• Title/Summary/Keyword: Cardiac mass

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Association Between Body Mass Index and Clinical Outcomes According to Diabetes in Patients Who Underwent Percutaneous Coronary Intervention

  • Byung Gyu Kim;Sung-Jin Hong;Byeong-Keuk Kim;Yong-Joon Lee;Seung-Jun Lee;Chul-Min Ahn;Dong-Ho Shin;Jung-Sun Kim;Young-Guk Ko;Donghoon Choi;Myeong-Ki Hong;Yangsoo Jang
    • Korean Circulation Journal
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    • v.53 no.12
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    • pp.843-854
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    • 2023
  • Background and Objectives: We evaluated the effect of diabetes on the relationship between body mass index (BMI) and clinical outcomes in patients following percutaneous coronary intervention (PCI) with drug-eluting stent implantation. Methods: A total of 6,688 patients who underwent PCI were selected from five different registries led by Korean Multicenter Angioplasty Team. They were categorized according to their BMI into the following groups: underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight to obese (≥25.0 kg/m2). Major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of death, nonfatal myocardial infarction, stroke, and target-vessel revascularization, were compared according to the BMI categories (underweight, normal and overweight to obese group) and diabetic status. All subjects completed 1-year follow-up. Results: Among the 6,688 patients, 2,561 (38%) had diabetes. The underweight group compared to normal weight group had higher 1-year MACCE rate in both non-diabetic (adjusted hazard ratio [HR], 2.24; 95% confidence interval [CI], 1.04-4.84; p=0.039) and diabetic patients (adjusted HR, 2.86; 95% CI, 1.61-5.07; p<0.001). The overweight to obese group had a lower MACCE rate than the normal weight group in diabetic patients (adjusted HR, 0.67 [0.49-0.93]) but not in non-diabetic patients (adjusted HR, 1.06 [0.77-1.46]), with a significant interaction (p-interaction=0.025). Conclusions: Between the underweight and normal weight groups, the association between the BMI and clinical outcomes was consistent regardless of the presence of diabetes. However, better outcomes in overweight to obese over normal weight were observed only in diabetic patients. These results suggest that the association between BMI and clinical outcomes may differ according to the diabetic status.

Atypical Presentation of Chronic Granulomatous Disease in a Neonate with a Pulmonary Granuloma Mimicking a Tumor: A Case Report (신생아에서 종양으로 오인되는 폐 육아종의 비전형적인 소견을 보인 만성 육아종성 질환: 증례 보고)

  • Young Jin Yoo;Joo Sung Sun;Jang Hoon Lee;Hyun Joo Jung;Yeong Hwa Koh;Joonho Jung;Hyun Gi Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.990-995
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    • 2020
  • Chronic granulomatous disease (CGD) is an uncommon primary immune deficiency caused by phagocytes defective in oxygen metabolite production. It results in recurrent bacterial or fungal infections. Herein, we present a case of CGD with a large pulmonary granuloma in a neonate and review the imaging findings. The patient was a 24-day-old neonate admitted to the hospital with fever. A round opacified lesion was identified on the chest radiograph. Subsequent CT and MRI revealed a round mass with heterogeneous enhancement in the right lower lobe. There were foci of diffusion restriction in the mass. Surgical biopsy of the mass revealed chronic granuloma. Finally, the neonate was diagnosed with CGD caused by mutation of the gp91phox gene. Herein, we present the clinical and imaging findings of this unusual case of CGD.

The Effects of Health Fitness and Body Composition in Elderly Men for 16 Weeks of Tai Chi Exercise (16주간의 태극권 운동이 남자 고령자들의 건강체력 및 신체조성에 미치는 영향)

  • Kim, Cheol-Woo
    • Journal of Life Science
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    • v.21 no.8
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    • pp.1127-1133
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    • 2011
  • Exercise has been shown to positively influence quality of life for elderly men with a wide variety of medical illnesses. Tai chi exercise, a slow and graceful form of exercise and meditation, has especially been offered as the ideal exercise for elderly men with diverse conditions, such as people suffering from chronic heart failure or breast cancer survivors. In one recent study, Tai Chi was found to improve exercise capacity, sleep stability, and quality of life in heart failure patients including elderly men. The purpose of the study was to examine the effects of 16 weeks of Tai Chi exercise (3 times/week, 60 min/trial, 40-50% HRR) on physical and physiological changes. Sixty four healthy volunteers without any particular disease between the ages of 65 and 79 years participated in the study. The results were as follows; Significant changes of cardiac endurance, strength, muscle endurance, flexibility and balance were observed following 16 weeks of Tai Chi exercise (p<0.05). In addition, significant changes of diastolic blood pressure, body fat and fat-free mass were observed following 16 weeks of Tai Chi exercise (p<0.05). These findings suggest that a brief period of Tai Chi exercise is beneficial, particularly to elderly men. It is especially beneficial for body composition, and physical fitness factors such as cardiopulmonary endurance, muscle endurance, flexibility, and balance. Further study is needed in this area for specific disease patients.

Evaluation of Radiation Dose and Image Quality Between Manual and Automatic Exposure Control Mode According to Body Mass Index in Cardiac CT (체질량지수에 따른 심장 CT검사의 수동노출조절 방법과 자동노출조절 방법의 방사선량 및 화질 평가)

  • Kim, Hyeong-Jin;Moon, Il-Bong;Han, Jae-Bok;Choi, Nam-Gil;Jang, Seong-Ju
    • The Journal of the Korea Contents Association
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    • v.13 no.4
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    • pp.290-299
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    • 2013
  • This study included 198 patients who underwent prospectively electrocardiogram-triggered high-pitch spiral mode(FLASH mode) in cardiac CT for health check: 123 patients who underwent manual exposure control(Group A) and 75 patients who underwent automatic exposure control(Group B). Patients were classified according to BMI grades: Grade 1, Grade 2, Grade 3, Grade 4. Radiation dose, objective and subjective image quality between two groups were compared. In Group B, tube voltage were significantly decreased in all BMI grades. Both $CTDI_{vol}$ and effective dose were significantly reduced in the BMI Grade 1, 3, and 4 whereas they were slightly reduced in the Grade 2(p>0.05), SNR was significantly decreased in the Grade 1 and increased in the Grade 3(p<0.05), but there was no significant difference in the Grade 2, 4 between the two groups(p>0.05). CNR was significantly decreased in the Grade 1(p<0.05), and there was no significant difference in the Grade 2, 3, 4 between the two groups(p>0.05). The subjective image quality showed no significant difference in all BMI Grades between the two groups(p>0.05). Automatic exposure control can lead to a significant reduction of radiation exposure dose without degradation of subjective image quality.

The Relationship between Obesity and Cardiac Autonomic Regulation in College-Aged Male Smokers (남자흡연대학생의 비만과 심장자율신경조절의 관련성)

  • Kim, Choun Sub;Kim, Maeng Kyu
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.1
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    • pp.142-152
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    • 2019
  • This study aimed to explore the association between obesity index and heart rate variability (HRV) in college-aged male smokers. A total of 85 male college students (> 10 cigarettes per day for at least 3 years) were participated in this study. According to a standardized protocol, body mass index (BMI), percent body fat (%BF), waist circumference (WC), and waist-to-hip ratio (WHR) were taken as obesity indices. Resting r-r interval was monitored for HRV analysis as an indicator of cardiac autonomic regulation. Compared with low WHR subjects, high WHR subjects had significantly lower values of rMSSD, pNN50, HF, and SD1, suggesting decreased parasympathetic activity. No such differences in LF/HF ratio were found between the WHR-based subgroups. Bivariate correlation analysis showed that obesity indices of WC, WHR, and %BF were significantly associated with rMSSD, pNN50, HF, and SD1, with a tendency for correlation coefficient to be higher with WHR than with WC or %BF. No significant association was found between BMI and HRV parameters indicative of parasympathetic activity. This study suggest that central obesity is significantly associated with decrease in parasympathetic activation, independent of BMI as an indicator of obesity, in male college smokers.

Use of Coronary CT Angiography as a Screening Tool for Coronary Artery Disease in Asymptomatic Healthy Individuals or Patients (무증상 정상인 또는 환자의 관상동맥 질환 선별 검사로서 관상동맥 전산화단층촬영 혈관조영술의 유용성)

  • Gong Yong Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.54-69
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    • 2022
  • Early detection of potential asymptomatic coronary artery disease is very important, as patients with sudden cardiac death often do not show symptoms such as chest pain or motor dyspnea. Coronary CT angiography (CCTA) has long been unjustified as a screening tool for asymptomatic patients because of the risks posed by radiation exposure. However, there are still various opinions regarding the usefulness of CCTA for screening for coronary artery disease (CAD) in asymptomatic healthy individuals or patients. This review investigated the usefulness of coronary artery calcium score and CCTA as screening tests for CAD in asymptomatic healthy individuals or patients through various literature reviews. With the development of CT technology, recent studies have been conducted in asymptomatic CAD patients with a reduced radiation dose of less than 1 mSv. A total of 2.6% of asymptomatic subjects on CCTA found significant CAD over 70%, and it was concluded that screening CCTA for CAD showed prognostic power in predicting the future occurrence of CAD in asymptomatic people. However, after the completion of the current NIH SCOT-HEART 2 study, it may be possible to determine whether CCTA is appropriate as a screening tool for CAD in asymptomatic healthy individuals.

Effect of Xenogeneic Substances on the Glycan Profiles and Electrophysiological Properties of Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes

  • Yong Guk, Kim;Jun Ho Yun;Ji Won Park;Dabin Seong;Su-hae Lee;Ki Dae Park;Hyang-Ae Lee;Misun Park
    • International Journal of Stem Cells
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    • v.16 no.3
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    • pp.281-292
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    • 2023
  • Background and Objectives: Human induced pluripotent stem cell (hiPSC)-derived cardiomyocyte (CM) hold great promise as a cellular source of CM for cardiac function restoration in ischemic heart disease. However, the use of animal-derived xenogeneic substances during the biomanufacturing of hiPSC-CM can induce inadvertent immune responses or chronic inflammation, followed by tumorigenicity. In this study, we aimed to reveal the effects of xenogeneic substances on the functional properties and potential immunogenicity of hiPSC-CM during differentiation, demonstrating the quality and safety of hiPSC-based cell therapy. Methods and Results: We successfully generated hiPSC-CM in the presence and absence of xenogeneic substances (xeno-containing (XC) and xeno-free (XF) conditions, respectively), and compared their characteristics, including the contractile functions and glycan profiles. Compared to XC-hiPSC-CM, XF-hiPSC-CM showed early onset of myocyte contractile beating and maturation, with a high expression of cardiac lineage-specific genes (ACTC1, TNNT2, and RYR2) by using MEA and RT-qPCR. We quantified N-glycolylneuraminic acid (Neu5Gc), a xenogeneic sialic acid, in hiPSC-CM using an indirect enzyme-linked immunosorbent assay and liquid chromatography-multiple reaction monitoring-mass spectrometry. Neu5Gc was incorporated into the glycans of hiPSC-CM during xeno-containing differentiation, whereas it was barely detected in XF-hiPSC-CM. Conclusions: To the best of our knowledge, this is the first study to show that the electrophysiological function and glycan profiles of hiPSC-CM can be affected by the presence of xenogeneic substances during their differentiation and maturation. To ensure quality control and safety in hiPSC-based cell therapy, xenogeneic substances should be excluded from the biomanufacturing process.

Reduced Ceramides Are Associated with Acute Rejection in Liver Transplant Patients and Skin Graft and Hepatocyte Transplant Mice, Reducing Tolerogenic Dendritic Cells

  • Hyun Ju Yoo;Yeogyeong Yi;Yoorha Kang;Su Jung Kim;Young-In Yoon;Phuc Huu Tran;Taewook Kang;Min Kyung Kim;Jaeseok Han;Eunyoung Tak;Chul-Soo Ahn;Gi-Won Song;Gil-Chun Park;Sung-Gyu Lee;Jae-Joong Kim;Dong-Hwan Jung;Shin Hwang;Nayoung Kim
    • Molecules and Cells
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    • v.46 no.11
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    • pp.688-699
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    • 2023
  • We set up this study to understand the underlying mechanisms of reduced ceramides on immune cells in acute rejection (AR). The concentrations of ceramides and sphingomyelins were measured in the sera from hepatic transplant patients, skin graft mice and hepatocyte transplant mice by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). Serum concentrations of C24 ceramide, C24:1 ceramide, C16:0 sphingomyelin, and C18:1 sphingomyelin were lower in liver transplantation (LT) recipients with than without AR. Comparisons with the results of LT patients with infection and cardiac transplant patients with cardiac allograft vasculopathy in humans and in mouse skin graft and hepatocyte transplant models suggested that the reduced C24 and C24:1 ceramides were specifically involved in AR. A ceramide synthase inhibitor, fumonisin B1 exacerbated allogeneic immune responses in vitro and in vivo, and reduced tolerogenic dendritic cells (tDCs), while increased P3-like plasmacytoid DCs (pDCs) in the draining lymph nodes from allogeneic skin graft mice. The results of mixed lymphocyte reactions with ceranib-2, an inhibitor of ceramidase, and C24 ceramide also support that increasing ceramide concentrations could benefit transplant recipients with AR. The results suggest increasing ceramides as novel therapeutic target for AR, where reduced ceramides were associated with the changes in DC subsets, in particular tDCs.

Radiation dose Assesment according to the Adaptive Statistical Iterative Reconstruction Technique of Cardiac Computed Tomography(CT) (심장 CT 검사시 ASIR 적용에 따른 선량 평가)

  • Jang, Hyun-Cheol;Kim, Hyun-Ju;Cho, Jae-Hwan
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.252-259
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    • 2011
  • To identify the effects of the application of the adaptive statistical iterative reconstruction (ASIR) technique in combination with the other two factors of body mass Index (BMI) and tube potential on radiation dose in cardiac CT. The patient receiving operation the cardiac CT examination was divided four groups into according to kVp.[A group(n=20), Non-ASIR, BMI < 25, 100 kVp; B group(n=20), Non-ASIR, BMI > 25, 120 kVp; C group(n=20), 40% ASIR BMI < 25, 100 kVp; D group(n=20), 40% ASIR, BMI > 25, 120 kVp] After setting up the region of interest in the main artery central part and right coronary artery and left anterior descending artery, the CT number was measured and an average and standard deviation were analyzed. There were A group and the difference which the image noise notes statistically between C. And A group was high so that the noise could note than C group (group A, 494 ${\pm}$ 32 HU; group C, 482 ${\pm}$ 48 HU: P<0.05) In addition, there were B group and the difference noted statistically between D. And B group was high so that the noise could note than D group (group B, 510 ${\pm}$ 45 HU; group D, 480 ${\pm}$ 82 HU: P<0.05). In the qualitative analysis of an image, there was no difference (p>0.05) which a group, B group, C group, and D as to average, A group 4.13${\pm}$0.2, B group 4.18${\pm}$0.1, and C group 4.1${\pm}$0.2 and D group note statistically altogether with 4.15${\pm}$0.1 as a result of making the clinical evaluation according to the coronary artery segments. And the inappropriate image was shown to the diagnosis in all groups. As to the radiation dose, a group 8.6${\pm}$0.9 and B group 14.9${\pm}$0.4 and C group 5.8${\pm}$0.5 and D group are 10.1${\pm}$0.6 mSv.

Postnatal left Ventricular Outflow Tract Obstruction Caused by Multiple Rhabdomyoma Tumors (다발성 횡문근육종으로 인해 출생직후 발생한 좌심실유출로 폐쇄)

  • Song, Seung-Hwan;Jun, Tae-Gook;Choi, Min-Suk;Yang, Ji-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.725-728
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    • 2010
  • Rhabdomyoma is the most common benign cardiac neoplasm in neonates. Most patients with rhabdomyoma experienced spontaneous regression. Yet some of them need surgical therapy because of hemodynamic problems of the heart such as arrhythmia, outflow tract obstruction and valvular dysfunction. We found multiple masses in both ventricles on the patient's fetal echocardiogram. Heart failure caused by severe left ventricular outflow tract obstruction quickly presented after birth. The mass interfering with the outflow tract was resected via the transaortic approach at the first day of birth. Postoperative echocardiography showed complete release of the outflow tract obstruction. He was discharged on the postoperative day 8. During the 3 years of follow up, we found that the sizes of the remnant masses had gradually decreased.