• Title/Summary/Keyword: Heart Ventricles

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Increased Expression of ATP-sensitive $K^+$ Channels Improves the Right Ventricular Tolerance to Hypoxia in Rabbit Hearts

  • Choi, Seong-Woo;Ahn, Jun-Seok;Kim, Hyoung-Kyu;Kim, Na-Ri;Choi, Tae-Hoon;Park, Sung-Woo;Ko, En-A;Park, Won-Sun;Song, Dae-Kyu;Han, Jin
    • The Korean Journal of Physiology and Pharmacology
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    • v.15 no.4
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    • pp.189-194
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    • 2011
  • ATP-sensitive $K^+$ channels ($K_{ATP}$) are major component of preventing ischemia-reperfusion injury. However, there is little information regarding to the expressional difference of $K_{ATP}$ and its function between left and right ventricles. In this study, we measured the lactate dehydrogenase release of rabbit heart slices in vitro and determined the difference of the $K_{ATP}$ expression at the both ventricles by measuring the level of $K_{ATP}$-forming Kir6.2 (OcKir6.2) mRNA using in situ hybridization. The hearts were preconditioned with 15 min hypoxia and reoxygenated for 15 min before a hypoxic period of 60 min, followed by reoxygenation for 180 min. With hypoxic preconditioning (100% $N_2$) with 15 min, left ventricles (LV) showed higher release of LDH comparing with right ventricles (RV). Adding $K_{ATP}$ blocker glibenclamide ($10{\mu}M$) prior to a hypoxic period of 60 min, hypoxic preconditioning effect of RV was more abolished than LV. With in situ hybridization, the optical density of OcKir6.2 was higher in RV. Therefore, we suggest that different $K_{ATP}$ expression between LV and RV is responsible for the different response to hypoxia and hypoxic preconditioning of rabbit hearts.

The Application of B-Type Natriuretic Peptide Level of the Dyspneic Patients : Differentiation Between Cor Pulmonale and Left Ventricular Dysfunction (호흡곤란을 주소로 내원한 환자에서 혈청 B-type Natriuretic Peptide 검사의 유용성 : 폐성심과 좌심부전의 감별에 대하여)

  • Park, Hong-Hoon;Kim, Sehyun;Choi, Jeongeun;Kim, Kang-Ho;Cheon, Seok-Cheol;Lee, Jihyun;Lee, Yong-Gu;Kim, In-Jae;Cha, Dong-Hoon;Hong, Sang-Bum;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.320-329
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    • 2003
  • Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.

Reconstruction of Tracheal Defect by Sternocleidomastoid Muscle Flap Covered with Skin Graft: A Case Report (피부이식과 흉쇄유돌근 피판을 이용한 기관 결손의 재건 1례)

  • Jang, Soo Kyung;Seo, Gang Hyeon;Choi, Sun;Park, Seok Hyun;Kim, Jin Hwan;Lee, Dong Jin
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.63-66
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    • 2021
  • Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial circumferential tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.

Protective Effect of Right Ventricular Mitochondrial Damage by Cyclosporine A in Monocrotaline-induced Pulmonary Hypertension

  • Lee, Dong Seok;Jung, Yong Wook
    • Korean Circulation Journal
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    • v.48 no.12
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    • pp.1135-1144
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    • 2018
  • Background and Objectives: Mitochondria play a key role in the pathophysiology of heart failure and mitochondrial permeability transition pore (MPTP) play a critical role in cell death and a critical target for cardioprotection. The aim of this study was to evaluate the protective effects of cyclosporine A (CsA), one of MPTP blockers, and morphological changes of mitochondria and MPTP related proteins in monocrotaline (MCT) induced pulmonary arterial hypertension (PAH). Methods: Eight weeks old Sprague-Dawley rats were randomized to control, MCT (60 mg/kg) and MCT plus CsA (10 mg/kg/day) treatment groups. Four weeks later, right ventricular hypertrophy (RVH) and morphological changes of right ventricle (RV) were done. Western blot and reverse transcription polymerase chain reaction (RT-PCR) for MPTP related protein were performed. Results: In electron microscopy, CsA treatment prevented MCT-induced mitochondrial disruption of RV. RVH was significantly increased in MCT group compared to that of the controls but RVH was more increased with CsA treatment. Thickened medial wall thickness of pulmonary arteriole in PAH was not changed after CsA treatment. In western blot, caspase-3 was significantly increased in MCT group, and was attenuated in CsA treatment. There were no significant differences in voltage-dependent anion channel, adenine nucleotide translocator 1 and cyclophilin D expression in western blot and RT-PCR between the 3 groups. Conclusions: CsA reduces MCT induced RV mitochondrial damage. Although, MPTP blocking does not reverse pulmonary pathology, it may reduce RV dysfunction in PAH. The results suggest that it could serve as an adjunctive therapy to PAH treatment.

Computational analysis of the electromechanical performance of mitral valve cerclage annuloplasty using a patient-specific ventricular model

  • Lee, Kyung Eun;Kim, Ki Tae;Lee, Jong Ho;Jung, Sujin;Kim, June-Hong;Shim, Eun Bo
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.1
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    • pp.63-70
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    • 2019
  • We aimed to propose a novel computational approach to predict the electromechanical performance of pre- and post-mitral valve cerclage annuloplasty (MVCA). Furthermore, we tested a virtual estimation method to optimize the left ventricular basement tightening scheme using a pre-MVCA computer model. The present model combines the three-dimensional (3D) electromechanics of the ventricles with the vascular hemodynamics implemented in a lumped parameter model. 3D models of pre- and post-MVCA were reconstructed from the computed tomography (CT) images of two patients and simulated by solving the electromechanical-governing equations with the finite element method. Computed results indicate that reduction of the dilated heart chambers volume (reverse remodeling) appears to be dependent on ventricular stress distribution. Reduced ventricular stresses in the basement after MVCA treatment were observed in the patients who showed reverse remodeling of heart during follow up over 6 months. In the case who failed to show reverse remodeling after MVCA, more virtual tightening of the ventricular basement diameter than the actual model can induce stress unloading, aiding in heart recovery. The simulation result that virtual tightening of the ventricular basement resulted in a marked increase of myocardial stress unloading provides in silico evidence for a functional impact of MVCA treatment on cardiac mechanics and post-operative heart recovery. This technique contributes to establishing a pre-operative virtual rehearsal procedure before MVCA treatment by using patient-specific cardiac electromechanical modeling of pre-MVCA.

Ventricular septal defect in an Abyssinian cat

  • Lee, Seung-Gon;Moon, Hyeong-Sun;Choi, Ran;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.48 no.1
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    • pp.99-103
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    • 2008
  • A 2-month-old female Abyssinian cat was presented with a severe ascites, cyanosis, and exercise intolerance. Diagnostic studies revealed V/VI holosystolic murmur, sinus tachycardia, generalized cardiomegaly with marked left atrial enlargement and shunt flow between left and right ventricles. Doppler study showed bi-directional shunts in rest and right-to-left shunt after exercise. Based on clinical signs and diagnostic findings, the cat was diagnosed as a reversed ventricular septal defect. The cat was treated with furosemide, nitroglycerine, dobutamine and oxygen supplement. Despite initial improvement of clinical signs after initiation of medical treatment, the cat died of sudden cardiac arrest. Necropsy revealed a perimembranous ventricular septal defect.

Staged Repair after Hybrid Palliation for Interrupted Aortic Arch with Systemic Outflow Tract Obstruction

  • Lee, June;Kim, Yong Han;Lee, Cheul
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.32-35
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    • 2019
  • Surgical management of interrupted aortic arch (IAA) with systemic outflow tract obstruction is clearly a challenge. If both ventricles are adequate, the Yasui operation is a useful option. Otherwise, a staged approach through initial hybrid palliation and delayed biventricular repair, tailored to the degree of obstructed outflow, serves to avoid a high-risk neonatal procedure. Herein, we present a patient with IAA and severe systemic outflow tract obstruction whose treatment involved hybrid palliation, followed by a Yasui operation.

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.

Reconstruction of Myocardial Current Distribution Using Magnetocardiogram and its Clinical Use (심자도를 이용한 심근 전류분포 복원과 임상적 응용)

  • 권혁찬;정용석;이용호;김진목;김기웅;김기영;박기락;배장호
    • Journal of Biomedical Engineering Research
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    • v.24 no.5
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    • pp.459-464
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    • 2003
  • The source current distribution in a heart was reconstructed from the magnetocardiogram (MCG) and its clinical usefulness was demonstrated. MCG was measured using 40-channel superconducting quantum interference device (SQUID) gradiometers for a patient of Wolff-Parkinson-White (WPW) syndrome, which has an accessory pathway between the atria and the ventricles. Reconstruction of source current distribution in a plane below the chest surface was performed using minimum norm estimation (MNE) algorithm and truncated singular value decomposition (SVD), In the simulation, we confirmed that the current distributions. which were computed for the test dipoles, represented well the essential feature of the test current configurations, In the current map of WPW syndrome, we observed abnormal currents that would bypass the atrioventricular junction at a delta wave. However, we could not observe such currents any more after the surgery. These results showed that the obtained current distribution using MCG signals is consistent with the electrical activity in a heart and has clinical usefulness.

A Study about Factors Influencing on the Postoperative Prognosis of the Right Ventricular Outflow Trac Obstruction (우심실유출로협착증의 수술예후에 영향을 미치는 인자에 관한 연구)

  • 최강주
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.435-443
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    • 1994
  • Surgical procedures to relieve congenital right ventricular outflow tract[RVOT] obstruction of heart were performed on 125 patients from September 1985 to August 1992. There were 65 males and 60 females. Ages ranged from 7 months to 33 years with a mean age of 8 years. All the patients were divided into three main groups[I, II, III] depending on the presence or absence of cyanosis and combined anomalies. The patient were classified into two groups; A and B according to the outcome after surgical repair. Group A included the patients who had a good postoperative outcome with or without mild complications such as wound disruption, or hydrothorax. Group B included the patients who had a poor outcome including hospital death and significant postoperative complications such as heart failure, low output syndrome, respiratory failure, hepatic failure and others. And the results were summarized as follows. 1. There were no significant differences in age, body surface area and aortic dimension among the group I, II, and III, but there were significant differences among groups in pulmonary arterial dimension, ACT[aortic cross clamping time], TBT [total bypass time], preoperative and postoperative ratio of systolic pressure of right and left ventricles [pre PRV/RV and post PRV/LV], and the size of Hegar dilator which passed through the RVOT postoperatively [p<0.05]. 2. In the group A and B, there were significant differences in pulmonary arterial dimension [group A:1.6$\pm$0.5 cm, group B:1.9$\pm$0.6 cm], ACT [group A:102.3$\pm$ 46.0 minute, group B:76.1$\pm$46.1 minute], TBT [group A:133.9$\pm$56.6 minute, group B:94.9$\pm$51.9 minute], pre PRV/LV [group A:1.06$\pm$0.24, group B:0.8$\pm$0.32], post PRV/LV [group A:0.58$\pm$0.18, group B:0.43$\pm$0.16].It has been concluded that postoperative prognosis of RVOT obstruction was influenced by pulmonary arterial dimension, ACT, TBT, severity of RVOT obstruction [pre PRV/LV] and post PRV/LV.

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