• Korean Circulation Journal
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• 제52권8호
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• pp.576-592
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• 2022

Acute heart failure is associated with high mortality and frequent rehospitalization, resulting in enormous healthcare costs and declining physical function, activities of daily living, and quality of life. Cardiac rehabilitation has been recommended as one of the non-pharmacologic treatments for patients with heart failure. However, much of the evidence for cardiac rehabilitation interventions reported to date has been limited to chronic heart failure. In recent years, the effectiveness of rehabilitation intervention in patients with acute heart failure has been reported, led by the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial. This review overviews the recent evidence of rehabilitation in patients with acute heart failure.

• Journal of Chest Surgery
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• 제17권3호
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• pp.409-417
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• 1984

In the early days of open heart surgery, acute respiratory failure following extracorporeal circulation was a significant deterrent to an uncomplicated recovery. Although a marked improvement in prevention and treatment of postoperative respiratory failure has been achieved, the problem has not been completely eliminated and continues to be a causative factor in morbidity and mortality Fates following open heart surgery. We have attempted to evaluate postoperative respiratory failure in patients undergoing cardiac operation with the aid of extracorporeal circulation. Our series comprised 92 patients who underwent elective open heart surgery at the Department of Thoracic and Cariodvascular Surgery, School of Medicine, Kyungpook National University, from January, 1980 to December, 1982. In our study, the overall incidence of acute respiratory failure following open heart surgery was 18.8 percent. The duration of extracorporeal circulation in a series of 18 patients who developed postoperative respiratory failure [Group B] was longer in the mean value [120.3 minutes] than the uncomplicated 74 patients [Group A] [85.8 minutes]. The duration of artificial ventilation after open heart surgery in Group A averaged 13.4 hours as contrasted with 76.5 hours in Group B. In Group B, the inspired oxygen concentration [FiO2] in artificial ventilation was continued in the higher level than Group A until 18 hours after operation. Upon pulmonary function test performed pre-and postoperatively, residual volume[RV], RV/TLC and FEV 1.0/FVC were remained essentially unchanged following extracorporeal circulation, whereas forced vital capacity [FVC], FEV 1.0 and FEF 25-75% were significantly decreased in the early postoperative days. The incidence of acute respiratory failure was significantly higher in a series of patients who developed postoperative complications, such as re- exploration due to massive bleeding, low cardiac output, acute renal failure and arrhythmias. A total of 9 patients died, giving an overall mortality was 33.3 percent whereas the mortality was only 1.1 percent for patients without respiratory failure.

• Tuberculosis and Respiratory Diseases
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• 제68권2호
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• pp.62-66
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• 2010

Background: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. Methods: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a $PaO_2/FiO_2$ ratio <100 mm Hg on $FiO_2$ of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. $EBS^{(R)}$, $Bio-pump^{(R)}$, and Centrifugal Rotaflow $pump^{(R)}$ were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. Results: Five of the 7 patients were male and the mean age was $46.3{\pm}18.3$. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was $17.3{\pm}13.7$ days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. Conclusion: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.

• International Journal of Heart Failure
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• 제6권3호
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• pp.129-136
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• 2024

Background and Objectives: Heart failure (HF) is a leading cause of hospitalization and death worldwide. The Steady Movement with Innovating Leadership for Heart Failure (SMILE HF) aims to evaluate the clinical characteristics, management, hospital course, and long-term outcomes of patients hospitalized for acute HF in South Korea. Methods: This prospective, observational multicenter cohort study was conducted on consecutive patients hospitalized for acute HF in nine university hospitals since September 2019. Enrolment of 2000 patients should be completed in 2024, and follow-up is planned through 2025. Results: Interim analysis of 1,052 consecutive patients was performed to understand the baseline characteristics. The mean age was 69±15 years; 57.6% were male. The mean left ventricular ejection fraction was 39±15%. The prevalences of HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction were 50.9%, 15.3%, and 29.2%. Ischemic cardiomyopathy (CMP) was the most common etiology (32%), followed by tachycardia-induced CMP (12.8%) and idiopathic dilated CMP (9.5%). The prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin receptor/neprilysin inhibitor, beta-blockers, spironolactone, and sodium-glucose cotransporter-2 inhibitors at discharge were 76.8%, 66.5%, 50.0%, and 17.5%, respectively. The post-discharge 90-day mortality and readmission rates due to HF aggravation were 2.0% and 6.4%, respectively. Our analysis reveals the current state of acute HF in South Korea. Conclusions: Our interim analysis provides valuable insights into the clinical characteristics, management, and early outcomes of acute HF patients in South Korea, highlighting the current state and treatment patterns in this population.

• 한국전자통신학회논문지
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• 제11권11호
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• pp.1141-1148
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• 2016

본 논문은 웨어러블 시스템을 이용하여, ECG 전기 패턴을 QRS을 이용하여 급성 심장마비 예측 감지 시스템으로, 웨어러블 심장 이상 징후 감지 스마트 워치와, 이를 포함 하고 디지털 ECG (X, Y) 패턴 좌표 DB를 이용하여 비정상 패턴을 즉시 감지하고, 급성 심장마비 예방 시스템 및 그 방법을 보여준다. 특히, 디지털 ECG(X, Y) 패턴 정보를 이용한 이상 징후 유형과 대비하는 단계를 통해서 급성 심장마비 발생 시, 골든타임을 놓치지 않고 응급 처치할 수 있음을 보여 준다.

• Korean Circulation Journal
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• 제53권7호
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• pp.452-471
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• 2023

The Korean Society of Heart Failure (KSHF) Guidelines provide evidence-based recommendations based on Korean and international data to guide adequate diagnosis and management of heart failure (HF). Since introduction of 2017 edition of the guidelines, management of advanced HF has considerably improved, especially with advances in mechanical circulatory support and devices. The current guidelines addressed these improvements. In addition, we have included recently updated evidence-based recommendations regarding acute HF in these guidelines. In summary, Part IV of the KSHF Guidelines covers the appropriate diagnosis and optimized management of advanced and acute HF.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.146-151
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• 2015

Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

• Journal of Chest Surgery
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• 제11권2호
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• pp.117-122
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• 1978

With the increasing performance of open heart surgery during recent years, the occurrence of renal failure associated with cardiopulmonary aypass has received considerable attention. This patient was 33 yaar old woman who undertaken mitral valve replacement under the cardiopulmonary bypass. Acute renal failure developed after 2nd postoperative day. So we report here the course of renal failure as it occur in immediate relation to open heart surgery and examine the role of preoperative, intraoperative and postoderative factors.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.122-127
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• 2020

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal complication of cancer and causes pulmonary hypertension and acute/subacute right heart failure. PTTM is most commonly associated with gastric cancer and more rarely associated with pancreatic cancer. We report a case of progressive right heart failure associated with clinically diagnosed pancreatic cancer, suggesting PTTM.

• International Journal of Heart Failure
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• 제6권2호
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• pp.70-75
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• 2024

With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea.