• Title/Summary/Keyword: 심근허혈

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Effects of 12 Week Regular Aerobic Exercise on ST-segment and QTc Interval in Type 2 Diabetes Mellitus Patients (12주 규칙적인 유산소 운동이 제 2형 당뇨환자의 ST 분절과 QTc 연장에 미치는 영향)

  • Kim, Young-Il;Paik, Il-Young;Jin, Hwa-Eun;Suh, Ah-Ram;Kwak, Yi-Sub;Woo, Jin-Hee
    • Journal of Life Science
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    • v.19 no.1
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    • pp.81-86
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    • 2009
  • The purpose of the present study was to examine effect of 12 week regular aerobic exercise on ST-segment and QTc interval in middle age type 2 diabetes mellitus (T2DM) patients. The subjects consist of 13 type 2 diabetes mellitus (T2DM) patients in middle age men and all of them had no other complications. Subjects participated in aerobic exercise training for 12 weeks. They started to exercise for $20{\sim}60$ min at $60{\sim}80%$ of $HR_{max}$, (exercise intensity has been increased gradually) per day, $3{\sim}5$ times a week. The results were compared before and after. Weight and BMI, % body fat, fasting glucose, HOMA-IR, $_{peak}DBP$ were significantly decreased and $_{peak}HR$, $_{peak}VO_2$, exercisre time were significantly increased after 12 week aerobic exercise. Also, QTc interval and ST-segment were significantly decreased during at rest, peak exercise after 12 week aerobic exercise. Conclusionally, 12 week aerobic exercise may be improvement in decreased cardiovascular mortality factors (ST-segment) and abnormal autonomic dysfunction (QTc interval) and potentially increased exercise capacity.

Effect of Pyruvate and Aspartate Enriched University of Wisconsin Solution on Myocardial Protection (피루브산염과 아스파라진산염을 첨가한 위스콘신대학 용액의 심근보호 효과)

  • 이정렬;김준석;한재진;강문철
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.11-19
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    • 2002
  • Background: Ischemia-reperfusion myocardial injury is an important factor to determine the early and the late mortality of transplanted patients. Recently, modulation of the cytosolic NADH/NAD+ ratio by Pyruvate and aspartate was tested to Protect the heart from ischemia-reperfusion injury. Material and Method: We added pyruvate and aspartate to the University of Wisconsin solution, and evaluated their effect on myocardial protection. We used 16 piglet(age 1 to 3 days) hearts. Eight hearts were arrested with and stored in the University of Wisconsin solution(UW solution) for 24 hours(control group), and the other eight hearts were arrested with and stored in the modified UW solution added pyruvate(3mmol/L) and aspartate(2 mmol/L)(test group). All hearts underwent modified reperfusion with blood cardioplegic solution followed by conversion to a left-sided working model with perfusion from a support pig. And then, we measured stroke work index(SWI), high-energy phosphate stores, and myocardial water content of the hearts. SWI was calculated at left ventricular end-diastolic pressures of 3, 6, 9, and 12 mmHg after 60 and 120 minutes reperfusion, respectively, Result: At 60 minutes and 120 minutes after reperfusion, SWI was higher in the test group than in the control group significantly. The levels of AMP, ADP, ATP of the test group were also higher. But, the creatine phosphate level and myocardial water content were similar in the two groups. Conclusion: From these results, we could Prove that pyruvate and aspartate enhance cardiac contractility and high-energy phosphate stores after ischemia.

Effects of vitamin C as antioxidant on recovery of left ventricular function after ischemia and reperfusion in isolated rat heart (항산화제로서 비타민 C가 적출된 쥐심장에서 허혈 및 재관류후 좌심실 기능회복에 미치는 영향)

  • 류한영;이철주
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.593-598
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    • 1996
  • The large number of past investigation on extended myocardial protection clearly indicates that cold potassium cardioplegia and topical cooling have limited capabilities. Accordingly, more recent experimen- tal approaches have focused on the modalities of reperfusion and their implication on postischemic myo- cardial recovery. Oxygen may play a crucial role in the development of ischemic and reperfusion injury. Reactive oxygen radicals may be produced during ischemia or reperfusion after incomplete reduction of molecular oxygen or from other pathway and then induce fatal injury of the heart. The important obser- vation of oxygen-induced myocardial damage during reperfusion has led to the concept of applying oxy- gen free radical scavengers. So, this study is on dietary vitamin C supplementation as antioxidant in rats to determine whether or not they have a higher tolerance against cardiac ischemia-reperf'usion injury under Langendorff system. Male or female Sprague-Dawley rats (190-33Og) were randomly separated into two groups. Group A was not treated(n=10). Group B received vitamin C supplement (n=10). Experiment was performed 24 hours after vitamin C 200mg fed orally as injectable ascorbic acid. There were significant differences in contractile parameters between control and vitamin C-treated group. The RLVP (r te of post/preischemic left ventricular pressure) and Rdp/dt (rate of post/preischemic dp/dt) were significant statistically between two groups (p<0.05). But, RHR (rate of post/preischemic heart rate), time to first beat and sta'utilization were not significant. In conclusion, pretreatment with the antioxidant, ascorbic acid, was found to preserve left ventricular contractile function. But the precise mechanism of action of ascorbic acid has not as yet been determined, so further study will be required.

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Protective Effects of Adenosine-enriched Cardioplegic Solution in Ischemic Myocardium (Adenosine을 함유한 심정지액의 심근보호 효과)

  • 이호철;정태은
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.199-207
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    • 1996
  • Ischemic myocardial damage is inevitable to cardiac surgery. Myocardial damage after initiation of reperfusion through the coronary arteries is one of the most important determinants of a successful surgery. Adenosine is a potent vasodilator, and is also known to induce rapid cardioplegic arrest by its property of antagonizing cardiac calcium channels and activating the potassium channel. Thus, we initiated this study with adenosine to improve postischemic recovery in the isolated rat heart. We tested the hypothesis that adenosine could be more effective than potassium in inducing rapid cardiac arrest and enhancing postischemlc hemodynamic recovery. Isolated rat hearts, connected to the Langendorff appratus, were perfused with Krebs-Henseleit buffer and all hearts were subjected to arrest for 60 minutes. Three groups of hearts were studied according to the composition of cardioplegic solutions : Group A (n=10), adenosine 10mmo1/L+potassium free modified St. Thomas cardioplegia : Group B (n=10), adenosine 400mo1/L+S1. Thomas cardioplegia:Group C(control, n=10), St. Thomas cardioplegia. Adenosine-treated groups (group A & B) resulted in more rapid cardiac arrest than control group (C) (p< 0.01). There was greater improvement in recovery of coronary blood flow at 20 and 30 minutes of reperfusion in group A and at 20 minutes in group B when compared with control group(p<0.01). Recovery of systolic blood pressure at 10 minutes after reperfusion in group A and B was significantly superior to that in group C (p<0.01). Recovery of dp/dt at 10 minute after reperfusion in group A was also significantly superior to group C (p<0.05). Group A and B showed better recovery rates than control group in aortic blood flow, cardiac output, and heart rate, but there were no statistical differences. CPK levels of coronary flow in group A were significantly low (p< 0.01). We concluded that adenosine-enriched cardioplegic solutions have better effects on rapid cardiac arrest and postischemic recovery when compared with potassium cardioplegia.

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Autologous Bone Marrow Cell Transplantation Combined with Off-pump Coronary Artery Bypass Grafting in Ischemic Myocardium (허혈성 심근에 관상동맥우회술과 병행한 자가 골수줄기세포 이식)

  • 김현옥;곽영란;강석민;장양수;임상현;안지영;이창영;강면식;유경종
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.547-552
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    • 2004
  • Recently, autologous bone marrow cell transplantation (CTx) for angiogenesis and myogenesis in ischemic myocardium has been extensively investigated to improve heart functions. This study was designed to evaluate the effects of CTx with off-pump coronary artery bypass grafting (OPCAB) in patients who were not feasible for complete revascularization. Material and Method: Four male patients underwent CTx and OPCAB simultaneously. Bone marrow was aspirated from iliac bone. Mean 1.5 ${\times}$ 10$^{9}$ mononuclear cells including mean 6.7 ${\times}$ 10$^{6}$ CD34 + cells and 3.7 ${\times}$ 10$^{6}$ AC133 + cells were obtained and concentrated with 10 cc. These cells were transplanted into non-graftable ischemic myocardium after OPCAB. The heart function of all patients were evaluated using the MIBI scan, echocardiogram and MRI preoperatively. The effects of CTx was evaluated using MIBI scan and echocardiogram at 1 month postoperatively. Result: An average of 2 grafts were bypassed to left anterior descending artery territory. Other territories were transplanted with isolated mononuclear cell. All patients had uncomplicated postoperative course. After 1 month follow up, there were improvement in symptom, ejection fraction (from 49% to 55%) on echocardiogram and myocardial perfusion on MIBI scan in all patients. Conclusion: These preliminary data showed improvement of heart function and myocardial perfusion and also showed the feasibility and safety of combined therapy with OPCAB and CTx in ischemic myocardium. However, the effectiveness of CTx alone cannot be readily assessed. Further randomized, controlled studies are required to evaluate the effectiveness of CTx alone.

Prognostic Value of Normal Exercise $^{99m}Tc$-MIBI Myocardial Perfusion SPECT: Comparison with Exercise Electrocardiography and Coronary Angiography ($^{99m}Tc$-MIBI 운동부하 심근관류 SPECT에서 정상소견을 보인 환자의 예후: 운동부하 심전도와 관동맥 조영소견과의 비교)

  • Lee, Sang-Woo;Lee, Jae-Tae;Chun, Kyung-Ah;Kang, Do-Young;Kim, Dong-Hwan;Cho, Yong-Keun;Chae, Shung-Chull;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.199-206
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    • 2000
  • Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise $^{99m}Tc$-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. Materials and Methods: We evaluated 301 patients (mean age $52{\pm}10$ years, 166 males and 135 females) with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subject were evaluated for cardiac events and followed for 8-55 months (mean $19{\pm}10$ months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n=235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

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Protective Effect of Urokinase on Reperfusion Function in Isolated Perfused Rat Heart, and Anti-platelet Aggregation Effect Invitro and Exvivo (Urokinase의 적출심장의 심근허혈에 대한 보호작용과 invitro 및 exvivo항혈전작용 실험)

  • Kwon, Kwangil;Shin, Hongseup;Yoon, Jongok;Kim, Boshin;Min, Jiha;Lee, Byungho;Huh, Inhoe
    • Korean Journal of Clinical Pharmacy
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    • v.2 no.1
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    • pp.1-9
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    • 1992
  • Protective effect of urokinase on reperfusion were studied followed by global ischemia in the isolated perfused rat heart. Separately, anti-platelet aggregation effect of urokinase also investigated. Urokinase exhibited positive effect for the protection of rat heart function by increasing the LV dp/dt, coronary flow(CF) and the Tate pressure product(RPP), and by decreasing the LVEDP on reperfusion. Urokinase also decreased arrhythmia by $74.7\%(P<0.05) induced by global ischemia in the rat heart. In the platelet aggregation study, urokinase did not show the inhibitory effect of ADP or collagen induced platelet aggregation inviuo and exvivo.

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Delayed Enhancement Magnetic Resonance Imaging Findings in Cardiac Amyloidosis (심장 아밀로이드증의 지연 조영증강 MR 영상소견)

  • Song, Jin Hwa;Park, Eun-Ah;Lee, Whal;Chung, Jin Wook;Park, Jae Hyung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.33-40
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    • 2013
  • Purpose : To evaluate late gadolinium enhancement (LGE) pattern of left ventricular (LV) myocardium and presence or absence of LGE in other regions of the heart on cardiac magnetic resonance (CMR) imaging in patients diagnosed with cardiac amyloidosis. Materials and Methods: From 2009 to 2011, 9 patients who were suspected cardiac amyloidosis underwent CMR. We retrospectively analyzed the presence or absence of LGE and enhancement pattern in LV myocardium, and the presence or absence of LGE in other chambers as well. Also we measured interatrial septal thickness (IST), relative signal intensities of atrial septum and epicardial fat over the left atrial (LA) cavity on delayed enhanced images. MRI parameters in these patients were compared to those of control group of patients with ischemic heart disease by Wilcoxon rank sum test. Results: Of nine patients, LGE were found in 8; subendocardial circumferential pattern in 4 and diffuse pattern in 4. LGE in right ventricle was observed in 7. IST was significantly increased in patients with cardiac amyloidosis (P = 0.02). Ratio of atrial septum to LA cavity and ratio of epicardial fat to LA cavity showed a significant difference (P = 0.0002 and P = 0.0006, respectively). Conclusion: In LGE CMR, subendocardial or diffuse enhancement pattern is a typical finding for patients with cardiac amyloidosis. Atrial septum and epicardial fat show relatively increased signal intensities over LA blood cavity.

A Study on the Mechanism of Calcium Binding Inhibition of Cardiac Sarcoplasmic Reticulum by Oxygen Free Radicals (산소대사물에 의한 심장근 Sarcoplasmic reticulum의 칼슘운반 억제 기전에 관한연구)

  • Kim, Hae-Won;Chung, Myung-Hee;Kim, Myung-Suk;Park, Chan-Woong
    • The Korean Journal of Pharmacology
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    • v.21 no.2
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    • pp.79-89
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    • 1985
  • Mechanism of calcium transport inhibition of cardiac sarcoplasmic reticulum (SR) by oxygen free radicals was examined. Effects of oxygen free radicals generated by xanthine/xanthine oxidase (X/XO) system on isolated porcine ventricle SR were studied with respect to its calcium binding, lipid peroxidation, SH-group content and alteration of membrane protein components. The results are as follows. 1) Calcium binding of isolated SR was markedly inhibited by X/XO. 2) During the incubation of sarcoplasmic reticulum with xanthine/xanthine oxidase, there were marked inclose in lipid peroxidation and reduction of SH-group content. 3) An antioxidant, p-phenylenediamine effectively prevented the lipid peroxidation but partially prevented the calcium binding inhibition of X/XO treated SR. 4) The reduction of SH-group content of SR treated with X/XO was partially prevented by p-phenylendiamine. 5) When modifying SH-group of SR by treatment with DTNB, the inhibition of calcium binding activity was partially prevented. 6) On gel-permeation chromatography of X/XO-treated sarcoplasmic reticulum, there was an increase of small molecular weight products, probably protein degradation products. 7) Semicarbazide, which prevents the cross-linking reaction of protein components, did not affect the calcium binding inhibition of X/XO-treated SR. From these results, it is suggested that the inhibition of calcium binding of SR by oxygen free radicals results from the consequence of multiple changes of SR components, which are lipid peroxidation, SH-group oxidation and degradation of protein components.

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Automated Functional Morphology Measurement Using Cardiac SPECT Images (SPECT 영상을 사용한 기능적 심근형태의 자동 계측법 개발)

  • Choi, Seok-Yoon;Ko, Seong-Jin;Kang, Se-Sik;Kim, Chang-Soo;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.133-139
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    • 2012
  • For the examination of nuclear medicine, myocardial scan is a good method to evaluate a hemodynamic importance of coronary heart disease. but, the automatized qualitative measurement is additionally necessary to improve the decoding efficiency. we suggests the creation of cardiac three-dimensional model and model of three-dimensional cardiac thickness as a new measurement. For the experiment, cardiac reduced cross section was obtained from SPECT. Next, the pre-process was performed and image segmentation was fulfilled by level set. for the modeling of left cardiac thickness, it was realized by applying difference equation of two-dimensional laplace equation. As the result of experiment, it was successful to measure internal wall and external wall and three-dimensional modeling was realized by coordinate. and, with laplace formula, it was successful to develop the thickness of cardiac wall. through the three-dimensional model, defects were observed easily and position of lesion was grasped rapidly by the revolution of model. The model which was developed as the support index of decoding will provide decoding information to doctor additionally and reduce the rate of false diagnosis as well as play a great role for diagnosing IHD early.