• Title/Summary/Keyword: Cardiovascular risk

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Cardiovascular Disease in Pediatric Chronic Kidney Disease (소아 만성 콩팥병에서 나타나는 심혈관계 질환)

  • Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.7-12
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    • 2014
  • Cardiovascular disease (CVD) has been identified as one of the most important factors influencing the long-term prognosis of patients with chronic kidney disease (CKD). However, in pediatric CKD, the clinical importance of CVD tends to be overlooked due to the lack of typical manifestations of CVD in this population. The literature has identified several traditional risk factors of CVD that originate from CKD, including hypertension, diabetes mellitus, dyslipidemia and obesity, in addition to new and non-traditional risk factors including anemia, secondary hyperparathyroidism, oxidative stress and inflammation. In cases of pediatric CKD, cardiovascular disease is usually restricted to subclinical manifestations such as left ventricular hypertrophy, thickening of intimal media on the carotid artery and calcification of the coronary artery. Therefore, risk factors of CVD in pediatric CKD patients should be closely monitored.

Assessing Hematological Change Associated with Cardiovascular Disease Risk among Korean Taxi Drivers Using Data from the Second (2012-2014) Korean National Environmental Health Survey: A Propensity Score Matching Approach (제2기(2012-2014) 국민환경보건 기초조사 자료를 활용한 국내 남성 택시 기사의 심혈관계 위험도 관련 혈액학적 변화에 대한 연구: 성향점수 매칭을 활용하여)

  • Baek, Kiook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.4
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    • pp.367-377
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    • 2021
  • Objectives: Taxi drivers are exposed to various hazards, such as long periods of sedentary work and traffic-related air pollutants. However, studies on the health effects among taxi drivers in South Korea are insufficient. Methods: To assess subclinical hematologic change related to cardiovascular disease among male taxi drivers, we analyzed data from the second Korean National Environmental Health Survey. Fifty-nine taxi drivers and 1,912 controls were included in the analysis. Propensity score matching was performed to adjust for age, body mass index, and urinary cotinine. A total of 295 subjects were matched with 59 taxi drivers. Leukocyte count, platelet count, hematocrit, triglyceride, total cholesterol, HDL cholesterol land total IgE of the taxi drivers were compared with the control groups. Results: Taxi drivers showed significantly elevated blood leukocytes and platelets. Serum total IgE was significantly reduced in taxi drivers. However, blood leukocytes, platelets, and serum total IgE were not significantly correlated with work period among taxi drivers. Conclusions: Regarding the change of the blood leukocyte count, platelet count, and serum total IgE, taxi driving has the possibility to be associated with peripheral inflammation, humoral immunity and cardiovascular risk.

Hemorheology and Cardiovascular Disease

  • Cho, Young-I.;Kensey, Kenneth R.
    • 순환기질환의공학회:학술대회논문집
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    • 2002.11a
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    • pp.3-18
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    • 2002
  • Hemorheology plays an important role in atherosclerosis. Hemorheologic properties of blood include whole blood viscosity, plasma viscosity, hemaocrit, RBC deformability and aggregation, and fibrinogen concentration in plasma. Blood flow is determine by three parameters (pressure, lumen diameter, and whole blood viscosity), whole blood viscosity is one of the key physiological variables. However, the significance of whole blood viscosity has not yet not been fully appreciated. Whole blood viscosity has a unique property, non-Newtonian shear-thinning characteristics, which is primarily due to the presence of RBCs. Hence, RBC deformability and aggregation directly affect the magnitude of blood viscosity, and any factors or diseases affecting RBC characteristics influence blood viscosity. Therefore, on can see that whole blood viscosity is the causal mechanism by which traditional risk factors such as hypertension, hyperlipidemia, smoking, exercise, obesity, age, and gender are related to atherogenesis. In this regard, we included whole blood viscosity in the three key determinants of injurious pulsatile flow that results in mechanical injury and protective adaptation in the arterial system. Because whole blood viscosity is a potential predictor of cardiovascular diseases, it should be measured in routine cardiovascular profiles. Incorporating whole blood viscosity measurements into a standard clinical protocol could improve our ability to identify patients at risk for cardiovascular disease and its complications.

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Minimally Invasive Redo Mitral Valve Replacement under Fibrillatory Arrest in a Patient with a Calcified Aorta and Patent Previous Bypass Grafts

  • Kim, Seung Hyun;Kim, Hak Ju;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.283-285
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    • 2018
  • A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement.

Complete Repair of Coarctation of the Aorta and a Ventricular Septal Defect in a 1,480 g Low Birth Weight Neonate

  • Lee, Hong-Kyu;Cho, Joon-Yong;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.183-185
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    • 2011
  • Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonateswith very low birth weight (${\leq}$1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.

Communicating clinical research to reduce cancer risk through diet: Walnuts as a case example

  • Toner, Cheryl D.
    • Nutrition Research and Practice
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    • v.8 no.4
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    • pp.347-351
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    • 2014
  • Inflammation is one mechanism through which cancer is initiated and progresses, and is implicated in the etiology of other conditions that affect cancer risk and prognosis, such as type 2 diabetes, cardiovascular disease, and visceral obesity. Emerging human evidence, primarily epidemiological, suggests that walnuts impact risk of these chronic diseases via inflammation. The published literature documents associations between walnut consumption and reduced risk of cancer, and mortality from cancer, diabetes, and cardiovascular disease, particularly within the context of the Mediterranean Diet. While encouraging, follow-up in human intervention trials is needed to better elucidate any potential cancer prevention effect of walnuts, per se. In humans, the far-reaching positive effects of a plant-based diet that includes walnuts may be the most critical message for the public. Indeed, appropriate translation of nutrition research is essential for facilitating healthful consumer dietary behavior. This paper will explore the translation and application of human evidence regarding connections with cancer and biomarkers of inflammation to the development of dietary guidance for the public and individualized dietary advice. Strategies for encouraging dietary patterns that may reduce cancer risk will be explored.

Evaluation of the Risk Factors Predicting Morbidity and Mortality after Major Pulmonary Resection (주요 폐절제술시 이환율과 사망률을 예견하는 위험인자의 평가)

  • Choi, Ho;Lee, Cheol-Joo;Soh, Dong-Moon;Kim, Jung-Tae;Hong, Jun-Wha;Ryu, Han-Young;Park, Jae-Beom
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.549-555
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    • 1999
  • Background: Patients who are considered for major pulmonary resection are generally evaluated by spirometry and clinical assessment to predict morbidity and mortality. Despite this, none has yet proved to be a convenient and reliable estimate of risk. Material and Method: A retrospective analysis was performed in 167 patients who were diagnosed for lung cancer, bronchiectasis, pulmonary tuberculosis, and other benign pulmonary disease, and who underwent major lung resections. The relationship of 25 preoperative or postoperative variables to 19 postoperative events were classified into categories as operative mortality, pulmonary or cardiovascular morbidity, and other morbidity was assessed. Logistic regression analysis and $\chi$2 analysis were used to identify the relationship of the operative risk factors to the grouped postoperative complications. Result: The best single predictor of complications was the percent predicted postoperative diffusing capacity (pulmonary morbidity, p<0.009; cardiovascular morbidity, p<0.003: overall morbidity, p<0.004). Conclusion: The diffusing capacity of the lung for carbon monoxide was an important predictor of postoperative complications than the spirometry, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

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Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue

  • Ku, Min Jung;Kim, Su Wan;Lee, Seogjae;Chang, Jee Won;Lee, Jonggeun
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.258-262
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    • 2020
  • Background: The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass. Methods: Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31). Results: Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26℃ were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A. Conclusion: Surgeons' efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.

Outcomes of Nonpledgeted Horizontal Mattress Suture Technique for Mitral Valve Replacement

  • Kim, Gun Jik;Lee, Jong Tae;Lee, Young Ok;Cho, Joon Young;Oh, Tak-Hyuk
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.504-509
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    • 2014
  • Background: Most surgeons favor the pledgeted suture technique for heart valve replacements because they believe it decreases the risk of paravalvular leak (PVL). We hypothesized that the use of nonpledgeted rather than pledgeted sutures during mitral valve replacement (MVR) may decrease the incidence of prosthetic valve endocarditis (PVE) and risk of a major PVL. Methods: We analyzed 263 patients, divided into 175 patients who underwent MVR with nonpledgeted sutures from January 2003 to December 2013 and 88 patients who underwent MVR with pledgeted sutures from January 1995 to December 2001. We compared the occurrence of PVL and PVE between these groups. Results: In patients who underwent MVR with or without tricuspid valve surgery and/or a Maze operation, PVL occurred in 1.1% of the pledgeted group and 2.9% of the nonpledgeted group. The incidence of PVE was 2.9% in the nonpledgeted group and 1.1% in the pledgeted group. No differences were statistically significant. Conclusion: We suggest that a nonpledgeted suture technique can be an alternative to the traditional use of pledgeted sutures in most patients who undergo MVR, with no significant difference in the incidence of PVL.

Study on the Standards for Acknowledgement of Cerebral and Cardiovascular Diseases due to Occupational Cases (업무상 뇌.심혈관질환의 인정기준에 관한 고찰)

  • Choi, Soon-Young;Rim, Hwa-Young
    • Journal of the Korea Safety Management & Science
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    • v.12 no.3
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    • pp.61-72
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    • 2010
  • Judgment of cerebral and cardiovascular diseases arising out of duty follows the legal judgment method for the purpose of investigation of medical causes based on the Industrial Accident Compensation Insurance Act, with the characteristics of the occurrence as personal factors etc. act as risk factors while work-related ones as triggers, in the case of disease due to occupational cases, as whether it arose out of duty must be judged including even the individual's personal risk factors, there are limitations securing fairness even with existing laws, regulations and guidelines. This study was carried out to suggest basic data for the preparation of standardized guidances for diseases arising out of duty by reviewing the standards for the acknowledgment of cerebral and cardiovascular diseases due to occupational cases, and it has a significance in that it suggests target diseases that may be judged as cerebral and cardiovascular diseases, legal criteria for the acknowledgment and standards for the judgment of cerebral and cardiovascular diseases arising out of duty.