• Journal of Veterinary Clinics
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• v.29 no.3
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• pp.203-206
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• 2012

Treatment for heart failure is directed to reduce atrial volume overload by diuretic agents, to lessen ventricular pressure overload by vasodilatory agents and to increase myocardial performance through inotropic agents. Of those cardiac therapeutics, diuretic agents are the most important to control heart failure in dogs, although long-term use often causes detrimental side-effects such as acute renal failure and electrolyte abnormalities. Thus, this study was designed to find a new diuretic agent from medicinal herbs which has better diuretic effect and less unfavorable complications in dogs. In a preliminary study performed with 5 normal healthy dogs, the extract from Akebia quinata Decaisne showed mild to moderate diuretic effect (0.3-0.5 potency of furosemide 2 mg/kg) and minimal changes in serum chemistry and electrolyte. Although the study population was not large enough and study period was not sufficient enough, this study found a good alternative diuretic agent which can replace or reduce the use of furosemide in dogs with heart failure.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.702-705
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• 2006

Severe left ventricular dysfunction after relief of massive pericardial effusion has been rarely reported. Interventricular volume mismatch, acute distention of the cardiac chambers and interplay of autonomic none system are believed to be the possible causes for ventricular dysfunction. Presenting two patients who had marked decrease in global ventricular systolic function after relief of pericardial tamponade by subxyphoid pericardial window, we recommend gradual removal of pericardial fluid under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1041-1048
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• 2007

Not a few patients in children and adolescents are suffering from right ventricular (RV) dysfunction resulting from various conditions such as chronic lung disease, left ventricular dysfunction, pulmonary hypertension, or congenital heart defect. The RV is different from the left ventricle in terms of ventricular morphology, myocardial contractile pattern and special vulnerability to the pressure overload. Right ventricular failure (RVF) can be evaluated in terms of decreased RV contractility, RV volume overload, and/or RV pressure overload. The management for RVF starts from clear understanding of the pathophysiology of RVF. In addition to correction of the underlying disease, management of RVF per se is very important. Meticulous control of volume status, inotropic agents, vasopressors, and pulmonary selective vasodilators are the main tools in the management of RVF. The relative importance of each tool depends on the individual clinical status. Medical assist device and surgery can be considered selectively in case of refractory RVF to optimal medical treatment.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.35-45
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• 2021

Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1010-1014
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• 2004

Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.

• Journal of Yeungnam Medical Science
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• v.5 no.2
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• pp.183-187
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• 1988

Although halothane is one of the most widely used inhalation anesthetics, it may cause postanesthetic complications such as halothane hepatitis. Halothane hepatitis has been reported intermittentely with variable incidence. However it is not easy to prove halothane as a causative agent, because there are many factors causing postoperative hepatic dysfunction. The author had a case of acute hepatitis developing after open heart surgery used halothane. 37-year-old female underwent an open heart surgery for ASD repair under halothane anesthesia On the 14th postoperative day, she developed high fever of 38 C. Liver function tests showed marked elevation of SGOT, SGPT, and bilirubin, followed by gross jaundice. HB, Ag(-) and HB, Ab(+) were reported. She died of acute respiratory, hepatic, and renal failure on the 19th postoperative day Possible causes of the hepatitis were considered halothane, blood transfusion, and drugs.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.240-246
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• 1979

A 15-year-old boy having a small VSD was readmitted with clinical manifestations of acute endocarditis and aortic regurgitation one month after open heart surgery. In spite of vigorous treatment with broad-spectrum antibiotics, high fever persisted. Pseudomonas aeruginosa was isolated just one time among several blood cultures. Progressive pulmonary infarction due to embolization. Progressive congestive heart failure and D.I.C. caused patient`s death. Aspergillus was found in autopsy specimen.

• Journal of Cardiovascular Imaging
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• v.26 no.4
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• pp.217-225
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• 2018

BACKGROUND: In patients with acute heart failure (AHF), diastolic dysfunction, especially pseudonormal (PN) or restrictive filling pattern (RFP) of left ventricle (LV), is considered to be implicated in a poor prognosis. However, prognostic significance of diastolic dysfunction in patients with ischemic heart disease (IHD) has been rarely investigated in Korea. METHODS: We enrolled 138 patients with IHD presenting as AHF and sinus rhythm during echocardiographic study. Diastolic dysfunction of LV was graded as ${\geq}2$ (group 1) or 1 (group 2) according to usual algorithm using E/A ratio and deceleration time of mitral inflow, E'/A' ratio of tissue Doppler echocardiography and left atrial size. RESULTS: Patients in group 1 showed higher 2-year mortality rate ($36.2%{\pm}6.7%$) than those in group 2 ($13.6%{\pm}4.5%$; p = 0.008). Two-year mortality rate of patient with LV ejection fraction (LVEF) < 40% ($26.8%{\pm}6.0%$) was not different from those with LVEF 40%-49% ($28.0%{\pm}8.0%$) or ${\geq}50%$ ($13.7%{\pm}7.4%$; p = 0.442). On univariate analysis, PN or RFP of LV, higher stage of chronic kidney disease (CKD) and higher New York Heart Association (NYHA) functional class were poor prognostic factors, but LVEF or older age ${\geq}75$ years did not predict 2-year mortality. On multivariate analysis, PN or RFP of LV (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.09-5.84; p = 0.031), higher stage of CKD (HR, 1.57; 95% CI, 1.14-2.17; p = 0.006) and higher NYHA functional class (HR, 1.81; 95% CI, 1.11-2.94; p = 0.017) were still significant prognostic factors for 2-year mortality. CONCLUSIONS: PN or RFP of LV was a more useful prognostic factor for long-term mortality than LVEF in patients with IHD presenting as AHF.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.242-250
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• 2019

Background: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results: A total of 156 patients treated with NIV were enrolled (mean age, $71.9{\pm}11.6years$). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion: AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.

• Journal of Cardiovascular Imaging
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• v.31 no.4
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• pp.200-206
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• 2023

BACKGROUND: Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients. METHODS: We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients. RESULTS: A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = -0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E' ratio(r = -0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025). CONCLUSIONS: In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.