• Korean Journal of Clinical Laboratory Science
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• v.37 no.2
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• pp.88-95
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• 2005

Even though the echocardiograph has been recognized as the method of choice among various diagnostic tools to detect congestive heart failure (CHF), there were some limitations in relation to the consumption of time, labor and process. We analyzed results of N-terminal probrain-type natriuretic peptide (NT-proBNP) and various parameters of the echocardiographic findings to clarify the diagnostic usefulness of NT-proBNP in detecting patients with CHF. We analyzed the sera from total of 242 cases from in-patients and out-patients, which were requested from the cardiovascular section of department of Internal Medicine at Chungnam National University Hospital from March 2003 to May 2004. The procedures were performed in order as shown below; sampling, NT-proBNP analysis, data acquisition and data analysis. All data including personal information and echocardiographic findings ware acquired by medical record review. When classifying the study population into six groups according to the degree of left ventricular ejection fraction (LVEF), the serum level of NT-proBNP was higher in the group with 51-60% of LVEF (P=0.023). There were low correlation between the serum level of NT-proBNP and various parameters of the echocardiographic findings with LVESD (r=0.1513), LVEDD (r=0.0831), LVEF (r=0.2035), IVST (r=0.03) and LVPWT (r=0.0728), respectively. When comparing NT-proBNP with atrial and/or ventricular enlargement, the patient group with both left atrial and left ventricular enlargement (p=0.186) or only left atrial (p=0.105) or only left ventricular enlargement (p=0.256) showed higher level of NT-proBNP without statistical significance than patient group with no enlargement. Searching the optimal cutoff of the serum level of NT-proBNP, the sensitivity (98.9%) and the specificity (100%) was highest at the cutoff of 300 pg/mL than any other cutoffs. These findings suggested that the analysis of NT-proBNP in serum might detect the patients with CHF earlier than with the echocardiograph, especially in patients with asymptomatic or mild symptomatic CHF. In conclusion, NT-proBNP test was proved to be clinically useful to diagnose CHF patients.

• Journal of Genetic Medicine
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• v.13 no.1
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• pp.41-45
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• 2016

Marfan syndrome (MFS) is an inherited connective tissue disorder with a mutation in the fibrillin-1 (FBN1) gene. Fibrillin is a major building block of microfibrils, which constitute the structural component of the connective tissues. A 10-year-old girl visited our hospital with the chief complaint of precocious puberty. According to her medical history, she had a pulmonary wedge resection for a pneumothorax at 9 years of age. There was no family history of MFS. Mid parental height was 161.5 cm. The patient's height was 162 cm (>97th percentile), and her weight was 40 kg (75th-90th percentile). At the time of initial presentation, her bone age was approximately 11 years. From the ophthalmologic examination, there were no abnormal findings except myopia. There was no wrist sign. At the age of 14 years, she revisited the hospital with the chief complaint of scoliosis. Her height and weight were 170 cm and 50 kg, respectively, and she had arachnodactyly and wrist sign. We performed an echocardiograph and a test for the FBN1 gene mutation with direct sequencing of 65 coding exons, suspecting MFS. There were no cardiac abnormalities including mitral valve prolapse. A cytosine residue deletion in exon 7 (c.660delC) was detected. This is a novel mutation causing a frameshift in protein synthesis and predicted to create a premature stop codon. We report the case of a patient with MFS with a novel FBN1 gene missense mutation and a history of pneumothorax at a young age without cardiac abnormalities during her teenage years.

• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.347-351
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• 2015

A 3-year-old intact female Dachshund was referred due to paraplegia and cool extremities. History taking, physical examination, neurological examination, and blood profiling studies were evaluated to determine the diagnosis. Based on abdominal ultrasound and echocardiograph, features suggestive of adult heartworm were detected in aberrant places. The result of enzyme-linked immunosorbent assay (ELISA) testing with a commercial heartworm antigen kit was positive. The dog fell into a comatose state, and the client requested the dog be euthanized. On post-mortem examination, the patient was diagnosed with ectopic parasitism of heartworm in the left side of heart, aorta, aorta abdominalis, and iliac arteries, a circumstance that induced systemic thromboembolism. This case report describes the clinical, diagnostic imaging, and necropsy findings of canine ectopic parasitism of heartworm.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.113-116
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• 2014

A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

• Journal of Veterinary Clinics
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• v.40 no.1
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• pp.31-37
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• 2023

Vertebral left atrial size (VLAS) is an important indicator to predict myxomatous mitral valve degeneration (MMVD) in dogs. When the caudal margin of cardiac silhouette and the dorsal margin of caudal vena cava (CdVC) could not be seen exactly, another way to evaluate VLAS is needed. The objective of this study was to assess whether a new modified VLAS (m-VLAS) could be used as an indicator to predict MMVD in 57 small breed dogs with MMVD. The m-VLAS was also used to classify American College of Veterinary Internal Medicine staging groups and left heart enlargement confirmed with echocardiograph (EchoLHE) groups. The m-VLAS was measured as the distance from the ventral aspect of the carina to the dorsal aspect of the intersection of the cardiac silhouette and the farthest LA caudal margin, not the CdVC, followed by drawing the same line beginning at the cranial edge of T4. Based on VLAS values and m-VLAS values measured for dogs with MMVD, correlations between these values and left heart enlargement groups were then evaluated. There were significant differences in both the VLAS and the m-VLAS between EchoLHE groups. The AUC of the ROC curve of the m-VLAS to detect EchoLHE was higher than that of the VLAS. The optimal cutoff value for the m-VLAS was >2.7, which had a higher specificity (86.84%) than the VLAS specificity (71.05%). This study reveals that a new m-VLAS is a more specific indicator than the VLAS for predicting left side heart enlargement in small breed dogs. Therefore, the m-VLAS can be used as a clinically useful radiographic measurement alternative to or better than the VLAS.

• Tuberculosis and Respiratory Diseases
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• v.59 no.2
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• pp.170-178
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• 2005

Background : Idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare but significantly imperative in inducing chronic pulmonary hypertension. Clinically, it is difficult to distinguish between IPAH and CTEPH. However, the treatment of pulmonary hypertension is different depending on the disease. The present study was performed to analyze the similarities and differences in clinical features between IPAH and CTEPH. Methods : During a nine-year period, thirty-three patients with IPAH and twenty-two patients with CTEPH were enrolled. Symptoms, physical findings, chest radiograph, electrocardiograph, pulmonary function test, echocardiograph, perfusion lung scan, right heart catheterization results were analyzed between both the groups. Results : The median age of IPAH group was 33 (6~70) years that was lower than that (52(27~80) years) of CTEPH group. Amongst the IPAH patients, there was female predominance (76 %) and there was no sex difference between the patients with CTEPH. Both the groups exhibited similarity in the results of chest radiograph, electrocardiograph, pulmonary function test, and echocardiograph. In the perfusion lung scan, all IPAH patients exhibited findings with normal (28%) or low probability (72%) of pulmonary embolism and all CTEPH patients exhibited findings with high probability of pulmonary embolism. Conclusion : Although IPAH and CTEPH bear similarities in terms of symptoms, physical signs and general investigation results, there were differences in age distribution, sex predominance and results of perfusion lung scan.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.629-633
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• 2008

Purpose : This study was designed to investigate normal domestic values for the diameter of the left main coronary artery (LCA), the left anterior descending coronary artery (LAD) and the right coronary artery (RCA). These data are necessary to define dilatation of coronary arteries in Kawasaki disease cases. Methods : Study subjects were 43 normal healthy children whose ages ranged from 3 months to 6 years. They children visited Konkuk University hospital for echocardiograph examination between March 2005 and November 2007. Measurements of coronary arterial diameters at each branch were done by off-line analyses of recorded images. Simple regression analysis of each the measurements were performed using the body size (body surface area, etc.) as the independent variable. Results : Body surface area was significantly related to the diameters of LCA ($r^2=0.20$, P=0.0038), of LAD ($r^2=0.41$, P<0.0001), and of RCA ($r^2=0.30$, P=0.0002). In the regression model, the estimates of the y-intercept were 1.703, 1.058, and 1.007; the estimates of the regression coefficient were 0.971, 1.175, and 1.177; and the estimates of the standard deviation were 0.315, 0.221, and 0.282 with respect to the three coronary arteries. Conclusion : A the linear regression model of the diameters of three coronary arteries adjusted for body surface area was produced. With these results, the Z-score calculation of the diameter of three coronary arteries, based on normal domestic data, will be possible.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.124-129
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• 1999

Background: Ventricular septal defect(VSD) that causes pulmonary hypertension increase right ventricular workload. Echocardiographic assessment of right ventricular systolic time interval (RVSTI) has been used to predict pulmonary artery pressure in various cardiopulmonary diseases. This study was undertaken in infants with simple VSD to observe the alteration of the right ventricular workload through the changes of RVSTI after repair of VSD. Material and Method: We evaluated heart rate, the ratio of the left atrium/aortic root diameter (LA/Ao), right ventricular pre-ejection period(RVPEP), right ventricular ejection time(RVET), and its ratio(RVPEP/RVET) as a predictor of right ventricular workload in 12 children with simple VSD. These were measured three times at the preoperative period, at the 3 month and between 6 month and 1 year(average 9.5${\pm}$1.8month) after repair of VSD by M-mode & Doppler echocardiograph from the pulmonic valve echogram. Result: Heart rate was decreased significantly after repair(137.1${\pm}$13.7 vs 114.4${\pm}$21.1 and 104.1${\pm}$10.2, p<0.01). LA/Ao ratio was decreased significantly after repair(1.71${\pm}$0.32 vs 1.47${\pm}$0.33 and 1.39${\pm}$0.23, p<0.05). RVPEP/RVET were decreased after repair (0.38${\pm}$0.09 vs 0.32${\pm}$0.08 and 0.29${\pm}$0.09, p<0.01). Heart rate corrected RVPEP/RVET were significantly decreased only after 6 months(0.32${\pm}$0.03 vs 0.30${\pm}$0.05 and 0.28${\pm}$0.06, p<0.05). Conclusion: We found elevated right ventricular workload was progressively decreased until more than 6 months after repair and the RVSTI may serve a useful guide in postoperative care for children with VSD.