1
|
Park S, Chang J, Hong SP, Jin ES, Kong MG, Choi HY, Kwon SS, Park GM, Park RW. Impact of Trimetazidine on the Incident Heart Failure After Coronary Artery Revascularization. J Cardiovasc Pharmacol 2023; 82:318-326. [PMID: 37437526 DOI: 10.1097/fjc.0000000000001453] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/22/2023] [Indexed: 07/14/2023]
Abstract
ABSTRACT Abnormal myocardial metabolism is a common pathophysiological process underlying ischemic heart disease and heart failure (HF). Trimetazidine is an antianginal agent with a unique mechanism of action that regulates myocardial energy metabolism and might have a beneficial effect in preventing HF in patients undergoing myocardial revascularization. We aimed to evaluate the potential benefit of trimetazidine in preventing incident hospitalization for HF after myocardial revascularization. Using the common data model, we identified patients without prior HF undergoing myocardial revascularization from 8 hospital databases in Korea. To compare clinical outcomes using trimetazidine, database-level hazard ratios (HRs) were estimated using large-scale propensity score matching for each database and pooled using a random-effects model. The primary outcome was incident hospitalization for HF. The secondary outcome of interest was major adverse cardiac events (MACEs). After propensity score matching, 6724 and 11,211 patients were allocated to trimetazidine new-users and nonusers, respectively. There was no significant difference in the incidence of hospitalization for HF between the 2 groups (HR: 1.08, 95% confidence interval [CI], 0.88-1.31; P = 0.46). The risk of MACE also did not differ between the 2 groups (HR: 1.07, 95% CI, 0.98-1.16; P = 0.15). In conclusion, the use of trimetazidine did not reduce the risk of hospitalization for HF or MACE in patients undergoing myocardial revascularization. Therefore, the role of trimetazidine in contemporary clinical practice cannot be expanded beyond its current role as an add-on treatment for symptomatic angina.
Collapse
Affiliation(s)
- Sangwoo Park
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Junhyuk Chang
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Korea
| | - Seung-Pyo Hong
- Department of Cardiology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Min Gyu Kong
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ha-Young Choi
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Seong Soon Kwon
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea; and
| | - Gyung-Min Park
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Rae Woong Park
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Korea
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|
2
|
Jin ES, Shim JS, Kim SE, Bae JH, Kang S, Won JC, Shin MJ, Jin HY, Moon J, Lee H, Kim HC, Jeong IK. Dyslipidemia Fact Sheet in South Korea, 2022. Diabetes Metab J 2023; 47:632-642. [PMID: 37528532 PMCID: PMC10555536 DOI: 10.4093/dmj.2023.0135] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGRUOUND This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. METHODS We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. RESULTS In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia-more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)-was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL. CONCLUSION Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Eun Kim
- Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Jae Hyun Bae
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Shinae Kang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Chul Won
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Min-Jeong Shin
- School of Biosystem and Biomedical Science, Korea University, Seoul, Korea
| | - Heung Yong Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jenny Moon
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - In-Kyung Jeong
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - on Behalf of the Committee of Public Relation of the Korean Society of Lipid and Atherosclerosis
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
- School of Biosystem and Biomedical Science, Korea University, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| |
Collapse
|
3
|
Jin ES, Shim JS, Kim SE, Bae JH, Kang S, Won JC, Shin MJ, Jin HY, Moon J, Lee H, Kim HC, Jeong IK. Dyslipidemia Fact Sheet in South Korea, 2022. J Lipid Atheroscler 2023; 12:237-251. [PMID: 37800108 PMCID: PMC10548191 DOI: 10.12997/jla.2023.12.3.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 10/07/2023] Open
Abstract
Objective This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022. Methods We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020. Results In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia (more than one out of three conditions [low-density lipoprotein-cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein-cholesterol (men and women) <40 mg/dL]) was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-high-density lipoprotein-cholesterolemia in women changed from <40 to <50 mg/dL. Conclusion Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Eun Kim
- Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Shinae Kang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - Jong Chul Won
- Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea
| | - Min-Jeong Shin
- School of Biosystem and Biomedical Science, Korea University, Seoul, Korea
| | - Heung Yong Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical School, Jeonbuk National University, Jeonju, Korea
| | - Jenny Moon
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - In-Kyung Jeong
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | | |
Collapse
|
4
|
Bae JH, Jin ES, Kim SE, Kang S, Lee JY, Kim M, Jin HY, Shin MJ, Jeong IK. Public Awareness of Dyslipidemia Among the Korean Population: A Survey Study. J Lipid Atheroscler 2023; 12:307-314. [PMID: 37800113 PMCID: PMC10548193 DOI: 10.12997/jla.2023.12.3.307] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 10/07/2023] Open
Abstract
Objective We aimed to assess the level of public awareness regarding dyslipidemia and its management among the Korean population. Methods We conducted a web- or mobile-based survey study targeting the general population, using various recruitment methods, between July 25, 2022 and August 26, 2022. The questionnaire consisted of 12 questions designed to collect demographic information and evaluate participants' awareness and knowledge about dyslipidemia. Results In total, 2,882 participants who completed the survey were included in the analysis. Among the participants, a substantial majority (89.1%) were familiar with the concepts of "good cholesterol" and "bad cholesterol," while a comparatively lower percentage (just 46.7%) were acquainted with the term "dyslipidemia." Noticeable variations in understanding were observed when examining specific aspects of dyslipidemia management, including diet, exercise, and pharmacotherapy. Conclusion The results of this survey underscore the significance of enhancing public awareness about dyslipidemia within the context of health literacy, demonstrating the necessity for a more comprehensive approach that includes education and policymaking to effectively manage dyslipidemia.
Collapse
Affiliation(s)
- Jae Hyun Bae
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Shinae Kang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Young Lee
- Department of Internal Medicine, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Minsu Kim
- Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea
| | - Heung Yong Jin
- Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Min-Jeong Shin
- School of Biosystem and Biomedical Science, Korea University College of Health Science, Seoul, Korea
| | - In-Kyung Jeong
- Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| |
Collapse
|
5
|
Jin ES, Kim JY, Min J, Jeon SR, Choi KH, Khan SA, Moon GS, Jeong JH. Preliminary Study on Effect of Lactiplantibacillus plantarum on Osteoporosis in the Ovariectomized Rat. Food Sci Anim Resour 2023; 43:712-720. [PMID: 37483997 PMCID: PMC10359845 DOI: 10.5851/kosfa.2023.e29] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Osteoporosis is a growing global health concern primarily associated with decreased estrogen in postmenopausal women. Recently, some strains of probiotics were examined for potential anti-osteoporotic effects. This study intended to evaluate the impacts of Lactiplantibacillus plantarum MGE 3038 strain (MGE 3038) in ovariectomized rats. For this purpose, twelve weeks old female Wistar rats (n=21; 250-300 g) were divided into 3 groups; ovariectomy (OVX) group, OVX/MGE 3038 group and Sham group (control). In these groups; two went through respective OVX and one had daily MGE 3038 administration through oral gavage. Prior to 16 weeks after OVX, we collected blood samples and extracted the tibiae. We scanned the extracted tibiae by in-vivo micro-computed tomography (micro-CT) and evaluated pathology by hematoxylin and eosin (H&E) and Masson's trichrome staining. The serum levels of C-telopeptide of type I collagen (CTX), osteocalcin (OC), and the receptor activator of nuclear factor-ĸB ligand (RANKL) were examined. The OVX/MGE 3038 group showed increases in bone mineral density, trabecular bone volume, trabecular number, and trabecular thickness (Tb.Th), and a decrease in trabecular spacing than the OVX group. However, OVX/MGE 3038 group and control group were measurably comparable in Tb.Th. Micro-CT, H&E, and Masson's trichrome findings exhibited increased preservation and maintenance of trabecular bone structure in the OVX/MGE 3038 group in comparison to the OVX group. In serum, the levels of CTX, OC and RANKL were significantly different between the OVX and OVX/MGE 3038 groups. Taken together, L. plantarum MGE 3038 could be helpful for the treatment of osteoporosis.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Department of Internal Medicine, College
of Medicine, Kyung Hee University, Seoul 02447, Korea
- Laboratory of Stem Cell Therapy, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
| | - Ji Yeon Kim
- Laboratory of Stem Cell Therapy, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
| | - JoongKee Min
- Laboratory of Stem Cell Therapy, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
| | - Sang Ryong Jeon
- Laboratory of Stem Cell Therapy, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
- Department of Neurological Surgery, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
| | - Kyoung Hyo Choi
- Laboratory of Stem Cell Therapy, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
- Department of Rehabilitation Medicine,
Asan Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
| | - Shehzad Abid Khan
- 4D Convergence Technology Institute, Korea
National University of Transportation, Jeungpyeong 27909,
Korea
| | - Gi-Seong Moon
- 4D Convergence Technology Institute, Korea
National University of Transportation, Jeungpyeong 27909,
Korea
- Department of Biotechnology, Korea
National University of Transportation, Jeungpyeong 27909,
Korea
| | - Je Hoon Jeong
- Laboratory of Stem Cell Therapy, Asan
Medical Center, College of Medicine, University of Ulsan,
Seoul 05505, Korea
- Department of Neurosurgery, Soonchunhyang
University Bucheon Hospital, Bucheon 14584, Korea
| |
Collapse
|
6
|
Hwang HJ, Sohn IS, Jin ES, Bae YJ. Adherence and clinical outcomes for twice-daily versus once-daily dosing of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: Is dosing frequency important? PLoS One 2023; 18:e0283478. [PMID: 36996134 PMCID: PMC10062560 DOI: 10.1371/journal.pone.0283478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/09/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Twice-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) may reduce drug adherence compared with once-daily dosing of NOACs in patients with atrial fibrillation (AF), thus worsening clinical outcomes. We evaluated adherence to apixaban and dabigatran requiring twice-daily dosing compared with edoxaban or rivaroxaban with a once-daily dosing regimen and the subsequent clinical outcomes in patients with AF. METHODS Adherence to each NOAC and outcomes were compared between patients who were diagnosed with AF and initiated NOACs between 2016 and 2017 using Korean claims data. High adherence was defined as the proportion of days covered (PDC) of the index NOAC ≥80%. The clinical outcomes included stroke, acute myocardial infarction, death, and composite outcome. RESULTS A total of 33,515 patients were analyzed (mean follow-up, 1.7 ± 1.3 years). The proportion of patients with high adherence to NOACs was 95%, which did not significantly differ according to the dosing regimen. The mean PDC for NOACs was as high as ~96%, which was the highest for apixaban users, intermediate for edoxaban or rivaroxaban users, and lowest for dabigatran users, regardless of the dosing regimen. Adverse outcomes in low adherence patients for each NOAC were higher than that of high adherence patients, regardless of the dosing frequency. CONCLUSIONS Adherence between once- and twice-daily dosing NOACs in patients with AF was high and similar among both dosing regimens. Patients with low NOAC adherence had poorer clinical outcomes, regardless of the dosing frequency.
Collapse
Affiliation(s)
- Hui-Jeong Hwang
- Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Il Suk Sohn
- Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Yoon-Jong Bae
- Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Korea
| |
Collapse
|
7
|
Jung M, Byeon K, Kang KW, Park YM, Hwang YM, Lee SH, Jin ES, Roh SY, Kim JS, Ahn J, Lee SR, Choi EK, Ahn MS, Lee EM, Park HC, Lee KH, Kim M, Choi JH, Ko JS, Kim JB, Kim C, Lip GYH, Shin SY. Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA 2DS 2-VASc Score 0-1: A Korean Multi-Center Cohort. Yonsei Med J 2022; 63:892-901. [PMID: 36168241 PMCID: PMC9520051 DOI: 10.3349/ymj.2022.0157] [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: 05/11/2022] [Revised: 07/17/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA2DS2-VASc score of 0-1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m²), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA2DS2-VASc score 0-1. MATERIALS AND METHODS This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0-1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. RESULTS Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA2DS2-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P-Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11-0.63, p=0.003). CONCLUSION The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0-1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA2DS2-VASc score 0-1.
Collapse
Affiliation(s)
- Moonki Jung
- Department of Cardiology, Heart and Brain Hospital, Chung-Ang University Gwangmyeong Hospital, College of Medicine, Chung-Ang University, Gwangmyeong, Korea
| | - Kyeongmin Byeon
- Department of Cardiology, Heart and Brain Hospital, Chung-Ang University Gwangmyeong Hospital, College of Medicine, Chung-Ang University, Gwangmyeong, Korea
| | - Ki-Woon Kang
- Cardiovascular & Arrhythmia Center, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Yae Min Park
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - You Mi Hwang
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sung Ho Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Sun Jin
- Cardiovascular Center, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Seung-Young Roh
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Jin Seok Kim
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| | - Jinhee Ahn
- Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - So-Ryoung Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Min-Soo Ahn
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Eun Mi Lee
- Division of Cardiology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Hwan-Cheol Park
- Department of Cardiology, Hanyang University Guri Hospital, Guri, Korea
| | - Ki Hong Lee
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Min Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Joon Hyouk Choi
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Jeju National University, Jeju National University Hospital, Jeju, Korea
| | - Jum Suk Ko
- Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Jin Bae Kim
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Denmark.
| | - Seung Yong Shin
- Cardiovascular & Arrhythmia Center, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea.
| | | |
Collapse
|
8
|
Jin ES, Kim JY, Min J, Jeon SR, Choi KH, Khan SA, Moon GS, Jeong JH. Effect of Lactobacillus plantarum on Osteoporosis in
the Ovariectomized Rat. Food Sci Anim Resour 2022. [DOI: 10.5851/kosfa.2022.e55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
9
|
Jeong JH, Jin ES, Kim JY, Min J, Jeon SR, Lee M, Choi KH. Bone formation effect of highly concentrated tricalcium phosphate biocomposite screws in a rabbit osteoporosis model. J Orthop Res 2022; 40:1321-1328. [PMID: 34432337 DOI: 10.1002/jor.25171] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 07/11/2021] [Accepted: 08/13/2021] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to determine the efficacy of highly concentrated tricalcium phosphate (TCP) biocomposite screws on local bone formation in a rabbit model of osteoporosis induced by bilateral ovariohysterectomy (OHE). Fourteen 24-week-old female New Zealand rabbits (weight, 3-3.5 kg) were divided into two groups: (1) OHE and biodegradable poly(lactic-co-glycolic acid) (PLGA) without ß-TCP plate or screw insertion (OHE/Bio ScRew [BSR]) group and (2) OHE and biocomposite PLGA with highly concentrated ß-TCP plate and screw insertion (OHE/highly concentrated ß-triCalcium phosphate [HCCP]). Both groups underwent bilateral OHE and had two different types of screws and plates inserted at the proximal tibia. Bilateral tibiae were extracted at 25 weeks post-OHE. The extracted tibiae were scanned with ex vivo microcomputed tomography (micro-CT). Parameters including bone mineral density (BMD), trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb. Th), and trabecular separation (Tb. Sp) were evaluated after staining the tibial samples with hematoxylin and eosin (H&E) and Masson's trichrome. We then performed pathological assessments. Micro-CT images revealed improved new bone formation near the implant in the OHE/HCCP group with higher values of BMD, BV/TV, and Tb.N but lower values of Tb. Th and Tb. Sp than the OHE/BSR group. Analyses of H&E and Masson's trichrome staining showed better new bone formation around the implant in the OHE/HCCP group than in the OHE/BSR group. The use of highly concentrated TCP biocomposite screw and plate might improve local bone formation and facilitate osteoconductivity in an osteoporotic rabbit model.
Collapse
Affiliation(s)
- Je Hoon Jeong
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.,Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun-Sun Jin
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Ji Yeon Kim
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JoongKee Min
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Ryong Jeon
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Minsu Lee
- OSTEONIC Co., Ltd., Seoul, Republic of Korea
| | - Kyoung Hyo Choi
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
10
|
Seo WW, Seo SI, Kim Y, Yoo JJ, Shin WG, Kim J, You SC, Park RW, Park YM, Kim KJ, Rhee SY, Park M, Jin ES, Kim SE. Impact of pitavastatin on new-onset diabetes mellitus compared to atorvastatin and rosuvastatin: a distributed network analysis of 10 real-world databases. Cardiovasc Diabetol 2022; 21:82. [PMID: 35606846 PMCID: PMC9128291 DOI: 10.1186/s12933-022-01524-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Statin treatment increases the risk of new-onset diabetes mellitus (NODM); however, data directly comparing the risk of NODM among individual statins is limited. We compared the risk of NODM between patients using pitavastatin and atorvastatin or rosuvastatin using reliable, large-scale data. METHODS Data of electronic health records from ten hospitals converted to the Observational Medical Outcomes Partnership Common Data Model (n = 14,605,368 patients) were used to identify new users of pitavastatin, atorvastatin, or rosuvastatin (atorvastatin + rosuvastatin) for ≥ 180 days without a previous history of diabetes or HbA1c level ≥ 5.7%. We conducted a cohort study using Cox regression analysis to examine the hazard ratio (HR) of NODM after propensity score matching (PSM) and then performed an aggregate meta-analysis of the HR. RESULTS After 1:2 PSM, 10,238 new pitavastatin users (15,998 person-years of follow-up) and 18,605 atorvastatin + rosuvastatin users (33,477 person-years of follow-up) were pooled from 10 databases. The meta-analysis of the HRs demonstrated that pitavastatin resulted in a significantly reduced risk of NODM than atorvastatin + rosuvastatin (HR 0.72; 95% CI 0.59-0.87). In sub-analysis, pitavastatin was associated with a lower risk of NODM than atorvastatin or rosuvastatin after 1:1 PSM (HR 0.69; CI 0.54-0.88 and HR 0.74; CI 0.55-0.99, respectively). A consistently low risk of NODM in pitavastatin users was observed when compared with low-to-moderate-intensity atorvastatin + rosuvastatin users (HR 0.78; CI 0.62-0.98). CONCLUSIONS In this retrospective, multicenter active-comparator, new-user, cohort study, pitavastatin reduced the risk of NODM compared with atorvastatin or rosuvastatin.
Collapse
Affiliation(s)
- Won-Woo Seo
- Departments of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea
| | - Seung In Seo
- Departments of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea.,Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
| | - Yerim Kim
- Departments of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Jong Jin Yoo
- Departments of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea
| | - Woon Geon Shin
- Departments of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea.,Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
| | - Jinseob Kim
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, South Korea
| | - Seng Chan You
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University, Suwon, South Korea
| | - Young Min Park
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Kyung-Jin Kim
- Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Meeyoung Park
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Eun-Sun Jin
- Cardiovascular Center, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, South Korea
| | - Sung Eun Kim
- Departments of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea.
| |
Collapse
|
11
|
Jin ES, Kim JY, Yang JM, Kim JS, Min J, Jeon SR, Choi KH, Moon GS, Jeong JH. The Effect of Genetically Modified Lactobacillus plantarum Carrying Bone Morphogenetic Protein 2 Gene on an Ovariectomized Rat. J Korean Neurosurg Soc 2021; 65:204-214. [PMID: 34727681 PMCID: PMC8918239 DOI: 10.3340/jkns.2021.0098] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022] Open
Abstract
Objective Osteoporosis result from age-related decline in the number of osteoblast progenitors in the bone marrow. Probiotics have beneficial effects on the host, when administered in appropriate amounts. This study investigated the effects of probiotics expressing specific genes, especially the effects of genetically modified bone morphogenetic protein (BMP)-2-expressing Lactobacillus plantarum CJNU 3003 (LP) on ovariectomized rats. Methods Twenty-eight female Wistar rats (250-300 g, 12 weeks old) were divided into four groups : the sham (control), the ovariectomy (OVX)-induced osteoporosis group (OVX), the OVX and LP (OVX/LP), OVX and genetically modified BMP-2-expressing LP (OVX/LP with BMP) groups. The three groups underwent bilateral OVX and two of these groups were administered two different types of LP via oral gavage daily. At 16 weeks post-OVX, blood was collected from the heart and the bilateral tibiae were extracted and were scanned by ex-vivo micro-computed tomography and stained with hematoxylin-and-eosin (H&E) and Masson's trichrome stain for pathological assessment. The serum levels of osteocalcin (OC), rat C-telopeptide of type I collagen (CTX-I), BMP-2, and receptor activator of nuclear factor-ĸB ligand (RANKL) were measured. Results The 3D-micro-computed tomography images showed that the trabecular structure in the OVX/LP with BMP group was maintained compared with OVX and OVX/LP groups. No significant differences were detected in trabecular thickness (Tb.Th) between control and OVX/LP with BMP groups (p>0.05). Furthermore, a tendency toward increased BMD, trabecular bone volume, Tb.Th, and trabecular number and decreased trabecular separation was found in rats in the OVX/LP with BMP groups when compared with the OVX and OVX/LP groups (p>0.05). The H&E and Masson's trichrome stained sections showed a thicker trabecular bone in the OVX/LP with BMP group compared with the OVX and OVX/LP groups. There was no difference in serum levels of OC, CTX and RANKL control and OVX/LP with BMP groups (p>0.05). In contrast, significant differences were found in OC and CTX-1 levels between the OVX and OVX/LP with BMP groups (p<0.05). Conclusion Our results showed that the expression of genetically modified BMP-2 showed inhibition effect for bone loss in a rat model of osteoporosis.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.,Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Ji Yeon Kim
- Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Jung-Mo Yang
- Department of Biotechnology, Korea National University of Transportation, Jeungpyeong, Korea
| | - Jun-Sub Kim
- Department of Biotechnology, Korea National University of Transportation, Jeungpyeong, Korea
| | - JoongKee Min
- Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Sang Ryong Jeon
- Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.,Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Kyoung Hyo Choi
- Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.,Department of Rehabilitation Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Gi-Seong Moon
- Department of Biotechnology, Korea National University of Transportation, Jeungpyeong, Korea
| | - Je Hoon Jeong
- Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.,Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| |
Collapse
|
12
|
Lee E, Park HS, Han S, Nam GB, Choi JI, Pak HN, Oh IY, Shin DG, On YK, Park SW, Kim YH, Oh S, Ahn J, Ahn MS, Baek YS, Cha MJ, Cha TJ, Choi EK, Choi HO, Choi JI, Chun KJ, Gwag HB, Han S, Hwang Y, Hyun DW, Jin ES, Kang KW, Kim DH, Kim DK, Kim D, Kim JH, Kim JB, Kim M, Kim SH, Kim YR, Kim YH, Ko JS, Kwak JJ, Lee E, Lee S, Lee SR, Lee SH, Lee YS, Nam GB, Namgung J, Oh IY, Oh S, Oh YS, On YK, Pak HN, Park HC, Park HS, Park HW, Park SW, Park YM, Park YA, Rhee KS, Shim J, Shin DG, Song IG, Sung JH, Yang PS. Catheter ablation of atrial fibrillation in Korea: results from the Korean Heart Rhythm Society Ablation Registry for Atrial Fibrillation (KARA). Int J Arrhythm 2021. [DOI: 10.1186/s42444-021-00047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study aims to investigate the current status of AF (atrial fibrillation) catheter ablation in Korea.
Methods
The patients who underwent AF catheter ablation from September 2017 to December 2019 were prospectively enrolled from 37 arrhythmia centers. Demographic data, procedural characteristics, the extent of catheter ablation, acute success of the ablation lesion set, rate and independent risk factor for recurrence of AF were analyzed.
Results
A total of 2402 AF patients [paroxysmal AF (PAF) 45.7%, persistent AF (PeAF) 43.1% and redo AF 11.2%] were included. Pulmonary vein isolation (PVI) was performed in 2378 patients (99%) and acute success rate was 97.9%. Additional non-PV ablation (NPVA) were performed in 1648 patients (68.6%). Post-procedural complication rate was 2.2%. One-year AF-free survival rate was 78.6% and the PeAF patients showed poorer survival rate than the ones with other types (PeAF 72.4%, PAF 84.2%, redo AF 80.0%). Additional NPVA did not influence the recurrence of AF in the PAF patients (PVI 17.0% vs. NPVA 14.6%, P value 0.302). However, it showed lower AF recurrence rate in the PeAF patients (PVI 34.9% vs. NPVA 24.4%, P value 0.001). Valvular heart disease, left atrial diameter, PeAF, PVI alone, need of NPVA for terminating AF, and failed ablation were independent predictors of AF recurrence.
Conclusions
Additional NPVA was associated better rhythm outcome in the patients with PeAF, not in the ones with PAF. The independent risk factors for AF recurrence in Korean population were similar to previous studies. Further research is needed to discover optimal AF ablation strategy.
Collapse
|
13
|
Hwang HJ, Sohn IS, Park CB, Jin ES, Cho JM, Kim CJ. Clinical outcomes of discordant exercise electrocardiographic and echocardiographic findings compared with concordant findings in patients with chest pain and no history of coronary artery disease: An observational study. Medicine (Baltimore) 2019; 98:e17195. [PMID: 31574826 PMCID: PMC6775389 DOI: 10.1097/md.0000000000017195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to evaluate comparative clinical outcomes of discordant electrocardiographic (ECG) and echocardiographic (Echo) findings compared with concordant findings during treadmill exercise echocardiography in patients with chest pain and no history of coronary artery disease (CAD).A total of 1725 consecutive patients who underwent treadmill echocardiography with chest pain and no history of CAD were screened. The patients were classified into 4 groups: ECG-/Echo- (negative ECG and Echo), ECG+/Echo- (positive ECG and negative Echo), ECG-/Echo+, and ECG+/Echo+. Concomitant CAD was determined using coronary angiography or coronary computed tomography. Major adverse cardiac events (MACEs) were defined as a composite of coronary revascularization, acute myocardial infarction, and death.MACEs were similar between ECG-/Echo- and ECG+/Echo- groups. Compared with ECG+/Echo- group, ECG-/Echo+ group had more MACEs (adjusted hazard ratio [HR] adjusted by clinical risk factors [95% confidence interval {CI}], 3.57 [1.75-7.29], P < .001). Compared with ECG+/Echo+ group, ECG-/Echo+ group had lower prevalence of concomitant CAD and fewer MACEs (HR, 0.49 [0.29-0.81], P = .006).Positive exercise Echo alone during treadmill exercise echocardiography had worse clinical outcomes than positive ECG alone, and the latter had similar outcomes to both negative ECG and Echo. Positive exercise Echo alone also had better clinical outcomes than both positive ECG and Echo. Therefore, exercise Echo findings might be superior for predicting clinical outcomes compared with exercise ECG findings. Additional consideration of ECG findings on positive exercise Echo will also facilitate better prediction of clinical outcomes.
Collapse
|
14
|
Jin ES, Kim JY, Min JK, Jeon SR, Choi KH, Lee MS, Jeong JH. Bilateral ovario-hysterectomy induced osteoporotic rabbit model. J BIOL REG HOMEOS AG 2019; 33:391-396. [PMID: 30915825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- E S Jin
- Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - J Y Kim
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - J K Min
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
| | - S R Jeon
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Neurological surgery, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - K H Choi
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Rehabilitation Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - M S Lee
- OSTEONIC, Co., Ltd., Seoul, Republic of Korea
| | - J H Jeong
- Laboratory of Stem Cell Therapy, College of Medicine, Asan Medical Center, University of Ulsan, Ulsan, Republic of Korea
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Gyunggi-do, Republic of Korea
| |
Collapse
|
15
|
Oh S, Kim JS, Oh YS, Shin DG, Pak HN, Hwang GS, Choi KJ, Kim JB, Lee MY, Park HW, Kim DK, Jin ES, Park J, Oh IY, Shin DH, Park HS, Kim JH, Kim NH, Ahn MS, Seo BJ, Kim YJ, Kang S, Lee J, Kim YH. Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II. J Korean Med Sci 2018; 33:e323. [PMID: 30505257 PMCID: PMC6262187 DOI: 10.3346/jkms.2018.33.e323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 05/01/2018] [Accepted: 08/07/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. METHODS We conducted a multicenter, prospective, non-interventional study. Patients with CHADS2 ≥ 1 and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. RESULTS A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had CHADS2 ≥ 2 and 83.6% had CHA2DS2-VASc ≥ 2. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. CONCLUSION INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.
Collapse
Affiliation(s)
- Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - June-Soo Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Seog Oh
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Gu Shin
- Department of Internal Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea
| | - Hui-Nam Pak
- Department of Internal Medicine, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Gyo-Seung Hwang
- Department of Internal Medicine, Ajou University Hospital, Suwon, Korea
| | - Kee-Joon Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Bae Kim
- Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Man-Young Lee
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyung-Wook Park
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Dae-Kyeong Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Eun-Sun Jin
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jaeseok Park
- Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Il-Young Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dae-Hee Shin
- Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Hyoung-Seob Park
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea
| | - Jun Hyung Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam, Korea
| | - Nam-Ho Kim
- Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Min-Soo Ahn
- Department of Internal Medicine, Yonsei University, Wonju Severance Christian Hospital, Wonju, Korea
| | - Bo-Jeong Seo
- Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea
| | - Young-Joo Kim
- Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea
| | - Seongsik Kang
- Department of Internal Medicine-Medical, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Young-Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
16
|
Jin ES, Kim JY, Lee B, Min J, Jeon SR, Choi KH, Jeong JH. Biodegradable Screws Containing Bone Morphogenetic Protein-2 in an Osteoporotic Rat Model. J Korean Neurosurg Soc 2018; 61:559-567. [PMID: 30041512 PMCID: PMC6129746 DOI: 10.3340/jkns.2017.0297] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/09/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect for biodegradable screws containing bone morphogenetic protein-2 (BMP-2) in an osteoporotic rat model. METHODS Twenty-four female Wistar rat (250-300 g, 12 weeks of age) were randomized into four groups. Three groups underwent bilateral ovariectomy (OVX). Biodegradable screws with or without BMP-2 were inserted in the proximal tibia in two implantation groups. The extracted proximal metaphysis of the tibiae were scanned by exo-vivo micro-computed tomography. Evaluated parameters included bone mineral density (BMD), trabecular bone volume (BV/TV), trabecular number, trabecular thickness, and trabecular separation (Tb.Sp). The tibia samples were pathologically evaluated by staining with by Hematoxylin and Eosin, and trichrome. RESULTS Trabecular formation near screw insertion site was evident only in rats receiving BMP-2 screws. BMD and BV/TV significantly differed between controls and the OVX and OVX with screw groups. However, there were no significant differences between control and OVX with screw BMP groups. Tb.Sp significantly differed between control and OVX and OVX with screw groups (p<0.05), and between the OVX and OVX with screw BMP group (p<0.05), with no statistically significant difference between control and OVX with screw BMP groups. Over the 12 weeks after surgery, bone lamellae in direct contact with the screw developed more extensive and thicker trabecular bone around the implant in the OVX with screw BMP group compared to the OVX with screw group. CONCLUSION Biodegradable screws containing BMP-2 improve nearby bone conditions and enhance ostoeintegration between the implant and the osteoporotic bone.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.,Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Kim
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bora Lee
- Department of Biostatistic Consulting, Soon Chun Hyang Medical Center, Bucheon, Korea
| | - JoongKee Min
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Ryong Jeon
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Hyo Choi
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Je Hoon Jeong
- Laboratory of Stem Cell Therapy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| |
Collapse
|
17
|
Kim JY, Kim SH, Kim YR, Kim YN, Kim J, Kim TH, Nam GB, Roh SY, Park KM, Park HS, Pak HN, Bae EJ, Oh S, Yoon N, Lee MY, Cho Y, Cho Y, Jin ES, Cha TJ, Choi JI. 2018 KHRS Guidelines for Catheter Ablation of Ventricular Arrhythmias – Part2. Int J Arrhythm 2018. [DOI: 10.18501/arrhythmia.2018.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
18
|
Roh SY, Kim SH, Kim YN, Kim JY, Kim J, Kim TH, Nam GB, Park KM, Park HS, Pak HN, Bae EJ, Oh S, Yoon N, Lee MY, Cho Y, Cho Y, Jin ES, Cha TJ, Choi JI, Kim YR. 2018 KHRS Guidelines for Catheter Ablation of Ventricular Arrhythmias – Part1. Int J Arrhythm 2018. [DOI: 10.18501/arrhythmia.2018.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
19
|
Cho Y, Kim SH, Kim YR, Kim YN, Kim JY, Kim TH, Nam GB, Roh SY, Park KM, Park HS, Pak HN, Bae EJ, Oh S, Yoon N, Lee MY, Cho Y, Jin ES, Cha TJ, Choi JI, Kim J. 2018 KHRS Guidelines for Catheter Ablation of Ventricular Arrhythmias – Part3. Int J Arrhythm 2018. [DOI: 10.18501/arrhythmia.2018.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
20
|
Kim DH, Park CB, Jin ES, Hwang HJ, Sohn IS, Cho JM, Kim CJ. Predictors of decreased left ventricular function subsequent to follow-up echocardiography after percutaneous coronary intervention following acute ST-elevation myocardial infarction. Exp Ther Med 2018; 15:4089-4096. [PMID: 29725361 PMCID: PMC5920495 DOI: 10.3892/etm.2018.5962] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 03/06/2016] [Accepted: 02/24/2017] [Indexed: 11/25/2022] Open
Abstract
The preferred treatment for patients with ST elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (PCI). However, not all patients improve or maintain heart function following primary PCI, and certain patients may experience decreased heart function. The present study investigated factors associated with left ventricular (LV) dysfunction, and improvement or deterioration of LV ejection fraction (LVEF) at follow-up echocardiography following successful primary PCI. The clinical outcomes following primary PCI were also investigated. The present study assessed 4,044 patients who underwent primary PCI following a diagnosis of STEMI between January 2008 and March 2012. A total of 1,736 patients who underwent echocardiography between 30 days and 1 year after STEMI and PCI, and who had completed clinical follow-up, were included in the present study. A total of 243 patients (14.0%) demonstrated LV dysfunction at follow-up echocardiography. Multivariate analysis revealed that LV dysfunction (≤40%) at index STEMI, LVEF at index admission, renal insufficiency (creatinine ≥1.4 mg/dl), peak creatine kinase (CK) and peak CK MB isoenzyme (CKMB) were independent predictors of LV dysfunction at follow-up. Independent predictors for the deterioration of LVEF at follow-up were dyslipidemia, LVEF at index admission, LVEF ≤40% at index admission, peak CK and peak troponin-I. Furthermore, being male, having no history of coronary artery disease, pre-thrombolysis in myocardial infarction (TIMI) flow, LVEF at index admission, LVEF ≤40% at index admission, peak CKMB and peak troponin I were independent predictors of LVEF improvement at follow-up. One-year major adverse cardiac events were significantly increased in the LV dysfunction group compared with patients who did not exhibit LV dysfunction according to Cox regression analysis (13.6 vs. 20.4%; P=0.017). Therefore, the present study may provide valuable prognostic information for clinicians to advise patients who experience LV dysfunction despite having undergone successful primary PCI. Additional management is required in patients with these high-risk features following STEMI.
Collapse
Affiliation(s)
- Dong-Hee Kim
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Chang-Bum Park
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Hui-Jeong Hwang
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Il Suk Sohn
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Jin-Man Cho
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| | - Chong-Jin Kim
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul 05278, Republic of Korea
| |
Collapse
|
21
|
Jeong JH, Jin ES, Kim JY, Lee B, Min J, Jeon SR, Lee M, Choi KH. The Effect of Biocomposite Screws on Bone Regeneration in a Rat Osteoporosis Model. World Neurosurg 2017; 106:964-972. [DOI: 10.1016/j.wneu.2017.07.083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 11/29/2022]
|
22
|
Abstract
The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified cerebral artery disease. Some clinical factors such as age, hypertension, and osteoporotic hip fracture, smoking history and anti-osteoporosis drug use were associated with cerebral artery disease.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Department of Internal Medicine, College of Medicine, Kyung Hee University
| | - Je Hoon Jeong
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital
| | - Bora Lee
- Department of Biostatistic Consulting, Soon Chun Hyang Medical Center, Bucheon, Republic of Korea
| | - Soo Bin Im
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital
| |
Collapse
|
23
|
Hwang HJ, Sohn IS, Kim DH, Park CB, Jin ES, Cho JM, Kim CJ. PS 05-39 INCREASED INTERARM BLOOD PRESSURE DIFFERENCE IS ASSOCIATED WITH SLOW HEART RATE RECOVERY IN PATIENTS WITH CHEST DISCOMFORT. J Hypertens 2016. [DOI: 10.1097/01.hjh.0000500300.16819.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Jin ES, Park CB, Kim DH, Hwang HJ, Cho JM, Sohn IS, Kim CJ. Comparative clinical implications of admission electrocardiographic findings for patients with non-ST-segment elevation myocardial infarction. Medicine (Baltimore) 2016; 95:e4862. [PMID: 27631250 PMCID: PMC5402593 DOI: 10.1097/md.0000000000004862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/26/2022] Open
Abstract
Early risk stratification is crucial for appropriate management using invasive strategies in non-ST elevation myocardial infarction (NSTEMI), and electrocardiography (ECG) has been widely used for risk stratification. However, ECG findings in NSTEMI vary, and there is a need to define the clinical characteristics and outcomes according to ECG.We analyzed the admission ECGs of 345 NSTEMI patients who underwent coronary angiography from 2006 to 2013. Demographics, procedural characteristics, and clinical outcomes were analyzed.The ST-segment depression, T-wave inversion, and no ECG change groups included 114, 90, and 141 patients, respectively. The ST-segment depression group trended toward older, nonsmoking, and female, with a lower body mass index (BMI) and a higher incidence of comorbidities, than the no ECG change group. The ST-segment depression group also had a higher Killip class, a lower left ventricular ejection fraction, a higher regional wall motion score index (RWMSI), and 3-vessel coronary artery disease angiographically, than the no ECG change group. Patients with T-wave inversion trended toward older, female, lower BMI, less smoking, lower creatine kinase MB, and more left anterior descending (LAD) artery involvement, than the no ECG change group. In clinical outcomes, the ST-segment depression group had a higher mortality rate at 30 days and 12 months after the index procedure than the no ECG change group, whereas the T-wave inversion group showed similar clinical outcomes.Patients with ST-segment depression have a greater burden of comorbidities with risk factors and worse clinical outcomes, whereas patients with T-wave inversion have an intermediate number of risk factors but similar outcomes, compared with the no ECG change group. Further study is necessary to evaluate the prognostic impact of the baseline ECG on admission.
Collapse
Affiliation(s)
| | - Chang-Bum Park
- Department of Internal Medicine, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
- Correspondence: Chang-Bum Park, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, Republic of Korea (e-mail: )
| | | | | | | | | | | |
Collapse
|
25
|
Lee WS, Nam GB, Kim SH, Choi JH, Jo U, Kim WY, Oh YS, Park KN, Seo GW, Kim KH, Jin ES, Rhee KS, Jung L, Hwang KW, Kim YR, Kwon CH, Kim J, Choi KJ, Kim YH. ECG features and proarrhythmic potentials of therapeutic hypothermia. Heart 2016; 102:1558-65. [DOI: 10.1136/heartjnl-2015-308821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 04/21/2016] [Indexed: 11/03/2022] Open
|
26
|
Sohn I, Hwang HJ, Park CB, Jin ES, Cho JM, Kim CJ. Clinical Usefulness of Urgent Echocardiography in Non-Cardiac Patients with Elevated Cardiac Enzyme and Chest Pain. J Card Fail 2015. [DOI: 10.1016/j.cardfail.2015.08.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
27
|
Jeong JH, Park J, Jin ES, Min J, Jeon SR, Kim DK, Choi KH. Adipose tissue-derived stem cells in the ovariectomy-induced postmenopausal osteoporosis rat model. Tissue Eng Regen Med 2014. [DOI: 10.1007/s13770-014-0001-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
|
28
|
Hwang HJ, Lee HM, Yang IH, Lee JL, Pak HY, Park CB, Jin ES, Cho JM, Kim CJ, Sohn IS. The value of assessing myocardial deformation at recovery after dobutamine stress echocardiography. J Cardiovasc Ultrasound 2014; 22:127-33. [PMID: 25309689 PMCID: PMC4192410 DOI: 10.4250/jcu.2014.22.3.127] [Citation(s) in RCA: 12] [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: 07/01/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this study was to evaluate whether performing an assessment of myocardial deformation using speckle tracking imaging during the recovery period after dobutamine stress echocardiography (DSE) allows detection of significant coronary artery disease (CAD) in patients with chest discomfort. Methods DSE and coronary angiography were performed in 44 patients with chest discomfort. The mean global longitudinal peak systolic strain (GLS) was measured at rest, at low stress (dobutamine infusion rate of 10 µg/kg/min) and at recovery (5 min after cessation of dobutamine infusion) of DSE using automated function imaging with apical views. Fractional flow reserve (FFR) was also performed in patients with intermediate coronary stenosis. CAD was defined as having a ≥ 70% diameter stenosis on coronary angiography or as having a FFR < 0.8. Patients were divided two groups based on the absence or presence of CAD [CAD (-) group vs. CAD (+) group]. Results There were no significant differences in the clinical characteristics and results of conventional echocardiography between the two groups. GLS at recovery was lower in the CAD (+) group than in the CAD (-) group (-18.0 ± 3.4% vs. -21.0 ± 1.9%, p = 0.003). The optimal cutoff of GLS at recovery for detection of CAD was -19% (sensitivity of 70.6%, specificity of 83.3%). Conclusion Assessment of GLS at recovery of DSE is a reliable and objective method for detection of CAD. This finding may suggest that systolic myocardial stunning remains even after recovery of wall motion abnormalities in patients with CAD.
Collapse
Affiliation(s)
- Hui-Jeong Hwang
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyae-Min Lee
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - In-Ho Yang
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jung Lok Lee
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyun Young Pak
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Chang-Bum Park
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jin-Man Cho
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Chong-Jin Kim
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| | - Il Suk Sohn
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
| |
Collapse
|
29
|
Yi HJ, Jeong JH, Jin ES, Shin IY, Hwang HS, Moon SM. Evaluation of vitamin D level in patients from neurosurgical intensive care unit. Neural Regen Res 2014; 8:1528-34. [PMID: 25206449 PMCID: PMC4107809 DOI: 10.3969/j.issn.1673-5374.2013.16.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 02/08/2013] [Indexed: 01/08/2023] Open
Abstract
Vitamin D plays an important role in maintaining normal bone metabolism. Recent studies have suggested that vitamin D influences many other physiological processes, including muscle function, cardiovascular homeostasis, nerve function, and immune response. Furthermore, accumulated evidence suggests that vitamin D also mediates the immune system response to infection. Critical neurosurgical patients have higher infection and mortality rates. To correlate vitamin D deficiency to the immunological status of neurosurgical intensive care unit patients, we detected serum vitamin D level in 15 patients with clinically suspected infection and 10 patients with confirmed infection. Serum level of 25-hydroxyvitamin D, the primary circulating form of vitamin D, was significantly decreased in patients with suspected or confirmed infection after a 2-week neurosurgical intensive care unit hospitalization, while serum level of 1,25-dihydroxyvitamin D, the active form of vitamin D, was significantly decreased in patients after a 4-week neurosurgical intensive care unit hospitalization. These findings suggest that vitamin D deficiency is linked to the immunological status of neurosurgical intensive care unit patients and vitamin D supplementation can improve patient's immunological status.
Collapse
Affiliation(s)
- Ho Jun Yi
- Department of Neurosurgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Je Hoon Jeong
- Department of Neurosurgery, Soon Chun Hyang University Bucheon Hospital, Gyeonggi-do, Korea
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Kangdong, Kyung Hee University, Seoul, Korea
| | - Il Young Shin
- Department of Neurosurgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Hyung Sik Hwang
- Department of Neurosurgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Seung-Myung Moon
- Department of Neurosurgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| |
Collapse
|
30
|
Cho SJ, Park SM, Ryu SM, Jin ES, Lee KH. Nonaneurysmal Infectious Aortitis. Ann Vasc Surg 2014; 28:1313.e13-6. [DOI: 10.1016/j.avsg.2013.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 08/13/2013] [Accepted: 09/08/2013] [Indexed: 10/25/2022]
|
31
|
Jin ES, Jeong JH, Min J, Jeon SR, Choi KH. Implantation of adipose tissue-derived mesenchymal stem cells in degenerative intervertebral disc of rat: When is the most effective time during the degeneration period. Tissue Eng Regen Med 2014. [DOI: 10.1007/s13770-014-0055-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
32
|
Choi HO, Nam GB, Jin ES, Kim KH, Kim SH, Hwang ES, Park KM, Kim J, Rhee KS, Choi KJ, Kim YH. Temporal variation and morphologic characteristics of J-waves in patients with early repolarisation syndrome. Heart 2013; 99:1818-24. [DOI: 10.1136/heartjnl-2013-303731] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|
33
|
Joe BH, Hwang HJ, Park CB, Jin ES, Sohn IS, Cho JM, Kim CJ. Takotsubo cardiomyopathy recurrence with left ventricular apical ballooning following isolated right ventricular involvement: A case report. Exp Ther Med 2013; 6:260-262. [PMID: 23935757 PMCID: PMC3735877 DOI: 10.3892/etm.2013.1112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 02/08/2013] [Accepted: 05/02/2013] [Indexed: 01/26/2023] Open
Abstract
We report a case of Takotsubo cardiomyopathy, which involved the right ventricle at first presentation and demonstrated involvement of the left ventricle during recurrence. The patient was admitted to Kyung Hee University Hospital due to a left hip fracture, which was considered a result of physical stress. Complete recovery was confirmed by echocardiography prior to recurrence. The cause of the second event was surgery for the left hip fracture. Recurrence of Takotsubo cardiomyopathy at various cardiac locations provides evidence against the existing hypotheses that variants of Takotsubo cardiomyopathy are associated with anatomically different distributions of cardiac adrenergic receptors, the degree of stimulation by sympathetic activity and different susceptibilities to such sympathetic stimulation.
Collapse
Affiliation(s)
- Byung-Hyun Joe
- Cardiovascular Center, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
34
|
Jin ES, Min J, Jeon SR, Choi KH, Jeong JH. Analysis of molecular expression in adipose tissue-derived mesenchymal stem cells : prospects for use in the treatment of intervertebral disc degeneration. J Korean Neurosurg Soc 2013; 53:207-12. [PMID: 23826475 PMCID: PMC3698229 DOI: 10.3340/jkns.2013.53.4.207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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: 08/06/2012] [Revised: 02/12/2013] [Accepted: 04/08/2013] [Indexed: 01/06/2023] Open
Abstract
Objective Recent studies have shown encouraging progress toward the use of autogenic and allogenic mesenchymal stem cells (MSCs) to arrest, or even lead to partial regeneration in, intervertebral disc (IVD) degeneration. However, this technology is still in its infancy, and further development is required. The aim of this study was to analyze whether rat adipose-derived mesenchymal stem cells (ADMSC) can differentiate towards IVD-like cells after treatment with transforming growth factor β3 (TGF-β3) in vitro. We also performed quantitative analysis of gene expression for ADMSC only, ADMSCs treated with TGF-β3, and co-cultured ADMSCs treated with TGF-β3. Methods ADMSCs were sub-cultured to homogeneity and used in fluorocytometry assays for CD11, CD45, and CD90/Thy1. ADMSCs were differentiated in spheroid culture towards the chondrogenic lineage by the presence of TGF-β3, dexamethasone, and ascorbate. We also co-cultured pure ADMSCs and nucleus pulposus cells in 24-well plates, and performed immunohistochemical staining, western blotting, and RT-PCR for quantitativeanalysis of gene expression. Results Results of fluorocytometry were positive for CD90/Thy1 and negative for CD11 and CD45. TGF-β3-mediated induction of ADMSCs led to the expression of the differentiation markers of intervertebral disc-like cells, such as aggrecan, collagen II, and sox-9. Co-cultured ADMSCs treated with TGF-β3 showed higher expression of differentiation markers and greater extracellular matrix production compared with ADMSCs treated with TGF-β3 alone. Conclusion ADMSC treated with TGF-β3 may be an attractive source for regeneration therapy in degenerative IVD. These findings may also help elucidate the pathologic mechanism of MSC therapy in the degeneration of IVD in vivo.
Collapse
Affiliation(s)
- Eun-Sun Jin
- Laboratory of Stem Cell Therapy, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. ; Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | | | | | | | | |
Collapse
|
35
|
Kim DH, Joung HJ, Kim SY, Ko WJ, Jin ES, Kim CJ. Clinical Characteristics of Elderly Patients Undergoing Coronary Angiography for Chest Pain. ACTA ACUST UNITED AC 2013. [DOI: 10.4235/jkgs.2013.17.1.37] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Dong-Hee Kim
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyun-Jun Joung
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Se-Yun Kim
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Weon-Jin Ko
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Eun-Sun Jin
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Chong-Jin Kim
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| |
Collapse
|
36
|
Kim KH, Nam GB, Jin ES, Kim DK, Seol SH, Kim DI, Choi H, Kim YR, Kim SH, Choi KJ, Kim YH. Coronary Sinus Activation Pattern in the Differential Diagnosis of Regular Atrial Tachyarrhythmias During Catheter Ablation of Atrial Fibrillation. Circ J 2013; 77:619-625. [DOI: 10.1253/circj.cj-12-0753] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 08/30/2023]
Affiliation(s)
- Ki-Hun Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine
| | - Gi-Byoung Nam
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Eun-Sun Jin
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University
| | - Dong-Kie Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine
| | - Sang-Hoon Seol
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine
| | - Doo-Il Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine
| | - HyungOh Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Yoo Ri Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - Sung-Hwan Kim
- Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University
| | - Kee-Joon Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine
| | - You-Ho Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine
| |
Collapse
|
37
|
Seo CH, Jeong JH, Lee DH, Kang TC, Jin ES, Lee DH, Jeon SR, Choi KH, Hwang HS. Radiological and pathological evaluation of the spinal cord in a rat model of electrical injury-induced myelopathy. Burns 2012; 38:1066-71. [PMID: 22683141 DOI: 10.1016/j.burns.2012.02.016] [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] [Received: 10/26/2011] [Revised: 01/11/2012] [Accepted: 02/17/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND No study has reported an animal-based experimental model of electrical injury to the spinal cord. This paper presents the first systematic establishment of an animal model of electrical injury to the spinal cord with subsequent pathophysiologic analysis. METHOD The voltage required for the electrical shock was generated by an electroconvulsive therapy apparatus (57800 ECT unit; UGO BASILE, Italy). We used one side ear as the entry site and the contralateral hind limb as the exit site. Seven electrical shock (frequency, 120 Hz; pulse width, 0.9 ms; duration, 3 s; current, 99 mA) was applied to each rat and used rat showing hind limb weakness. Radiologic and histologic evaluations were performed at one day, one, two and four weeks after injury. RESULTS Twelve rats showed the hind limb weakness among the total 18 rats. Manganese-enhanced magnetic resonance imaging showed interruption of spinal cord enhancement in the thoracic area. Histological examination showed a greater decrease in the number of neurons in the ventral horn versus the dorsal horn. CONCLUSION This study demonstrates a novel design and analysis of an animal-based experimental model of spinal cord injury by electrical etiology. This model is useful for experimental studies of injuries to the spinal cord.
Collapse
Affiliation(s)
- Cheong Hoon Seo
- Department of Rehabilitation Medicine, College of Medicine, Hallym University, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Jo U, Hwang HJ, Kim HS, Joe BH, Park CB, Jin ES, Sohn IS, Cho JM, Kim CJ. Takotsubo cardiomyopathy in a patient with coronary artery--left ventricular fistulae. Int J Cardiol 2012; 157:e5-6. [PMID: 21982620 DOI: 10.1016/j.ijcard.2011.08.856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 08/26/2011] [Indexed: 11/26/2022]
|
39
|
Park SH, Sohn IS, Joe BH, Hwang HJ, Park CB, Jin ES, Cho JM, Kim CJ, Bae JH, Lee SH. Early cardiac valvular changes in ankylosing spondylitis: a transesophageal echocardiography study. J Cardiovasc Ultrasound 2012; 20:30-6. [PMID: 22509436 PMCID: PMC3324725 DOI: 10.4250/jcu.2012.20.1.30] [Citation(s) in RCA: 18] [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: 11/01/2011] [Revised: 01/05/2012] [Accepted: 02/16/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study was conducted to determine the early cardiac valvular changes in young male ankylosing spondylitis (AS) patients. METHODS A total of 70 AS patients on treatment without clinical cardiac symptoms were divided into group I (< 10 years, n = 50) and group II (≥ 10 years, n = 20) depending on their disease duration after first diagnosis. Twenty-five healthy volunteers were selected as control subjects. All the subjects underwent transthoracic and transesophageal echocardiography, electrocardiography, and rheumatologic evaluation for AS patients. RESULTS The thickness of both the aortic and mitral valve was more increased in AS patients than in controls. Aortic valve thickness over 1.3 mm could predict AS with a sensitivity of 73% and specificity of 76%. The prevalence of aortic valve thickening was higher in the AS group compared to the controls. The prevalence of aortic and mitral regurgitation was very low and there was no difference between the controls and the patients. The aortic valve thickening was related to longer disease duration, high blood pressure, disease activity and inflammatory markers. CONCLUSION Thickening of the aortic and mitral valve was observed without regurgitation in male AS patients early in the course of their disease without clinical cardiac manifestations. This subclinical change of aorto-mitral valve in early AS should be considered and followed up to determine its prognostic implication and evolution.
Collapse
Affiliation(s)
- So-Hee Park
- Department of Cardiology, School of Medicine Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Park CB, Joe BH, Hwang HJ, Jin ES, Kim CJ. Coronary perforation during conventional time domain optical coherence tomography. Int J Cardiol 2012; 155:e14-5. [PMID: 21784543 DOI: 10.1016/j.ijcard.2011.06.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2011] [Accepted: 06/25/2011] [Indexed: 11/13/2022]
|
41
|
Park KM, Rhee KS, Jin ES, Nam GB, Choi KJ, Kim YH. Effects of slow pathway ablation on fast pathway function in patients with atrioventricular nodal reentrant tachycardia: cryo- vs. radiofrequency ablation. Circ J 2012; 76:1091-6. [PMID: 22333216 DOI: 10.1253/circj.cj-11-1325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/09/2022]
Abstract
BACKGROUND In typical atrioventricular nodal reentrant tachycardia, radiofrequency (RF) ablation of the slow pathway (SP) is known to change the effective refractory period of the fast pathway (ERP(FP)) after successful RF ablation of the SP. The purpose of this study was to ascertain the mechanism of the ERP(FP) changes after SP ablation by comparing the results of both cryo- and RF ablation. METHODS AND RESULTS A total of 112 patients were enrolled prospectively and their electrophysiological properties analyzed before and after successful SP ablation. Patients were grouped into cryoablation (n=54) and RF ablation (n=58) groups and each group was subdivided into complete ablation (CG) and modification (MG) based on the presence of the SP after successful ablation. CG was performed in 64 patients: 30 by cryoablation and 34 by RF ablation. In patients who underwent complete SP ablation, the ERP(FP) was shortened significantly after cryoablation (375 ± 74 vs. 281 ± 39 ms, P<0.01), without significant change in the atrio-His (AH) or sinus cycle length (SCL) interval. Similarly, the ERP(FP) was shortened significantly (358 ± 106 vs. 289 ± 84 ms, P=0.01) also after RF ablation without change in AH or SCL interval. CONCLUSIONS ERP(FP) shortening was observed after complete SP ablation with both cryo- and RF ablation without significant changes in indices of autonomic activity.
Collapse
Affiliation(s)
- Kyoung-Min Park
- Sanggye Paik Hospital, Department of Internal Medicine, University of Inje College of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
42
|
Joe BH, Jo U, Kim HS, Park CB, Hwang HJ, Sohn IS, Jin ES, Cho JM, Park JH, Kim CJ. APACHE II score, rather than cardiac function, may predict poor prognosis in patients with stress-induced cardiomyopathy. J Korean Med Sci 2012; 27:52-7. [PMID: 22219614 PMCID: PMC3247775 DOI: 10.3346/jkms.2012.27.1.52] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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: 07/11/2011] [Accepted: 11/07/2011] [Indexed: 12/05/2022] Open
Abstract
While the disease course of stress-induced cardiomyopathy (SIC) is usually benign, it can be fatal. The prognostic factors to predict poorer outcome are not well established, however. We analyzed the Acute Physiology And Chronic Health Evaluation (APACHE) II score to assess its value for predicting poor prognosis in patients with SIC. Thirty-seven consecutive patients with SIC were followed prospectively during their hospitalization. Clinical factors, including APACHE II score, coronary angiogram, echocardiography and cardiac enzymes at presentation were analyzed. Of the 37 patients, 27 patients (73%) were women. The mean age was 66.1 ± 15.6 yr, and the most common presentation was chest pain (38%). Initial echocardiographic left ventricular ejection fraction (EF) was 42.5% ± 9.3%, and the wall motion score index (WMSI) was 1.9 ± 0.3. Six patients (16%) expired during the follow-up period of hospitalization. Based on the analysis of characteristics and clinical factors, the only predictable variable in prognosis was APACHE II score. The patients with APACHE II score greater than 20 had tendency to expire than the others (P = 0.001). Based on present study, APACHE II score more than 20, rather than cardiac function, is associated with mortality in patients with SIC.
Collapse
Affiliation(s)
- Byung-Hyun Joe
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Uk Jo
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Chang-Bum Park
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Hui-Jeong Hwang
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Il-Suk Sohn
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Eun-Sun Jin
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Jin-Man Cho
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| | - Jeong-Hwan Park
- Department of Cardiology, Incheon Sarang Hospital, Inchon, Korea
| | - Chong-Jin Kim
- Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea
| |
Collapse
|
43
|
Nam GB, Jin ES, Choi H, Song HG, Kim SH, Kim KH, Hwang ES, Park KM, Kim J, Rhee KS, Choi KJ, Kim YH. Effect of substrate modification in catheter ablation of paroxysmal atrial fibrillation: pulmonary vein isolation alone or with complex fractionated electrogram ablation. Tex Heart Inst J 2012; 39:372-379. [PMID: 22719147 PMCID: PMC3368479] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Catheter ablation of atrial fibrillation that targets complex fractionated electrogram sites has been widely applied in the management of persistent atrial fibrillation. The clinical outcomes of pulmonary vein isolation alone and pulmonary vein isolation plus the use of complex fractionated electrogram-guided ablation (CFEA) have not been fully compared in patients with paroxysmal atrial fibrillation.This prospective study included 70 patients with symptomatic paroxysmal atrial fibrillation that remained inducible after pulmonary vein isolation. For radio-frequency catheter ablation, patients were nonrandomly assigned to a control group (pulmonary vein isolation alone, Group 1, n=35) or a CFEA group (pulmonary vein isolation plus additional CFEA, Group 2, n=35). The times to first recurrence of atrial tachyarrhythmias were compared between the 2 groups.In Group 2, CFEA rendered atrial fibrillation noninducible in 16 patients (45.7%) and converted inducible atrial fibrillation into inducible atrial flutters in 12 patients (34.3%). Atrial fibrillation remained inducible in 7 patients (20%) after the combined ablation procedures. After a mean follow-up of 23 months, freedom from recurrence of atrial tachyarrhythmias was significantly higher in Group 2 than in Group 1 (P=0.037). In Group 1, all of the recurrent tachyarrhythmias were atrial fibrillation, whereas regular tachycardia was the major mechanism of recurrent arrhythmias in Group 2 (atrial tachycardia or atrial flutter in 5 of 6 patients and atrial fibrillation in 1 patient).We found that CFEA after pulmonary vein isolation significantly reduced recurrent atrial tachyarrhythmia and might modify the pattern of arrhythmia recurrence in patients with paroxysmal atrial fibrillation.
Collapse
Affiliation(s)
- Gi-Byoung Nam
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Park JH, Sohn IS, Jin ES, Cho JM, Kim CJ, Lee YK. Heavy coronary calcium mimicking in-stent restenosis. Korean Circ J 2011; 41:421. [PMID: 21860648 PMCID: PMC3152741 DOI: 10.4070/kcj.2011.41.7.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 09/07/2010] [Accepted: 10/04/2010] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jeong-Hwan Park
- Department of Cardiology, Kyung Hee University College of Meidicine, East-West Neo Medical Center, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
45
|
Kwon O, Kang SH, Park HW, Choi SW, Kim SH, Kim KH, Jin ES, Nam GB. Lead fracture and free-wall perforation in a patient with an implantable cardioverter-defibrillator. Pacing Clin Electrophysiol 2010; 35:e167-9. [PMID: 21070262 DOI: 10.1111/j.1540-8159.2010.02956.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Intracardiac lead fracture or free-wall perforation is a rare complication of implantable defibrillators. Complete disconnection of the fractured electrode has not been reported yet. Here, we report a case of lead fracture/disconnection and free-wall perforation, which occurred consecutively in a patient.
Collapse
Affiliation(s)
- Osung Kwon
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Kim KH, Na JO, Nam GB, Jin ES, Choi H, Kim SH, Choi KJ, Kim YH. Effect of catheter ablation on the left ventricular mass index and other echocardiograph parameters in atrial fibrillation patients: comparison with antiarrhythmic drug treatment. J Echocardiogr 2010; 9:51-8. [PMID: 27276880 DOI: 10.1007/s12574-010-0069-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 08/06/2010] [Accepted: 09/02/2010] [Indexed: 01/19/2023]
Abstract
BACKGROUND Catheter ablation (CA) is reported to improve left ventricular (LV) function in patients with atrial fibrillation (AF). This study compared the effects of CA and antiarrhythmic drug treatment (AT) on LV remodeling and other echocardiography parameters in AF. METHODS We performed a non-randomized prospective study involving 72 drug-resistant AF patients who were treated with either CA (n = 42) or who declined CA and continued on AT (n = 30). Baseline and follow-up (mean 20.7 ± 7.5 months) echocardiography was performed in all patients. The maintenance of sinus rhythm was determined based on clinical interview, electrocardiography, and 24-h Holter and event recording. RESULTS There were no significant differences between the two groups in regard to demographic features, blood pressure, and medication. CA was superior to AT with respect to sinus rhythm maintenance, LV ejection fraction, left atrium (LA) diameter, and LA volume index. In addition, CA resulted in decreases in the LV mass [from 190.5 ± 36.1 to 179.3 ± 32.4 g (p = 0.02)] and the LV mass index [from 104.2 ± 20.5 to 98.2 ± 18.3 g/m(2) (p = 0.03)]. No parameter improved in AT patients. These improved echocardiographic parameters were observed in both groups with maintained sinus rhythm. CONCLUSION Reverse LV remodeling after CA may include a reduction in the LV mass index, which appears to be associated with sinus rhythm maintenance.
Collapse
Affiliation(s)
- Ki-Hun Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| | - Jin Oh Na
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| | - Gi-Byoung Nam
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea.
| | - Eun-Sun Jin
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| | - HyungOh Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| | - Sung-Hwan Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| | - Kee-Joon Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| | - You-Ho Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Poongnap-dong 388-1, Songpa-gu, Seoul, 138-736, Korea
| |
Collapse
|
47
|
Nam GB, Jin ES, Choi H, Song HG, Kim SH, Kim KH, Hwang ES, Park KM, Kim J, Rhee KS, Choi KJ, Kim YH. Mechanism of regular atrial tachyarrhythmias during combined pulomonary vein isolation and complex fractionated electrogram ablation in patients with atrial fibrillation. Circ J 2010; 74:434-41. [PMID: 20075559 DOI: 10.1253/circj.cj-09-0622] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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: 11/09/2022]
Abstract
BACKGROUND Atrial tachyarrhythmias (ATA) frequently develop during catheter ablation of atrial fibrillation (AF), but the mechanism of ATA during combined pulmonary vein isolation (PVI) and complex fractionated electrogram-guided ablation (CFEA) has not been reported. METHODS AND RESULTS This study involved 105 patients with symptomatic, drug-refractory AF. After PVI, CFEA was performed in the left/right atrium if AF remained inducible in paroxysmal AF (PAF) or persisted in persistent AF (PeAF). For the 70 PAF patients, PVI alone rendered AF non-inducible in 29 patients (41.4%), and converted inducible AF into inducible atrial flutter (AFl) in 10 patients (14.3%). For the remaining 31 PAF patients, additional CFEA rendered AF non-inducible in 11 patients (15.7%), whereas only AFl was inducible in 11 patients (15.7%). For 35 PeAF patients, PVI and CFEA converted AF into sinus rhythm in 2 (5.7%) and into AFl in 21 (60.0%) patients, while AF persisted in 12 patients (34.3%). The mechanism of ATA was focal (20/114, 17.5%), roof-dependent (20/114, 17.5%), peri-mitral (33/114, 28.9%), cavotricuspid isthmus-dependent (34/114, 29.8%) AFl or unknown (7/114, 6.1%). Successful ablation was achieved in 93/114 (81.6%) tachycardias. CONCLUSIONS The major mechanism of ATA during the combined approach of PVI and CFEA is macroreentry around large anatomic obstacles such as the pulmonary vein or the mitral or tricuspid annuli.
Collapse
Affiliation(s)
- Gi-Byoung Nam
- Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul 138-736, Republic of Korea.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Jang ST, Sohn IS, Jin ES, Cho JM, Kim CJ, Lim SJ. A case of cardiac dysfunction associated with monoclonal gammopathy of undetermined significance. J Korean Med Sci 2009; 24:354-6. [PMID: 19399286 PMCID: PMC2672144 DOI: 10.3346/jkms.2009.24.2.354] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 06/26/2008] [Indexed: 11/24/2022] Open
Abstract
The monoclonal gammopathies (MG) are monoclonal neoplasms related to each other by virtue of their development from common progenitors in the B lymphocyte lineage. Cardiac dysfunction in patients with MG is not well established. We experienced a case of cardiac dysfunction associated with MG identified by echocardiography and biopsy. Fifty nine year-old man was admitted because of dyspnea for several months. Echocardiography revealed diastolic dysfunction showing restrictive physiology with elevated left ventricular filling pressure. Bone marrow (BM) studies and immunoelectrophoresis were compatible with monoclonal gammopathy of undetermined significance. Endomyocardial, BM, and enteral biopsies for ruling out for amyloidosis (Congo-red stain) were negative. This is the case of non-amyloidotic light chain deposition cardiomyopathy.
Collapse
Affiliation(s)
- Suk-Tae Jang
- Department of Cardiology, East-West Neo Medical Center of Kyunghee University, Seoul, Korea
| | - Il-Suk Sohn
- Department of Cardiology, East-West Neo Medical Center of Kyunghee University, Seoul, Korea
| | - Eun-Sun Jin
- Department of Cardiology, East-West Neo Medical Center of Kyunghee University, Seoul, Korea
| | - Jin-Man Cho
- Department of Cardiology, East-West Neo Medical Center of Kyunghee University, Seoul, Korea
| | - Chong-Jin Kim
- Department of Cardiology, East-West Neo Medical Center of Kyunghee University, Seoul, Korea
| | - Sung-Jig Lim
- Department of Pathology, East-West Neo Medical Center of Kyunghee University, Seoul, Korea
| |
Collapse
|
49
|
Abstract
Pheochromocytoma is a rare cause of cardiogenic shock. Clinical management is directed at reducing the heart rate while maintaining blood pressure. However, medical treatment is often unsuccessful because of the high endogenous catecholamine level and low cardiac output. Percutaneous cardiopulmonary bypass system is a circulatory device that allows for safer use of heart-rate-reducing agents, which is advantageous when used early in the course of the cardiogenic shock induced by pheochromocytoma.
Collapse
Affiliation(s)
- Sung-Min Park
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University East-West Neo Medical Center, Seoul, Korea.
| | | | | | | | | | | | | |
Collapse
|
50
|
Sohn IS, Jin ES, Cho JM, Kim CJ, Bae JH, Moon JY, Lee SH, Kim MJ. Bloodletting-induced cardiomyopathy: reversible cardiac hypertrophy in severe chronic anaemia from long-term bloodletting with cupping. Eur J Echocardiogr 2008; 9:585-6. [PMID: 17683988 DOI: 10.1016/j.euje.2007.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cardiac hypertrophy in a patient with severe iron deficiency anaemia associated with long-term bloodletting using cupping, called 'puhang' in oriental medicine, is discussed using chest electrocardiographic and radiographic images. With iron supply, the patient showed remarkable improvement of cardiomegaly, which is a unique feature of chronic severe iron deficiency anaemia.
Collapse
Affiliation(s)
- Il-Suk Sohn
- Cardiovascular Center Kyunghee East-West Neo Medical Center, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, South Korea.
| | | | | | | | | | | | | | | |
Collapse
|