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Kim M, Kim HL, Park KT, Lim WH, Seo JB, Kim SH, Kim MA, Zo JH. P1348 Impact of left ventricular ejection fraction and aortic valve sclerosis on cardiovascular outcome in patients with acute ischemic stroke. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Previous studies have focused on only 1 or 2 echocardiographic parameters as prognostic marker in patients with acute ischemic stroke (AIS).
Purpose
Various echocardiographic parameters in the same patient were systemically evaluated for their prognostic significance in AIS.
Methods
A total of 900 patients with AIS who underwent transthoracic echocardiography (TTE) (72.6 ± 12.0 years and 60% male) were retrospectively reviewed. Composite events including all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and coronary revascularization were assessed during clinical follow-up.
Results
During a median follow-up of 3.3 years (interquartile range, 0.6-5.1 years), there were 151 (16.8%) composite events. Univariable analyses showed that low left ventricular ejection fraction (LVEF) (< 60%), increased peak tricuspid regurgitation (TR) velocity (> 2.8 m/s) and aortic valve (AV) sclerosis were associated with composite events (P < 0.05 for each). In the multivariable analyses after controlling for potential confounders, LVEF < 60% (hazard ratio [HR], 1.90; 95% confidence interval [CI], 1.30-2.77; P = 0.001) and AV sclerosis (HR, 1.56; 95% CI, 1.10-2.21; P = 0.013) were independent prognostic factors associated with composite events. Multivariable analysis showed that HR for composite events gradually increased according to LVEF and AV sclerosis: HR was 2.8-fold higher in the highest-risk group than in the lowest group (P = 0.001).
Conclusions
In patients with AIS, LVEF < 60% and the presence of AV sclerosis predicts the future vascular events. Patients with AIS exhibiting reduced LVEF and AV sclerosis may benefit from aggressive secondary prevention
Abstract P1348 Figure. COX plot for composite event
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Affiliation(s)
- M Kim
- Boramae Hospital, Seoul, Korea (Republic of)
| | - H L Kim
- Boramae Hospital, Seoul, Korea (Republic of)
| | - K T Park
- Boramae Hospital, Seoul, Korea (Republic of)
| | - W H Lim
- Boramae Hospital, Seoul, Korea (Republic of)
| | - J B Seo
- Boramae Hospital, Seoul, Korea (Republic of)
| | - S H Kim
- Boramae Hospital, Seoul, Korea (Republic of)
| | - M A Kim
- Boramae Hospital, Seoul, Korea (Republic of)
| | - J H Zo
- Boramae Hospital, Seoul, Korea (Republic of)
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Park J, Shin J, Kim HL, Song KJ, Jung JH, Lee HJ, You KM, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Clinical Factors Associated with Obstructive Coronary Artery Disease in Patients with Out-of-Hospital Cardiac Arrest: Data from the Korean Cardiac Arrest Research Consortium (KoCARC) Registry. J Korean Med Sci 2019; 34:e159. [PMID: 31172695 PMCID: PMC6556444 DOI: 10.3346/jkms.2019.34.e159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 02/12/2019] [Accepted: 05/19/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Although coronary artery disease (CAD) is a major cause of out-of-hospital cardiac arrest (OHCA), there has been no convinced data on the necessity of routine invasive coronary angiography (ICA) in OHCA. We investigated clinical factors associated with obstructive CAD in OHCA. METHODS Data from 516 OHCA patients (mean age 58 years, 83% men) who underwent ICA after resuscitation was obtained from a nation-wide OHCA registry. Obstructive CAD was defined as the lesions with diameter stenosis ≥ 50% on ICA. Independent clinical predictors for obstructive CAD were evaluated using multiple logistic regression analysis, and their prediction performance was compared using area under the receiver operating characteristic curve with 10,000 repeated random permutations. RESULTS Among study patients, 254 (49%) had obstructive CAD. Those with obstructive CAD were older (61 vs. 55 years, P < 0.001) and had higher prevalence of hypertension (54% vs. 36%, P < 0.001), diabetes mellitus (29% vs. 21%, P = 0.032), positive cardiac enzyme (84% vs. 74%, P = 0.010) and initial shockable rhythm (70% vs. 61%, P = 0.033). In multiple logistic regression analysis, old age (≥ 60 years) (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.36-3.00; P = 0.001), hypertension (OR, 1.74; 95% CI, 1.18-2.57; P = 0.005), positive cardiac enzyme (OR, 1.72; 95% CI, 1.09-2.70; P = 0.019), and initial shockable rhythm (OR, 1.71; 95% CI, 1.16-2.54; P = 0.007) were associated with obstructive CAD. Prediction ability for obstructive CAD increased proportionally when these 4 factors were sequentially combined (P < 0.001). CONCLUSION In patients with OHCA, those with old age, hypertension, positive cardiac enzyme and initial shockable rhythm were associated with obstructive CAD. Early ICA should be considered in these patients.
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Affiliation(s)
- Jiesuck Park
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jonghwan Shin
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hack Lyoung Kim
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Hee Jung
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hui Jai Lee
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Min You
- Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyun Lim
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Bin Seo
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyun Kim
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Hee Zo
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung A Kim
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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Ki YJ, Kim HL, Oh S, Jeon WK, Rhee TM, Lim WH, Seo JB, Kim SH, Kim MA, Zo JH. Gender Related Association between Arterial Stiffness and Aortic Root Geometry. J Cardiovasc Imaging 2019; 27:11-21. [PMID: 30701711 PMCID: PMC6358431 DOI: 10.4250/jcvi.2019.27.e3] [Citation(s) in RCA: 3] [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: 10/24/2018] [Revised: 11/22/2018] [Accepted: 12/03/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The gender-related change in aortic morphology by arterial stiffness has not been well studied. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and aortic root size according to gender. METHODS A total of 263 consecutive subjects (63.2 ± 10.6 years, 71.1% men) without overt cardiovascular disease who underwent both baPWV measurement and transthoracic echocardiography on the same day were retrospectively analyzed. The diameters of the aortic annulus (AN), sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) were measured using 2-dimensional echocardiography. RESULTS The body surface area (BSA)-corrected diameters of AN, SV, STJ, and AA were significantly higher in women than in men. Univariable analyses showed that baPWV was significantly correlated with SV/BSA and STJ/BSA in men, and with SV/BSA, STJ/BSA, and AA/BSA in women (p < 0.05 for each). In men, however, these associations disappeared in multiple linear regression models after controlling for potential confounders (p > 0.05 for each). In women, the associations of baPWV with diameters of STJ/BSA (β = 0.407, p < 0.001) and AA/BSA (β = 0.391, p = 0.005) remained significant in the same multivariate models. Women-specific correlation between aortic root size and baPWV was also similarly demonstrated in age-matched analyses (n = 61 in each gender). CONCLUSIONS Among Korean adult without overt cardiovascular disease, the association between increased arterial stiffness and aortic root dilatation is stronger in women than in men.
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Affiliation(s)
- You Jeong Ki
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hack Lyoung Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Boramae Medical Center, Seoul, Korea
| | - Won Kyeong Jeon
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Min Rhee
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyun Lim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Bin Seo
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyun Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung A Kim
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Hee Zo
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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Kang DH, Seo JS, Sun BJ, Ahn JM, Kim DH, Song JM, Song JK, Song H, Zo JH. CLINICAL AND ECHOCARDIOGRAPHIC PREDICTORS OF LONG-TERM OUTCOME IN ASYMPTOMATIC PATIENTS WITH SIGNIFICANT AORTIC STENOSIS. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61403-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kang DH, Kim DH, Sun BJ, Na JO, Park JS, Song JM, Song H, Zo JH, Song JK, Lee JW. PREDICTORS OF OUTCOME IN ASYMPTOMATIC PATIENTS WITH SEVERE RHEUMATIC MITRAL REGURGITATION. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61381-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee YJ, Han D, Koh YH, Zo JH, Kim SH, Kim DK, Lee JS, Moon HJ, Kim JS, Chun EJ, Youn BJ, Lee CH, Kim SS. Adult sail sign: radiographic and computed tomographic features. Acta Radiol 2008; 49:37-40. [PMID: 18210313 DOI: 10.1080/02841850701675677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. PURPOSE To investigate the sail sign appearing in adult chest radiography. MATERIAL AND METHODS Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). RESULTS The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy (n = 4) or sharp (n = 1) in its upper margin, and was sometimes double lined in the inferior margin (n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. CONCLUSION The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging.
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Affiliation(s)
- Yu-Jin Lee
- Department of Radiology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea
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Kim SH, Zo JH, Kim MA. Predictive value of blood glucose and brain natriuretic peptides as prognostic factors in patients with congestive heart failure under ventilator care. Heart Lung Circ 2008. [DOI: 10.1016/j.hlc.2007.11.067] [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: 11/16/2022]
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Kim SH, Zo JH, Kim MA. The increase of high density lipoprotein (HDL) level by fibrate therapy decreased arterial stiffness in patients with diabetes and hypertrigliceridemia. Vascul Pharmacol 2006. [DOI: 10.1016/j.vph.2006.08.277] [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: 11/16/2022]
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Zo JH, Lee SK, Kim SH, Kim MA. The Relationship of Pulse-wave Velocity with Carotid Intima-media Thickness and Carotid Artery Distensibility. J Cardiovasc Ultrasound 2006. [DOI: 10.4250/jcu.2006.14.3.92] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Joo Hee Zo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seon Kyung Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyun Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Myung A Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Kim MA, Kim SH, Zo JH, Hwangbo B, Lee JH, Chung HS. Right heart dysfunction in post-tuberculosis emphysema. Int J Tuberc Lung Dis 2004; 8:1120-6. [PMID: 15455598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
SETTING University-affiliated general hospital. OBJECTIVE To evaluate the pump performance of right heart before and after exercise in post-tuberculosis emphysema. DESIGN In patients with post-tuberculosis or primary emphysema (similar lung volumes), body plethysmography, arterial blood gas analysis and echocardiography were performed at rest and after exercise. Right heart pump performance was evaluated with the ejection fraction. RESULTS At rest, in post-tuberculosis emphysema, diffusing capacity (mean +/- SE 72.7 +/- 3.9 vs. 91.0 +/- 7.1% of reference) and right ventricular ejection fraction (57.5 + 1.4 vs. 61.3 +/- 1.2%) were lower and PaCO2 (42.7 +/- 1.1 vs. 38.6 +/- 0.7 mmHg) was higher, while lung compliance, airway resistance, PaO2, and alveolar-arterial oxygen difference were not different. After exercise, PaO2 (65.6 +/- 2.8 vs. 80.5 +/- 3.5 mmHg) and right ventricular ejection fraction (51.2 +/- 2.4 vs. 59.6 +/- 1.7%) were lower and PaCO2 (47.0 +/- 1.5 vs. 40.9 +/- 1.5 mmHg) was higher in post-tuberculosis emphysema, whereas alveolar-arterial oxygen difference was not different. PaCO2 and alveolar-arterial oxygen difference increased, and PaO2 and right ventricular ejection fraction decreased in post-tuberculosis emphysema, while they did not significantly change in primary emphysema. CONCLUSION In post-tuberculosis emphysema, the impairment of gas exchange was more serious. Global assessment should be focused on right heart dysfunction which might be more affected than in primary emphysema.
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Affiliation(s)
- M A Kim
- Seoul National University Boramae Hospital, Seoul, Republic of Korea
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Yoon CH, Seo JB, Hur J, Choi JH, Kim JH, Park SJ, Jo SH, Lee JH, Hwang KK, Kim SH, Zo JH, Kim MA, Kim HS. Characterization of Two Types of Endothelial Progenitor Cells(EPC). Korean Circ J 2004. [DOI: 10.4070/kcj.2004.34.3.304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Chang Hwan Yoon
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Jae Bin Seo
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Jin Hur
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Jin Ho Choi
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Ji Hyeon Kim
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Seung Jung Park
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Sang Ho Jo
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Jun Hee Lee
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Kyoung Kook Hwang
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Sang Hyun Kim
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Joo Hee Zo
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Myung A Kim
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
| | - Hyo Soo Kim
- Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Korea
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Choi JH, Zhang SY, Cho YS, Whang KK, Lee JH, Oh S, Chae IH, Zo JH, Kim HS, Oh BH, Lee MM, Choi YS, Park YB. Role of 5-HT2A Receptor Gene T102C Polymorphism in Coronary Artery Disease and Serum Lipid Level. Korean Circ J 2003. [DOI: 10.4070/kcj.2003.33.4.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jin Ho Choi
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Shu Ying Zhang
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young Seok Cho
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Kook Whang
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Hee Lee
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seil Oh
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - In Ho Chae
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Hee Zo
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Soo Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Hee Oh
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Myoung Mook Lee
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Shik Choi
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young Bae Park
- Cardiovascular Center, Seoul National University Hospital, Seoul, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Lee JH, Lee DH, Zo JH, Kim TH, Lee KL, Chung HS, Kim CH, Han SK, Sim YS, Lee HS, Yoon YB, Song IS, Kim CY. Hepatopulmonary syndrome in poorly compensated postnecrotic liver cirrhosis by hepatitis B virus in Korea. Korean J Intern Med 2001; 16:56-61. [PMID: 11590902 PMCID: PMC4531714 DOI: 10.3904/kjim.2001.16.2.56] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Hepatopulmonary syndrome (HPS) refers to the association of hypoxemia, intrapulmonary shunting and chronic liver disease. But there is no clear data about the prevalence of HPS in postnecrotic liver cirrhosis by hepatitis B virus (HBV), the most common cause of liver disease in Korea. The aim of this study was to investigate the prevalence of HPS in poorly compensated postnecrotic liver cirrhosis by HBV, and the correlation of the hepatopulmonary syndrome with clinical aspects of postnecrotic liver cirrhosis by HBV. METHODS Thirty-five patients underwent pulmonary function test, arterial blood gas analysis and contrast-enhanced echocardiography. All patients were diagnosed as HBV-induced Child class C liver cirrhosis and had no evidence of intrinsic cardiopulmonary disease. RESULTS Intrapulmonary shunt was detected in 6/35 (17.1%) by contrast-enhanced echocardiography. Two of six patients with intrahepatic shunts had significant hypoxemia (PaO2 < 70 mmHg) and four showed increased alveolar-arterial oxygen gradient over 20 mmHg. Only cyanosis could reliably distinguish between shunt positive and negative patients. CONCLUSIONS The prevalence of intrapulmonary shunt in poorly compensated postnecrotic liver cirrhosis by HBV was 17.1% and the frequency of hepatopulmonary syndrome was relatively low (5.7%). 'Subclinical' hepatopulmonary syndrome (echocardiographically positive intrapulmonary shunt but without profound hypoxemia) exists in 11.4% of cases with poorly compensated postnecrotic liver cirrhosis by HBV. Cyanosis is the only reliable clinical indicator of HPS of HBV-induced poorly compensated liver cirrhosis. Further studies are required to determine if the prevalence and clinical manifestations of HPS varies with etiology or with geographical and racial differences.
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Affiliation(s)
- J H Lee
- Department of Internal Medicine, Liver Research Institute, Seoul Municipal Boramae Hospital, Seoul, Korea
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Affiliation(s)
- D W Sohn
- Clinical Research Institute and Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Sung J, Han KH, Zo JH, Park HJ, Kim CH, Oh BH. Effects of red ginseng upon vascular endothelial function in patients with essential hypertension. Am J Chin Med 2001; 28:205-16. [PMID: 10999439 DOI: 10.1142/s0192415x00000258] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study is to estimate the effect of Korean red ginseng on vascular endothelial cell dysfunction in patients with hypertension. Seventeen patients with hypertension who were divided into ginseng-treated (7) and non-treated (10) groups and 10 normotensive subjects were included. To assess the function of the vascular endothelial cell, changes of forearm blood flow to infusion of acetylcholine, sodium nitroprusside and bradykinin in incremental doses were measured by venous occlusion plethysmography. In the ginseng-treated hypertensive group, forearm blood flows at the highest dose of acetylcholine and bradykinin were significantly higher than those of the non-treated hypertensive group and were not different from those of the control group. In the case of sodium nitroprusside infusion, no significant differences were observed between the control, non-treated and treated groups. In conclusion, Korean red ginseng can improve the vascular endothelial dysfunction in patients with hypertension possibly through increasing synthesis of nitric oxide.
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Affiliation(s)
- J Sung
- Department of Internal Medicine, Seoul National University College of Medicine, Korea
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Zo JH. The effects of gamma-radiation on cyclin-dependent kinases and their inhibitors in cultured vascular smooth muscle cells. Korean Circ J 2001. [DOI: 10.4070/kcj.2001.31.1.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Joo Hee Zo
- The Heart Center, Chonnam National University Hospital, Kwangju, Korea
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Sohn DW, Kim YJ, Zo JH, Lee MM, Park YB, Choi YS, Lee YW. The value of contrast echocardiography in the diagnosis of patent ductus arteriosus with Eisenmenger's syndrome. J Am Soc Echocardiogr 2001; 14:57-9. [PMID: 11174435 DOI: 10.1067/mje.2001.107007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
When patent ductus arteriosus (PDA) is complicated by pulmonary hypertension resulting in a right-to-left shunt, an erroneous diagnosis of primary pulmonary hypertension may be made, even after echocardiographic examination. Among the 8 patients referred to our echocardiography laboratory with the diagnosis of primary pulmonary hypertension between June 1994 and November 1999, 2 patients were found to have PDA with Eisenmenger's syndrome. Patent ductus arteriosus with Eisenmenger's syndrome can be diagnosed by the opacification of the abdominal aorta without opacification of the left-sided chambers during contrast echocardiography.
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Affiliation(s)
- D W Sohn
- Clinical Research Institute and Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yungun-Dong, Chongno-Gu, Seoul 110-744, Korea
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Sohn DW, Song JM, Zo JH, Chai IH, Kim HS, Chun HG, Kim HC. Mitral annulus velocity in the evaluation of left ventricular diastolic function in atrial fibrillation. J Am Soc Echocardiogr 1999; 12:927-31. [PMID: 10552353 DOI: 10.1016/s0894-7317(99)70145-8] [Citation(s) in RCA: 208] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study assessed the clinical utility of mitral annulus velocity in the evaluation of left ventricular diastolic function in patients with atrial fibrillation. Atrial fibrillation is the most common sustained arrhythmia encountered in clinical practice. The clinical usefulness of conventional Doppler indexes is limited in atrial fibrillation because of the altered left atrial pressure and loss of synchronized atrial contraction. Mitral inflow and mitral annulus velocities were measured simultaneously with tau in 27 patients with nonrheumatic atrial fibrillation at the cardiac catheterization laboratory. Among deceleration time of mitral inflow, peak mitral inflow velocity (E), and peak diastolic mitral annulus velocity (E), only E correlated with tau (r = 0.51, P =.007). Prolonged tau (>/=50 ms) could be predicted by E <8 cm/s with a sensitivity of 73% (16 of 22) and a specificity of 100% (5 of 5). The E/E ratio correlated with left ventricular filling pressure (r = 0.79, P <.001). The E/E ratio of >/=11 could predict elevated left ventricular filling pressure (>/=15 mm Hg) with a sensitivity of 75% (9 of 12) and a specificity of 93% (14 of 15). Mitral annulus velocity is useful in the detection of impaired left ventricular relaxation and estimation of filling pressure even in patients with atrial fibrillation.
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Affiliation(s)
- D W Sohn
- Heart Research Institute and Division of Cardiology, Department of Internal Medicine, and Department of Bioengineering, Seoul National University College of Medicine, Korea
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Zo JH. Echocardiographic Evaluation of Valvular Regurgitation: Semiquantitation Based on the Color Flow is Enough in Everyday Clinical Practice? Korean Circ J 1999. [DOI: 10.4070/kcj.1999.29.10.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Joo Hee Zo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Abstract
OBJECTIVES Atrial fibrillation is an important risk factor for systemic embolism. A number of clinical studies demonstrated the beneficial effect of anticoagulant therapy for the prevention of embolism. But there has been no study on the fate of left atrial thrombus demonstrated by transesophageal echocardiography in the course of anticoagulation therapy. METHODS Thirteen patients, demonstrated to have left atrial thrombus by transesophageal echocardiography were followed with anticoagulation therapy. Repeated transesophageal echocardiography was done 15 months after 1st study. RESULTS Among 9 patients with adequate anticoagulation effect (INR > 2.0), left atrial thrombus disappeared in 3 patients. The size of thrombus decreased from 2.2 +/- 0.8cm to 0.9 +/- 1.0cm (p < 0.05 by paired Student's t-test). CONCLUSIONS Left atrial thrombus could dissolve or decrease in size with adequate anticoagulation.
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Affiliation(s)
- C H Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Korea
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Han KR, Choi KJ, Lee MY, Nam GB, Zo JH, Kim HS, Sohn DW, Kim CH, Oh BH, Lee MM, Park YB, Choi YS, Seo JD, Lee YW. Radiofrequency Catheter Ablation for the Treatment of Atrioventricular Reentrant Tachycardia. Korean Circ J 1995. [DOI: 10.4070/kcj.1995.25.5.920] [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: 11/11/2022] Open
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Zo JH, Oh BH, Koo SH, Nam GB, Lee DS, Kim HS, Sohn DW, Kim CH, Lee MM, Park YB, Choi YS, Seo JD, Lee YW. Changes of Plasma Endothelin-1 Concentration after Percutaneous Mitral Commissurotomy. Korean Circ J 1995. [DOI: 10.4070/kcj.1995.25.5.903] [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: 11/11/2022] Open
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Jung KH, Park HK, Zo JH, Kim CH, Seo JD, Park SW. A Case of Chondrosarcoma Metastatic to the Heart. Korean Circ J 1995. [DOI: 10.4070/kcj.1995.25.5.1051] [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: 11/11/2022] Open
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Sung JD, Oh SI, Sohn KS, Choi SJ, Zo JH, Choi KJ, Kim HS, Kim CH, Shon DW, Oh BH, Lee MM, Park YB, Choi YS, Seo JD, Lee YW. Predicting Factors of Multivessel Coronary Artery Disease in Dobutamine Stress Echocardiography. Korean Circ J 1994. [DOI: 10.4070/kcj.1994.24.6.788] [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: 11/11/2022] Open
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Zo JH, Sin WS, Choi KJ, Lee MM, Park YB, Choi YS, Seo JD, Lee YW. A Case of Truncus Arteriosus. Korean Circ J 1990. [DOI: 10.4070/kcj.1990.20.3.441] [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: 11/11/2022] Open
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