soon Kil Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Wook-Jin Chung
- Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University, Incheon, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Taek Jong Hong
- Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan, Korea
| | - Ho Joong Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Young Jo Kim
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Chong-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
- Correspondence: Chong-Jin Kim ()
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Ahn MS, Yoo BS, Yoon J, Lee SH, Kim JY, Ahn SG, Youn YJ, Lee JW, Son JW, Kim HS, Kang DR, Cho HJ, Lee HY, Jeon ES, Kang SM, Choi DJ, Cho MC. Guideline-directed therapy at discharge in patients with heart failure and atrial fibrillation. Heart 2019; 106:292-298. [PMID: 31492703 PMCID: PMC7027027 DOI: 10.1136/heartjnl-2019-315240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/08/2019] [Accepted: 07/24/2019] [Indexed: 01/28/2023] Open
Abstract
Objectives This study evaluated the relationship between guideline adherence for recommended therapy on discharge and relevant 60-day and 1-year clinical outcomes in patients with acute heart failure (HF) with reduced ejection fraction and atrial fibrillation (AF). Methods Of 5625 acute patients with HF in the Korean Acute Heart Failure registry, 986 patients with HF and documented AF were analysed. Guideline adherence scores were calculated for the prescription of ACE inhibitors, angiotensin receptor blockers, β-blockers, mineralocorticoid receptor antagonists and anticoagulants. Results In patients with HF with AF, there was a significant trend of reduced 60-day and 1-year mortality rates and the composite end point with guideline adherence. According to the Cox proportion hazard model, poor adherence was associated with a significantly higher risk of 60-day mortality (HR 4.75; 95% CI 1.77 to 12.74) and the composite end point (HR 2.36; 95% CI 1.33 to 4.18) compared with good adherence. Furthermore, poor adherence was associated with a significantly higher risk of 1-year mortality compared with moderate (HR 1.64; 95% CI 1.15 to 2.33) and good adherence (HR 2.34; 95% CI 1.39 to 3.97) and with a higher risk of the 1-year composite end point compared with good adherence (HR 1.58; 95% CI 1.07 to 2.33). Conclusion Better adherence to guidelines was associated with better 60-day and 1-year prognoses in patients with HF with AF.
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Affiliation(s)
- Min-Soo Ahn
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Junghan Yoon
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Seung-Hwan Lee
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jang Young Kim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Sung Gyun Ahn
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Young Jin Youn
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jun-Won Lee
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jung-Woo Son
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Hye Sim Kim
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun-Jai Cho
- Division of Cardiology, Department of Internal Medicine/Cardiovascular Center, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun Seok Jeon
- Division of Cardiology, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Seok-Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Wonju College of Medicine, Seoul, Republic of Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Myeong-Chan Cho
- Chungbuk National University Hospital, Chungju-si, Republic of Korea
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10
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Ahn MS, Yoo BS, Yoon J, Lee SH, Kim JY, Ahn SG, Youn YJ, Lee JW, Son JW, Kim HS, Kang DR, Lee SE, Cho HJ, Lee HY, Jeon ES, Kang SM, Choi DJ, Cho MC. Prognostic Effect of Guideline-Directed Therapy Is More Noticeable Early in the Course of Heart Failure. J Korean Med Sci 2019; 34:e133. [PMID: 31050223 PMCID: PMC6497982 DOI: 10.3346/jkms.2019.34.e133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/17/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There have been few studies to evaluate the prognostic implications of guideline-directed therapy according to the temporal course of heart failure. This study assessed the relationship between adherence to guideline-directed therapy at discharge and 60-day clinical outcomes in de novo acute heart failure (AHF) and acute decompensated chronic heart failure (ADCHF) separately. METHODS Among 5,625 AHF patients who were recruited from a multicenter cohort registry of Korean Acute Heart Failure, 2,769 patients with reduced ejection fraction were analyzed. Guideline-directed therapies were defined as the use of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), β-blocker, and mineralocorticoid receptor antagonist. RESULTS In de novo AHF, ACEI or ARB reduced re-hospitalization (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.34-0.95), mortality (HR, 0.41; 95% CI, 0.24-0.69) and composite endpoint (HR, 0.52; 95% CI, 0.36-0.77) rates. Beta-blockers reduced re-hospitalization (HR, 0.62; 95% CI, 0.41-0.95) and composite endpoint (HR, 0.65; 95% CI, 0.47-0.90) rates. In ADCHF, adherence to ACEI or ARB was associated with only mortality and β-blockers with composite endpoint. CONCLUSION The prognostic implications of adherence to guideline-directed therapy at discharge were more pronounced in de novo heart failure. We recommend that guideline-directed therapy be started as early as possible in the course of heart failure with reduced ejection fraction.
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Affiliation(s)
- Min Soo Ahn
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea.
| | - Junghan Yoon
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Seung Hwan Lee
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Jang Young Kim
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Sung Gyun Ahn
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Young Jin Youn
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Jun Won Lee
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Jung Woo Son
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Hye Sim Kim
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Sang Eun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyun Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hae Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eun Seok Jeon
- Department of Internal Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Seok Min Kang
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
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11
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Lee JH, Park JJ, Cho Y, Oh IY, Yoo BS, Kim JJ, Kim KH, Kang SM, Baek SH, Jeon ES, Cho MC, Chae SC, Oh BH, Choi DJ. Prognostic Implication of Ventricular Conduction Disturbance Pattern in Hospitalized Patients with Acute Heart Failure Syndrome. Korean Circ J 2019; 49:602-611. [PMID: 30891964 PMCID: PMC6597449 DOI: 10.4070/kcj.2018.0290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/03/2018] [Accepted: 01/23/2019] [Indexed: 11/11/2022] Open
Abstract
Background and Objectives Conflicting data exist regarding the prognostic implication of ventricular conduction disturbance pattern in patients with heart failure (HF). This study investigated the prognostic impact of ventricular conduction pattern in hospitalized patients with acute HF. Methods Data from the Korean Acute Heart Failure registry were used. Patients were categorized into four groups: narrow QRS (<120 ms), right bundle branch block (RBBB), left bundle branch block (LBBB), and nonspecific intraventricular conduction delay (NICD). The NICD was defined as prolonged QRS (≥120 ms) without typical features of LBBB or RBBB. The primary endpoint was the composite of all-cause mortality or rehospitalization for HF aggravation within 1 year after discharge. Results This study included 5,157 patients. The primary endpoint occurred in 39.7% of study population. The LBBB group showed the highest incidence of primary endpoint followed by NICD, RBBB, and narrow QRS groups (52.5% vs. 49.7% vs. 44.4% vs. 37.5%, p<0.001). In a multivariable Cox-proportional hazards regression analysis, LBBB and NICD were associated with 39% and 28% increased risk for primary endpoint (LBBB hazard ratio [HR], 1.392; 95% confidence interval [CI], 1.152–1.681; NICD HR, 1.278; 95% CI, 1.074–1.520) compared with narrow QRS group. The HR of RBBB for the primary endpoint was 1.103 (95% CI, 0.915–1.329). Conclusions LBBB and NICD were independently associated with an increased risk of 1-year adverse event in hospitalized patients with HF, whereas the prognostic impacts of RBBB were limited. Trial Registration ClinicalTrials.gov Identifier: NCT01389843
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Affiliation(s)
- Ji Hyun Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jin Joo Park
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Youngjin Cho
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Il Young Oh
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Joong Kim
- Division of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Kye Hun Kim
- Department of Internal Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea
| | - Seok Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hong Baek
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Seok Jeon
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Byung Hee Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dong Ju Choi
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
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12
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Lee JH, Kim MS, Yoo BS, Park SJ, Park JJ, Shin MS, Youn JC, Lee SE, Jang SY, Choi S, Cho HJ, Kang SM, Choi DJ. KSHF Guidelines for the Management of Acute Heart Failure: Part II. Treatment of Acute Heart Failure. Korean Circ J 2019; 49:22-45. [PMID: 30637994 PMCID: PMC6331324 DOI: 10.4070/kcj.2018.0349] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 10/14/2018] [Accepted: 12/18/2018] [Indexed: 12/11/2022] Open
Abstract
The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic HF were introduced in March 2016. However, chronic and acute HF represent distinct disease entities. Here, we introduce the Korean guidelines for the management of acute HF with reduced or preserved ejection fraction. Part II of this guideline covers the treatment of acute HF.
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Affiliation(s)
- Ju Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Min Seok Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Sung Ji Park
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Joo Park
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jong Chan Youn
- Division of Cardiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Sang Eun Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se Yong Jang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Seonghoon Choi
- Division of Cardiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seok Min Kang
- Division of Cardiology, Department of Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
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13
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Kim MS, Lee JH, Cho HJ, Cho JY, Choi JO, Hwang KK, Yoo BS, Kang SM, Choi DJ. KSHF Guidelines for the Management of Acute Heart Failure: Part III. Specific Management of Acute Heart Failure According to the Etiology and Co-morbidity. Korean Circ J 2019; 49:46-68. [PMID: 30637995 PMCID: PMC6331326 DOI: 10.4070/kcj.2018.0351] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022] Open
Abstract
The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic heart failure (CHF) were introduced in March 2016. However, CHF and acute heart failure (AHF) represent distinct disease entities. Here, we introduce the Korean guidelines for the management of AHF with reduced or preserved ejection fraction. Part III of this guideline covers management strategies optimized according to the etiology of AHF and the presence of co-morbidities.
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Affiliation(s)
- Min Seok Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyun Jai Cho
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Jin Oh Choi
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Kuk Hwang
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seok Min Kang
- Division of Cardiology, Department of Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
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14
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Lee JH, Kim MS, Kim EJ, Park DG, Cho HJ, Yoo BS, Kang SM, Choi DJ. KSHF Guidelines for the Management of Acute Heart Failure: Part I. Definition, Epidemiology and Diagnosis of Acute Heart Failure. Korean Circ J 2019; 49:1-21. [PMID: 30637993 PMCID: PMC6331322 DOI: 10.4070/kcj.2018.0373] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 12/25/2022] Open
Abstract
The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic HF were introduced in March 2016. However, chronic and acute heart failure (AHF) represent distinct disease entities. Here, we introduce the Korean guidelines for the management of AHF with reduced or preserved ejection fraction. Part I of this guideline covers the definition, epidemiology, and diagnosis of AHF.
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Affiliation(s)
- Ju Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Min Seok Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eung Ju Kim
- Department of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Dae Gyun Park
- Division of Cardiology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seok Min Kang
- Division of Cardiology, Department of Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
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Han SH, Oh GC, Kwon HM, Park CG, Kim IJ, Hwang GS, Yoo BS, Park SH, Lee KJ, Kim HS. Comparison of efficacy and safety between two different irbesartan, generic vs branded, in the treatment of Korean patients with mild-to-moderate hypertension: an 8-week, multicenter, randomized, open-label, Phase IV clinical study. Drug Des Devel Ther 2018; 12:4217-4229. [PMID: 30587918 PMCID: PMC6304086 DOI: 10.2147/dddt.s172046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose This study aimed to compare the efficacy and safety of generic and branded irbesartan for 8 weeks in patients with mild-to-moderate essential hypertension. Patients and methods We screened 221 patients with mild-to-moderate hypertension. After exclusion per study criteria, 177 subjects were randomized to receive 150 mg generic irbesartan (n=91) or branded irbesartan (n=86) as the intention to treat set. The primary efficacy endpoint of this study was the change in mean sitting diastolic blood pressure (SiDBP) from baseline to 8 weeks between the generic and branded irbesartan groups. The secondary efficacy endpoints were the change in mean SiDBP at Week 4 from baseline and the change in mean sitting systolic blood pressure (SiSBP) at Weeks 4 and 8 from baseline in both groups. All safety issues were evaluated. Results At Week 8, the generic and branded irbesartan groups showed significantly reduced SiDBP (-10.3±8.0, -10.7±7.7 mmHg, all P<0.0001) compared with baseline values, and the mean between-group difference in SiDBP change after 8 weeks of treatment was -0.4±1.2 mmHg, showing the non-inferiority of generic irbesartan vs branded irbesartan. Furthermore, secondary efficacy, which was the mean change of SiDBP from baseline at 4 weeks, was comparable between the two groups (-9.4±8.1 vs -9.9±7.4 mmHg, P=0.69). There were no between-group differences in mean changes of SiSBP after 4 or 8 weeks of treatment (P=0.78, P=0.97, respectively), or in the incidence of adverse effects (16.7 vs 24.4%, P=0.20). Conclusion Generic irbesartan treatment in patients with mild-to-moderate essential hypertension has shown effective antihypertensive effects comparable with the branded irbesartan treatment, with similar incidence of adverse effects.
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Affiliation(s)
- Seung Hwan Han
- Division of Cardiology, Department of Internal Medicine, Gachon University College of Medicine, Gil Hospital, Incheon, Republic of Korea
| | - Gyu Chul Oh
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea,
| | - Hyuck Moon Kwon
- Cardiology Division, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Gyu Park
- Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
| | - In Jai Kim
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Gyo-Seung Hwang
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Seong Hoon Park
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Kwang Je Lee
- Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Hyo-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea,
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Kim SH, Yun SC, Park JJ, Lee SE, Jeon ES, Kim JJ, Cho MC, Chae SC, Kang SM, Choi DJ, Yoo BS, Kim KH, Oh BH, Baek SH. Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction: Results from The Korea Acute Heart Failure (KorAHF) Registry. Korean Circ J 2018; 49:238-248. [PMID: 30468042 PMCID: PMC6393317 DOI: 10.4070/kcj.2018.0259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/28/2018] [Accepted: 10/31/2018] [Indexed: 01/08/2023] Open
Abstract
Background and Objectives Beta-blockers are indicated in patients with heart failure (HF) with reduced ejection fraction. However, their efficacy in patients with HF with preserved ejection fraction (HFpEF) is uncertain. We investigated the hypothesis that beta-blockers are associated with reduced adverse events in patients with HFpEF. Methods The Korea Acute Heart Failure (KorAHF) is a prospective observational multicentre cohort study. The 5,625 patients hospitalized for acute HF syndrome in 10 tertiary university hospitals across the country have been consecutively enrolled between March 2011 and February 2014. Of these patients, 2,152 patients with HFpEF (ejection fraction ≥40%) were investigated. The primary outcome was all-cause mortality according to beta-blocker use. Results During a median follow-up duration of 807 days, 702 patients died. In Cox proportional hazards model beta-blocker use was associated with a 14% reduced all-cause death (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.75–0.98), but not with reduce rehospitalization (HR, 1.03; 95% CI, 0.85–1.27). In the propensity-score matched population, beta-blockers were also associated with reduced all-cause death (HR, 0.80; 95% CI, 0.69–0.94) but not with reduced rehospitalization (HR, 1.08; 95% CI, 0.87–1.33). Conclusions In Korean patients with HFpEF, use of beta-blockers is associated with reduced all-cause death but not with reduced rehospitalization.
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Affiliation(s)
- Sung Hwan Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Cheol Yun
- Department of Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jin Joo Park
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Eun Lee
- Division of Cardiology, Heart institute, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Eun Seok Jeon
- Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jae Joong Kim
- Division of Cardiology, Heart institute, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Seok Min Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kye Hun Kim
- Department of Internal Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea
| | - Byung Hee Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Hong Baek
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Cho JY, Kim KH, Lee SE, Lee HY, Choi JO, Jeon ES, Kim JJ, Hwang KK, Chae SC, Baek SH, Kang SM, Choi DJ, Yoo BS, Cho MC, Oh BH. P6542Post-discharge worsening renal function predicts long-term adverse clinical outcomes in patients with acute heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Y Cho
- Chonnam National University Hospital, Cardiology, Gwangju, Korea Republic of
| | - K H Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea Republic of
| | - S E Lee
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - H Y Lee
- Seoul National University Hospital, Seoul, Korea Republic of
| | - J O Choi
- Samsung Medical Center, Seoul, Korea Republic of
| | - E S Jeon
- Samsung Medical Center, Seoul, Korea Republic of
| | - J J Kim
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - K K Hwang
- Chungbuk National University Hospital, Cheongju, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S H Baek
- Seoul St. Mary's Hospital, Seoul, Korea Republic of
| | - S M Kang
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - D J Choi
- Seoul National University Bundang Hospital, Seongnam, Korea Republic of
| | - B S Yoo
- Wonju Christian Hospital, Wonju, Korea Republic of
| | - M C Cho
- Chungbuk National University Hospital, Cheongju, Korea Republic of
| | - B H Oh
- Seoul National University Hospital, Seoul, Korea Republic of
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18
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Choi KH, Han S, Lee GY, Choi JO, Jeon ES, Lee HY, Lee SE, Kim JJ, Chae SC, Baek SH, Kang SM, Choi DJ, Yoo BS, Kim KH, Cho MC, Park HY, Oh BH. Prognostic Significance of Left Axis Deviation in Acute Heart Failure Patients with Left Bundle branch block: an Analysis from the Korean Acute Heart Failure (KorAHF) Registry. Korean Circ J 2018; 48:1002-1011. [PMID: 30334387 PMCID: PMC6196157 DOI: 10.4070/kcj.2018.0048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/11/2018] [Accepted: 05/30/2018] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality. Results The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).
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Affiliation(s)
- Ki Hong Choi
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seongwook Han
- Division of Cardiology, Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ga Yeon Lee
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Oh Choi
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Seok Jeon
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Hae Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Eun Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae Joong Kim
- Division of Cardiology, Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Sang Hong Baek
- Division of Cardiology, Department of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Min Kang
- Division of Cardiology, Department of Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Ju Choi
- Division of Cardiology, Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kye Hun Kim
- Division of Cardiology, Department of Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea
| | - Myeong Chan Cho
- Division of Cardiology, Department of Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyun Young Park
- Division of Cardiovascular and Rare Diseases, Department of Biomedical Science, National Institute of Health (NIH), Osong, Korea
| | - Byung Hee Oh
- Division of Cardiology, Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
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19
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Hong S, Lee JH, Kim KM, Lee JW, Youn YJ, Ahn MS, Ahn SG, Lee SH, Yoon J, Choe KH, Yoo BS. Is There a Sex-Related Difference in the Obesity Paradox in Systolic Heart Failure? Sex-Related Difference in the Obesity Paradox. Yonsei Med J 2018; 59:57-62. [PMID: 29214777 PMCID: PMC5725365 DOI: 10.3349/ymj.2018.59.1.57] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/11/2017] [Accepted: 09/09/2017] [Indexed: 11/27/2022] Open
Abstract
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.
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Affiliation(s)
- Soonchang Hong
- Department of Thoracic and Cardiovascular Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Ji Hyun Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Min Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jun Won Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Young Jin Youn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Min Soo Ahn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Gyun Ahn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea.
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20
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Kim MS, Lee JH, Kim EJ, Park DG, Park SJ, Park JJ, Shin MS, Yoo BS, Youn JC, Lee SE, Ihm SH, Jang SY, Jo SH, Cho JY, Cho HJ, Choi S, Choi JO, Han SW, Hwang KK, Jeon ES, Cho MC, Chae SC, Choi DJ. Korean Guidelines for Diagnosis and Management of Chronic Heart Failure. Korean Circ J 2017; 47:555-643. [PMID: 28955381 PMCID: PMC5614939 DOI: 10.4070/kcj.2017.0009] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/19/2017] [Accepted: 06/23/2017] [Indexed: 11/11/2022] Open
Abstract
The prevalence of heart failure (HF) is skyrocketing worldwide, and is closely associated with serious morbidity and mortality. In particular, HF is one of the main causes for the hospitalization and mortality in elderly individuals. Korea also has these epidemiological problems, and HF is responsible for huge socioeconomic burden. However, there has been no clinical guideline for HF management in Korea.
The present guideline provides the first set of practical guidelines for the management of HF in Korea and was developed using the guideline adaptation process while including as many data from Korean studies as possible. The scope of the present guideline includes the definition, diagnosis, and treatment of chronic HF with reduced/preserved ejection fraction of various etiologies.
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Affiliation(s)
- Min-Seok Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju-Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Eung Ju Kim
- Department of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Dae-Gyun Park
- Division of Cardiology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sung-Ji Park
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Joo Park
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi-Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Byung Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong-Chan Youn
- Division of Cardiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Sang Eun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sang Hyun Ihm
- Department of Cardiology, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Se Yong Jang
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Sang-Ho Jo
- Division of Cardiology, Hallym University Pyeongchon Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seonghoon Choi
- Division of Cardiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Woo Han
- Division of Cardiology, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Kyung Kuk Hwang
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Eun Seok Jeon
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Shung Chull Chae
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Dong-Ju Choi
- Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
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21
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Yoo BS. Oral pharmacological treatment of congestive heart failure. J Korean Med Assoc 2015. [DOI: 10.5124/jkma.2015.58.3.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Byung Su Yoo
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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22
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Kim JH, Park K, Yim SH, Choi JE, Sung JS, Park JY, Choi YY, Jeon HS, Park JY, Yoon HK, Kim YH, Yoo BS, Kim YT, Hu HJ, Chung YJ, Kim H, Sung SW, Hong YC. Genome-wide association study of lung cancer in Korean non-smoking women. J Korean Med Sci 2013; 28:840-7. [PMID: 23772147 PMCID: PMC3677999 DOI: 10.3346/jkms.2013.28.6.840] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/16/2013] [Indexed: 11/20/2022] Open
Abstract
Lung cancer in never-smokers ranks as the seventh most common cause of cancer death worldwide, and the incidence of lung cancer in non-smoking Korean women appears to be steadily increasing. To identify the effect of genetic polymorphisms on lung cancer risk in non-smoking Korean women, we conducted a genome-wide association study of Korean female non-smokers with lung cancer. We analyzed 440,794 genotype data of 285 cases and 1,455 controls, and nineteen SNPs were associated with lung cancer development (P < 0.001). For external validation, nineteen SNPs were replicated in another sample set composed of 293 cases and 495 controls, and only rs10187911 on 2p16.3 was significantly associated with lung cancer development (dominant model, OR of TG or GG, 1.58, P = 0.025). We confirmed this SNP again in another replication set composed of 546 cases and 744 controls (recessive model, OR of GG, 1.32, P = 0.027). OR and P value in combined set were 1.37 and < 0.001 in additive model, 1.51 and < 0.001 in dominant model, and 1.54 and < 0.001 in recessive model. The effect of this SNP was found to be consistent only in adenocarcinoma patients (1.36 and < 0.001 in additive model, 1.49 and < 0.001 in dominant model, and 1.54 and < 0.001 in recessive model). Furthermore, after imputation with HapMap data, we found regional significance near rs10187911, and five SNPs showed P value less than that of rs10187911 (rs12478012, rs4377361, rs13005521, rs12475464, and rs7564130). Therefore, we concluded that a region on chromosome 2 is significantly associated with lung cancer risk in Korean non-smoking women.
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Affiliation(s)
- Jin Hee Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Kyunghee Park
- Department of Epidemiology and Biostatistics, Seoul National University School of Public Health, Seoul, Korea
| | - Seon-Hee Yim
- Department of Medical Humanities and Social Sciences, The Catholic University of Korea College of Medicine, Seoul, Korea
- Integrated Research Center for Genome Polymorphism, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Eun Choi
- Department of Biochemistry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Sook Sung
- Genomic Research Center for Lung and Breast/Ovarian Cancers, Korea University Anam Hospital, Seoul, Korea
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Ju-Yeon Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yi Young Choi
- Department of Biochemistry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyo-Sung Jeon
- Department of Biochemistry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Yong Park
- Department of Biochemistry, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yeul Hong Kim
- Genomic Research Center for Lung and Breast/Ovarian Cancers, Korea University Anam Hospital, Seoul, Korea
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Byung Su Yoo
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hae-Jin Hu
- Integrated Research Center for Genome Polymorphism, The Catholic University of Korea College of Medicine, Seoul, Korea
- Department of Microbiology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yeun-Jun Chung
- Integrated Research Center for Genome Polymorphism, The Catholic University of Korea College of Medicine, Seoul, Korea
- Department of Microbiology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ho Kim
- Department of Epidemiology and Biostatistics, Seoul National University School of Public Health, Seoul, Korea
| | - Sook Whan Sung
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
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Seong YW, Yoo BS, Kim JT, Park IK, Kang CH, Kim YT. Video-Assisted Thoracoscopic Lobectomy in Children: Safety and Efficacy Compared with the Conventional Thoracotomy Approach. Innovations�(Phila) 2012; 7:394-8. [DOI: 10.1177/155698451200700604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective There have been only small numbers of reports for video-assisted thoracoscopic surgery (VATS) lobectomy in children because of its technically demanding aspects. This study was performed to evaluate the safety and the efficacy of the VATS lobectomy compared with the conventional lobectomy by thoracotomy and to investigate the risk factors of thoracotomy conversion. Methods From May 2005 to October 2010, a total of 37 pediatric patients underwent VATS lobectomy and 28 pediatric patients underwent conventional lobectomy. The VATS lobectomy group consisted of relatively older patients compared with the thoracotomy group. Clinical outcomes from the two groups were analyzed and compared. Results Of the 37 patients in the VATS group, 8 patients (23%) required thoracotomy conversion and 29 patients (77%) were successfully operated on thoracoscopically. There were no in-hospital mortalities in both groups. Annual thoracotomy conversion rate has decreased from 50% in 2005 to 9% in 2010. There were no significant differences in the outcome between the VATS group and the thoracotomy group. Morbidities in the VATS group included prolonged drainage longer than 7 days (two patients), prolonged air leakage (two patients), and bleeding (one patient). There was no difference in the incidence of morbidities between the two groups. Univariate analyses revealed failure of single-lung ventilation (P = 0.007) and history of pneumonia (P = 0.001) to be risk factors of thoracotomy conversion. Conclusions Video-assisted thoracoscopic surgery lobectomy in children is a safe and effective treatment modality, with results comparable with those of conventional lobectomy. In the univariate analysis, failure of single-lung ventilation and history of pneumonia were the two factors related to thoracotomy conversion.
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Affiliation(s)
- Yong Won Seong
- Department of Thoracic and Cardiovascular Surgery, and Seoul National University Hospital, Seoul, Republic of Korea
| | - Byung Su Yoo
- Department of Thoracic and Cardiovascular Surgery, and Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Tae Kim
- Department of Anesthesiology, Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - In Kyu Park
- Department of Thoracic and Cardiovascular Surgery, and Seoul National University Hospital, Seoul, Republic of Korea
| | - Chang Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, and Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, and Seoul National University Hospital, Seoul, Republic of Korea
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Kim MY, Cho MY, Baik SK, Jeong PH, Suk KT, Jang YO, Yea CJ, Kim JW, Kim HS, Kwon SO, Yoo BS, Kim JY, Eom MS, Cha SH, Chang SJ. Beneficial effects of candesartan, an angiotensin-blocking agent, on compensated alcoholic liver fibrosis - a randomized open-label controlled study. Liver Int 2012; 32:977-87. [PMID: 22364262 DOI: 10.1111/j.1478-3231.2012.02774.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 01/28/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent studies have shown that the renin-angiotensin system is implicated in hepatic fibrogenesis in vitro and in vivo. However, no study was done in humans with alcoholic liver disease. AIM To investigate the antifibrotic effect of angiotensin II type 1 receptor (AT1-R) blocking agents (ARB) in patients with alcoholic liver disease. METHODS The primary outcome was improvement in patients' histological features. Eighty-five patients with compensated alcoholic liver fibrosis (≥ F2) which was confirmed by baseline liver biopsy were randomized (intention-to-treat (ITT)) to receive either ARB, candesartan (8 mg/day) with ursodeoxycholic acid (UDCA) (600 mg/day) (n = 42) or UDCA alone (n = 43) as control for 6 months and follow-up liver biopsies were conducted. RESULTS According to the Laennec fibrosis system, candesartan showed significantly higher rates of histological improvements (ITT, 33.3% vs. 11.6%, P = 0.020). In addition, the fibrosis score was significantly reduced from 3.4 ± 1.4 to 3.1 ± 1.5 (P = 0.005) in the candesartan group. Candesartan also reduced the area of fibrosis and α-smooth muscle actin positive from 11.3 ± 6.0 to 8.3 ± 4.7 and 28.7 ± 10.5 to 23.9 ± 10.3 (%), and the hydroxyproline levels (μg/g liver tissue) from 7.8 ± 2.4 to 6.3 ± 1.7 respectively (P < 0.05). In addition, the relative expression of transforming growth factor-β1(TGF-β1), collagen-1, AT1-R, tissue inhibitor of metalloproteinase 1 (TIMP-1), metalloproteinases2 (MMP2), Rac1 and p22phox by real-time RT-PCR decreased in the candesartan group (P < 0.05). Mean arterial blood pressure in the candesartan group decreased mildly but significantly (P < 0.001). No significant complications and side effects were observed during the present study. CONCLUSIONS Administration of ARB in compensated alcoholic liver disease induces improvement of fibrosis in histological and quantitative measurements.
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Affiliation(s)
- Moon Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
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Kim MY, Baik SK, Won CS, Park HJ, Jeon HK, Hong HI, Kim JW, Kim HS, Kwon SO, Kim JY, Yoo BS, Lee SH. Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis. Korean J Hepatol 2011; 16:376-82. [PMID: 21415581 PMCID: PMC3304603 DOI: 10.3350/kjhep.2010.16.4.376] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background/Aims The blunted ventricular systolic and diastolic contractile responses to physical and pharmacological stress in cirrhosis are termed cirrhotic cardiomyopathy (CCM). CCM has been known to involve multiple defects in the β-adrenergic signaling pathway. The aim of this study was to determine whether cirrhotic patients have blunted cardiac responses to catecholamine stimulation through dobutamine stress echocardiography (DSE). Methods Seventy-one cirrhotic patients with normal left ventricular (LV) chamber size and ejection fraction were enrolled. The LV systolic and diastolic functions were evaluated by two-dimensional and Doppler echocardiography at rest and during peak dobutamine infusion (40 µg/kg/min). An abnormal response was defined as a decrease of less than 10% in LV end-diastolic volume, a decrease of less than 20% in end-systolic volume, and an increase of less than 10% in LV ejection fraction (EF) at peak dobutamine infusion, based on previously used criteria. The early/late diastolic flow (E/A) ratio and diastolic parameters were also measured. Results A blunted LV response to dobutamine was observed in 18 of 71 cirrhotic patients (25.4%). The baseline EF was significantly higher in 18 patients with a blunted DSE response than that of those with a normal DSE response (P<0.05). The baseline and peak E/A ratios, which are common diastolic dysfunction markers, were higher in the cirrhosis group than in the control group (P<0.001). No adverse events associated with DSE were observed. Conclusions Blunted cardiac responses to dobutamine stimulation, which are implicated in defects in the β-adrenergic signaling pathway, might contribute to the pathogenesis of CCM in patients with cirrhosis.
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Affiliation(s)
- Moon Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Sung JK, Kim JY, Youn YJ, Lee JW, Ahn SG, Yoo BS, Lee SH, Yoon J, Choe KH, Yoon JH, Park JK, Koh SB. Urine Albumin Creatinine Ratio is Associated with Carotid Atherosclerosis in a Community Based Cohort: Atherosclerosis Risk of Rural Area in Korean General Population Study. J Cardiovasc Ultrasound 2010; 18:134-8. [PMID: 21253362 PMCID: PMC3021891 DOI: 10.4250/jcu.2010.18.4.134] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 10/15/2010] [Accepted: 10/18/2010] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Albuminuria is a surrogate marker of endothelial dysfunction and a predictor of cardiovascular events. Data are limited with regard to the relationship between albuminuria and subclinical atherosclerosis in a community-based cohort. We determined the association between albuminuria measured by the urine albumin creatinine ratio (UACR) and carotid intima media thickness (CIMT) in a Korean rural population. METHODS We enrolled 1,369 healthy subjects older than 40 years (857 males and 518 females) with normal renal function and measured the CIMT. We excluded subjects with overt proteinuria (> 300 mg/day) or with treatment of diabetes mellitus, hypertension, dyslipidemia, and any cardiovascular disease. The subjects were stratified into the quartile value of the UACR (lowest quartile: UACR < 4.8 and highest quartile: UACR > 17.7). And we evaluate the relationship between UACR and CIMT by linear regression and logistic regression analysis. RESULTS Increasing quartile of the UACR had a stepwise increase in body mass index, blood pressure, cholesterol profile [low density lipoprotein (LDL)-cholesterol and triglyceride], glucose, homeostratic model assessment of insulin resistance (HOMA-IR), and C-reactive protein (all p values < 0.001). Maximal CIMT from the 1(st) to the 4(th) quartile values of the UACR were 0.74 ± 0.17, 0.77 ± 0.18, 0.78 ± 0.18, and 0.82 ± 0.21 mm, respectively (p < 0.001). In a multivariate regression model adjusted for age, sex, systolic blood pressure, triglyceride, LDL-cholesterol, fasting blood sugar, waist circumference, adiponectin, HOMA-IR, high sensitive C-reactive protein, smoking, UACR showed a significant association with maximal CIMT (B = 0.014, R(2) = 0.145, p = 0.002). CONCLUSION Albuminuria measured by the UACR was significantly associated with both CIMT and traditional risk factors of atherosclerosis except for smoking in healthy Koreans.
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Affiliation(s)
- Joong Kyung Sung
- Devision of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Choi JW, Kim JH, Yoo BS, Kang CH, Kim YT. Horner's Syndrome: A Rare Complication of Tube Thoracostomy -A case report-. Korean J Thorac Cardiovasc Surg 2010. [DOI: 10.5090/kjtcs.2010.43.6.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jae Woong Choi
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital
| | - Joo-Hyun Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital
| | - Byung Su Yoo
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital
| | - Chang-Hyun Kang
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital
| | - Young Tae Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital
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Affiliation(s)
- Min Soo Ahn
- Department of Cardiology, Pusan National University College of Medicine, Busan, Korea
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Ahn MS, Yoon J, Lee JW, Lee KH, Kim JY, Yoo BS, Lee SH, Choe KH. Effectiveness of the hugging balloon technique in coronary angioplasty for a heavy, encircling, calcified coronary lesion. Korean Circ J 2009; 39:499-501. [PMID: 19997547 PMCID: PMC2790133 DOI: 10.4070/kcj.2009.39.11.499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2009] [Revised: 07/23/2009] [Accepted: 08/05/2009] [Indexed: 11/16/2022] Open
Abstract
We report our experience in coronary angioplasty and intravascular ultrasonography (IVUS) on a heavy, encircling, calcified lesion that was not dilated with the use of a cutting balloon and a non-compliant balloon. The angioplasty was successfully performed with a simple and inexpensive hugging balloon technique.
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Affiliation(s)
- Min Soo Ahn
- Department of Cardiology, Pusan National University School of Medicine, Busan, Korea
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Sugiyama M, Funauchi M, Yamagata T, Nozaki Y, Yoo BS, Ikoma S, Kinoshita K, Kanamaru A. Predominant inhibition of Th1 cytokines in New Zealand black/white F1 mice treated with FK506. Scand J Rheumatol 2009; 33:108-14. [PMID: 15163112 DOI: 10.1080/03009740310004351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The T-helper 1/T-helper 2 (Th1/Th2) cell balance was examined in 6-month-old New Zealand black/white F1 (B/WF1) mice treated with an immunosuppressive agent, FK506. The survival rate of mice treated with 10 mg/kg/day of FK506 was 7/8, while that of those treated with 2.5 mg/kg/day was 5/8, and 4/8 after treatment for 8 weeks with placebo. Proteinuria, which was already positive in all mice before the treatment, in the seven of eight mice treated with 10 mg/kg/day remained mildly positive (< or = 1+), while seven of eight mice treated with 2.5 mg/kg/day and six of eight mice treated with the placebo showed severe proteinuria (> or = 2+). Pathological changes in the kidneys of mice treated with 10 mg/kg/day of FK506 were less severe than in mice treated with the placebo or 2.5 mg/kg/day of FK506. Expression of mRNA was unchanged for all cytokines determined in the groups treated with 2.5 mg/kg/day of FK506 or placebo. In contrast, expression of mRNA for interleukin (IL)-2, and interferon (IFN)-gamma was suppressed, while that for IL-4 and IL-10 was not suppressed in the group treated with 10 mg/kg of FK506. The serum levels of IgG-class anti-DNA antibodies, which had been elevated before the treatment, were suppressed--especially in the IgG2a subclass--and the deposition of IgG2a and IgG2b in the glomeruli was reduced in the group treated with 10 mg/kg/day of FK506 compared with the other groups. These findings suggest that an improvement in the lupus nephritis of 6-month-old B/WF1 mice induced by FK506 might be associated with a predominant inhibition of Th1 cytokine.
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Affiliation(s)
- M Sugiyama
- Division of Haematology, Nephrology, and Rheumatology, Kinki University School of Medicine, Osaka, Japan.
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Baik SK, Jeong PH, Ji SW, Yoo BS, Kim HS, Lee DK, Kwon SO, Kim YJ, Park JW, Chang SJ, Lee SS. Acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis: a randomized comparison. Am J Gastroenterol 2005; 100:631-5. [PMID: 15743362 DOI: 10.1111/j.1572-0241.2005.41381.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Octreotide and terlipressin are widely used in acute variceal hemorrhage to reduce the bleeding rate. They purportedly act by mesenteric arterial vasoconstriction, thus reducing portal venous flow (PVF) and portal pressure. Little is known about the immediate-early hemodynamic effects of these drugs. AIM To compare the acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis. PATIENTS Forty-two cirrhotic patients with a history of variceal bleeding were randomized to receive either octreotide 100 microg intravenous bolus followed by a continuous infusion at 250 microg/h (n = 21), or terlipressin 2 mg intravenous bolus (n = 21). METHODS Mean arterial pressure (MAP), heart rate (HR), hepatic venous pressure gradient (HVPG), and PVF, assessed by duplex Doppler ultrasonography, were measured before and at 1, 5, 10, 15, 20, and 25 min after the start of drug administration. RESULTS Octreotide markedly decreased HVPG (-44.5 +/- 17.8%) and PVF (-30.6 +/- 13.6%) compared to the baseline at 1 min (p < 0.05). Thereafter, both variables rapidly returned toward the baseline, and by 5 min, no significant differences in HVPG (-7.1 +/- 28.9%) and PVF (10.2 +/- 26.2%) were noted. A similar transient effect on MAP and HR was observed. Terlipressin significantly decreased HVPG (-18.3 +/- 11.9%) and PVF (-32.6 +/- 10.5%) at 1 min (p < 0.05) and sustained these effects at all time points. The effects on arterial pressure and HR were also sustained. CONCLUSIONS Octreotide only transiently reduced portal pressure and flow, whereas the effects of terlipressin were sustained. These results suggest that terlipressin may have more sustained hemodynamic effects in patients with bleeding varices.
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Affiliation(s)
- Soon Koo Baik
- Department of Internal Medicine,Yonsei University Wonju College of Medicine, Wonju, South Korea
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Wang HS, Yoo BS, Chung IH, Ryu HY, Lee NW, Kim JY, Lee SW, Hwang SO, Yoon J, Choe KH. Is B-type Natriuretic Peptide(BNP) Measurement Useful Test for Diagnosing Systolic Heart Failure in Patients with Moderate to Severe Renal Insufficiency? Korean Circ J 2005. [DOI: 10.4070/kcj.2005.35.12.897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hee Sung Wang
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Il Hyung Chung
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Ho Yoel Ryu
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Nak Won Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Whan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Oh Hwang
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Yoo BS, Yoon J, Yoon KH, Lee SK, Lee SH, Kim JY, Ko JY, Hwang SO, Choe KH. LB30057, a Direct Thrombin Inhibitor, the Effect of Restenosis in Porcine Coronary Injury Model. Korean Circ J 2005. [DOI: 10.4070/kcj.2005.35.1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Byung Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hee Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang Koo Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Ji Yean Ko
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Oh Hwang
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Shim HW, Moon MS, Shin KS, Cho HJ, Yoo BS, Kim IG. Alpha-difluoromethylornithine, ornithine decarboxylase inhibitor, antagonizes H2O2-induced cytotoxicity in HL-60 leukemia cells: regulation of iron-dependent lysosomal damage. Cell Biol Toxicol 2004; 19:393-405. [PMID: 15015763 DOI: 10.1023/b:cbto.0000013355.63593.35] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Recent studies indicate that reactive oxygen species, such as H2O2, can be generated by anti-cancer drugs, can damage cells, and then induce apoptotic cell death. In this study, we reported whether polyamines were capable of affecting apoptotic cell death triggered by H2O2 in leukemia cells or not. Alpha-difluoromethylornithine treatment (DFMO, 3 mmol/L, 48 h), which depletes intracellular putrescine by inhibiting ornithine decarboxylase, reduced H2O2-induced cell death in the HL-60 leukemia cells. Cytotoxicity caused by H2O2 in putrescine-depleted cells was 50% lower than that in the control cells, as determined by propidium iodide, the annexin V and DNA fragmentation assays. Following putrescine (1 mmol/L) supplement, cell death induction caused by H2O2 was restored to a similar level as the DFMO-untreated control cells. It seems that this partly resulted from the intralysosomal iron-dependent oxidation of the cells because DFMO did not significantly affect the increment of enzymes related to oxidative-stress resistance. Putrescine depletion by DFMO treatment reduced the cellular iron uptake of the cells by about 70%. In parallel to the reduction of iron uptake, lysosomal damage (assayed by acridine orange relocalization or uptake test) in the DFMO-treated cells was far less than that in the control cells. Moreover, putrescine supplement also restored the iron uptake to the control cell levels. Pre-incubation with desferrioxamine (DFO), which chelates iron and forms a non-reactive Fe-DFO complex that is localized in the lysosomal compartment, inhibited H2O2-induced cell death. This work suggests that polyamines may play a critical role in apoptotic cell death triggered by H2O2 via the regulation of the iron-dependent instability of the lysosome.
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Affiliation(s)
- H W Shim
- Department of Radiation Biology, Environment Radiation Research Group, Korea Atomic Energy Research Institute, Yusong, Taejon, Korea
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Weon CS, Kim JY, Lee MY, Yoo BS, Lee SH, Yoon JH, Choe KH. Five Cases of Coronary Arteriovenous Fistula from Coronary Artery to Left Ventricle. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.10.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Chan Sik Weon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Mi Young Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jung Han Yoon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Yoo BS, Kim WJ, Jung HS, Kim JY, Lee SW, Hwang SO, Yoon J, Choe KH. The Clinical Experiences of B-type Natriuretic Peptide Blood Concentrations for Diagnosis in Congestive Heart Failure : The Single Hospital Experience Based on the Large Clinical Database. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.7.684] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Byung Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Woo Jae Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hyun Suk Jung
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Whan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Oh Hwang
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Kim WJ, Kim JY, Ju HS, Kim JK, Jung HS, Yoo BS, Lee SH, Yoon JH, Choe KH, Kim SH. A Case of Torsades de Pointes Induced by Complete Atrioventricular Block and Hypokalemia. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.2.220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Woo Jae Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hun Su Ju
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jung Kwon Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hyun Sook Jung
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jung Han Yoon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sang Ha Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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38
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Yoo BS, Yoon J, Kim WJ, Jung HS, Ahn MS, Lee KH, Kim JY, Lee SH, Ko JY, Hwang SO, Jung YH, Choe KH. The Clinical Significance of Serum-Hydroxyproline in Acute Coronary Syndrome. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.12.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Byung Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Woo Jae Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hyun Sook Jung
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Min Soo Ahn
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Ji Yean Ko
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Oh Hwang
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Young Ho Jung
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
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39
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Chung IH, Kim JY, Wang HS, Yoo BS, Lee SH, Yoon J, Choe KH. A Case of Percutaneous Aspiration Thromboembolectomy of the Common Femoral Artery, Using the PercuSurge GuardWire(TM) System, with a 7 Fr. Guiding Catheter. Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.8.804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Il Hyung Chung
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hee Sung Wang
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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40
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Kim JY, Yoon J, Yoo BS, Lee SH, Jung SH, Hong IS, Choe KH. A Case of Cardiac Metastasis from Lung Cancer Presented with Persistent ST Segment Elevation Simulating Acute Myocardial Infarction. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.5.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jang Young Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Junghan Yoon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Soon Hee Jung
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - In Soo Hong
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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41
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Kim JY, Yoon J, Jung HS, Kim WJ, Ahn MS, Lee KH, Yoo BS, Lee SH, Hwang SO, Choe KH. The Experience of Transradial Coronary Intervention for Chronic Total Occlusion. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.9.805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jang Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Junghan Yoon
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun Sook Jung
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Woo Jae Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min Soo Ahn
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyung Hoon Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Oh Hwang
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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42
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Kim JY, Yoon J, Lee SH, Yoo BS, Jung HS, Kim WJ, Ju HS, Hwang SO, Choe KH. Efficacy of Embolic Protection using PercuSurge GuardWire System During Primary Percutaneous Coronary Intervention with the Lesions Suggesting Large Thrombus Burden. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.12.1103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jang Young Kim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Junghan Yoon
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Hyun Sook Jung
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Woo Jae Kim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Hun Su Ju
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Sung Oh Hwang
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Korea
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43
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Ahn MS, Yoo BS, Kim JY, Ko JY, Lee KH, Kim WJ, Jung HS, Park IH, Lee MO, Kim SN, Lee SH, Hwang SO, Yoon JH, Choe KH. Predictive Factors of Survival for Intra-aortic Balloon Pump in Acute Myocardial Infarction Treated with Angioplasty. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.1.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Min Soo Ahn
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Ji Yeon Ko
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Woo Jae Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hyun Sook Jung
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Il Hyung Park
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Myung Ok Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Nyun Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Oh Hwang
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jung Han Yoon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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44
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Jung HS, Kim JY, Ahn MS, Lee KH, Kim WJ, Yoo BS, Lee SH, Yoon JH, Choe KH. A Case of Percutaneous Removal of Cutted Left Atrial Pressure Catheter after Mitral Valve Replacement. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.1.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hyun Sook Jung
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Min Soo Ahn
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Woo Jae Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jung Han Yoon
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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45
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Jeong MH, Kim W, Kang JC, Han SW, Hur SH, Kim KB, Cha KS, Kim MH, Kang HS, Bae JH, Chae IH, Oh BH, Hong MK, Park SW, Park SJ, Choi SY, Tahk SJ, Choi DH, Jang YS, Cho SY, Yoo BS, Yoon JH, Choe KH. A Comparison of Tenecteplase(TNK-tPA) and Alteplase(rt-PA) in Korean Patients with Acute Myocardial Infarction(A Randomized, Multi-Centered Coronary Angiographic Trial). Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.5.362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Weon Kim
- Chonnam National University Hospital, Gwangju, Korea
| | | | | | - Seung Ho Hur
- Chonnam National University Hospital, Gwangju, Korea
| | - Kwon Bae Kim
- Chonnam National University Hospital, Gwangju, Korea
| | - Kwang Soo Cha
- Chonnam National University Hospital, Gwangju, Korea
| | - Moo Hyun Kim
- Chonnam National University Hospital, Gwangju, Korea
| | | | - Jong Hwa Bae
- Chonnam National University Hospital, Gwangju, Korea
| | - In Ho Chae
- Chonnam National University Hospital, Gwangju, Korea
| | - Byung Hee Oh
- Chonnam National University Hospital, Gwangju, Korea
| | | | | | | | - So Yeon Choi
- Chonnam National University Hospital, Gwangju, Korea
| | | | | | - Yang Soo Jang
- Chonnam National University Hospital, Gwangju, Korea
| | - Seung Yun Cho
- Chonnam National University Hospital, Gwangju, Korea
| | - Byung Su Yoo
- Chonnam National University Hospital, Gwangju, Korea
| | - Jung Han Yoon
- Chonnam National University Hospital, Gwangju, Korea
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46
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Yoo BS, Yoon JH, Kim JY, Choi HM, Lee SH, Hwang SO, Choe KH, Ko JS. The Effect of Farnesyl Transferase Inhibitor on the Proliferation of Vascular Smooth Muscle Cells and Neointima Formation. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.4.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Byung Su Yoo
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jung han Yoon
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jang Young Kim
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Hyun Min Choi
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Seung Hwan Lee
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sung Oh Hwang
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Kyung Hoon Choe
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Jong Sung Ko
- Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea
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47
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Funauchi M, Yoo BS, Nozaki Y, Sugiyama M, Ohno M, Kinoshita K, Kanamaru A. Dysregulation of the granulocyte-macrophage colony-stimulating factor receptor is one of the causes of defective expression of CD80 antigen in systemic lupus erythematosus. Lupus 2002; 11:317-21. [PMID: 12090568 DOI: 10.1191/0961203302lu201oa] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
CD80 and CD86, expressed on the antigen-presenting cells (APCs) provide costimulatory signals for T lymphocytes. Recently, defective expression of CD80 has been reported in systemic lupus erythematosus (SLE) although its mechanism is unclear. Here, expression of the B7 antigens induced by interferon-gamma, interleukin-4 or granulocyte-macrophage stimulating-factor (GM-CSF) along the differentiation process of APCs was investigated. In contrast to CD86, expression of CD80 on the CD14+ cells induced by GM-CSF was reduced in SLE. GM-CSF receptor (GM-CSFR) was down-regulated by GM-CSF or phorbol 12-myristate 13-acetate in both of the normal controls and SLE patients, while this change was more remarkable in the latter. In the presence of 1-(5-isoquinolinsulfonyl)-2-methylpiperazine, an inhibitor of protein kinase C, the PMA-induced down-regulation of GM-CSFR was reversed in the normal controls but not in SLE. These data suggest that dysregulation of the GM-CSFR might be associated with the defective expression of CD80, leading to dysfunction of the APCs in SLE.
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Affiliation(s)
- M Funauchi
- Third Department of Internal Medicine, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan
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48
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Funauchi M, Nozaki Y, Yoo BS, Kinoshita K, Kanamaru A. A case of limb-girdle muscular dystrophy with serum anti-nuclear antibody which led to a mistaken diagnosis of polymyositis. Clin Exp Rheumatol 2002; 20:707-8. [PMID: 12412206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
A 45-year-old woman had first been diagnosed with polymyositis because of the presence of focal necrosis, regeneration and inflammatory infiltration in the muscle fibers, and elevated creatinine phosphokinase levels. However, a pathological re-evaluation and family history led to the definite diagnosis of limb-girdle muscular dystrophy (MD). This case suggests that MD should be taken into consideration in the differential diagnosis of the inflammatory myopathies and genetic surveys including dystrophin molecule may be necessary if the condition manifests during or after adolescence, or when the family history is uninformative. In this case, the serum anti-nuclear antibody was positive, and it may represent the first time that ANA positivity has been found in limb-girdle MD.
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Affiliation(s)
- M Funauchi
- Division of Hematology, Nephrology and Rheumatology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama 589-8511, Osaka, Japan
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49
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Hwang SO, Lee KH, Lee JW, Lee SY, Yoo BS, Yoon J, Choe KH. Simultaneous sterno-thoracic cardiopulmonary resuscitation improves short-term survival rate in canine cardiac arrests. Resuscitation 2002; 53:209-16. [PMID: 12009225 DOI: 10.1016/s0300-9572(02)00011-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We have reported previously that simultaneous sterno-thoracic cardiopulmonary resuscitation (SST-CPR) using a device that compresses the sternum and constricts the thorax circumferentially during a compression systole that can be achieved using standard cardiopulmonary resuscitation (STD-CPR). This study was designed to assess whether SST-CPR improves the survival rate of dogs with cardiac arrest compared with STD-CPR. Twenty-nine mongrel dogs (19-31 kg) were enrolled in this study. After 4 min of ventricular fibrillation induced by an AC current, animals were randomized to be resuscitated by either STD-CPR (n=15) or SST-CPR (n=14). Defibrillation was attempted 10 min after the induction of cardiac arrest. Standard advanced cardiac life support was started if defibrillation was unsuccessful. Aortic blood pressure, coronary perfusion pressure, and end tidal CO(2) tension were measured during CPR and the post-resuscitation period. Survival was determined 12 h after the induction of cardiac arrest. SST-CPR resulted in a significantly (P<0.001) higher systolic arterial pressure (91+/-47 vs 47+/-24 mmHg), diastolic pressure (43+/-24 vs 17+/-10 mmHg), coronary perfusion pressure (35+/-25 vs 13+/-9 mmHg), and end tidal CO(2) tension (9+/-4 vs 3+/-2 mmHg). Two of 15 animals (13%) resuscitated by STD-CPR and seven of 14 animals (50%) resuscitated by SST-CPR survived for 12 h after cardiac arrest (P<0.05). In conclusion, SST-CPR improves the short-term survival rate in canine cardiac arrest compared with STD-CPR.
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Affiliation(s)
- Sung Oh Hwang
- Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
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50
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Lee KH, Ko JY, Choi HM, Ahn MS, Kim JY, Yoo BS, Lee SH, Hwang SO, Yoon JH, Choe KH. The Comparison of Reasons for not Receiving Reperfusion Therapy on Acute Myocardial Infarction for the Recent 10 Years. Korean Circ J 2002. [DOI: 10.4070/kcj.2002.32.11.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kyung Hoon Lee
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Ji Yeon Ko
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Hyun Min Choi
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Min Soo Ahn
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Jang Young Kim
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Byung Su Yoo
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Seung Hwan Lee
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Sung Oh Hwang
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Jung Han Yoon
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
| | - Kyung Hoon Choe
- Department of Internal Medicine, Wonju college of Medicine, Yonsei University, Korea
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