• Title/Summary/Keyword: Hypertrophy, left ventricular

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Systematic Diagnosis and Long-term Care of Cardiopulmonary Disease (심폐기 질환의 체계적인 진단과 장기-치료 관찰)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.171-178
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    • 1998
  • K14 patient with chronic dyspnea, who is senile female, early had suffered from radical mastectomy, radiotherapy, autoplastic transplantation, and knee arthritis. Abnormalities of cardiopulmonary function such as obesita, hypertension, mild left ventricular hypertrophy, and chronic pulmonary disease were found from K14 patient's clinical datas, which based on medical history and diagnosis, as well as evaluation of blood pressure, obesity, clinical diagnosis, chest PA, electrocardiogram, ultrasonocardiograph, and spirometery test. Diagnostic results were exactly analyzed, also long-term cares of K14 patient were discussed with related to the clinical literatures.

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Traumatic Arterial Injury with Arterio-Venous Fistula & False Aneurysm (5 Case Reports) (가성 동맥류를 동반한 외상성 동정맥루 (5치험례))

  • 문한배;유영선;강중원
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.75-80
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    • 1968
  • This is a case report of traumatic arterial injuries with false aneurysm & arterio-venous fistula treated surgically at National Medical Center. 3 cases were A-V fistula and 2 cases only false aneurysm. Physiological disturbance were produced by only arteriovenous fistula; In one case ulceration of mid. 1/3 tibia due to diminished arterial flow and in 2 cases left ventricular hypertrophy, in which cases Bramhan`s sign were positive. Removing out the fistulous lesions and aneurysm, all of the arterial continuities has been reconstructed by means of end to end anastomosis, Dacron graft and vein graft, veins were managed by ligations of both ends in two cases and end to end anostomosis in one case. Immediate post operative results were good, and two cases were followed for 10 months.

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Bilateral Atrioventricular Valve Dysplasia in a Middle Aged Turkish Angora Cat: A Case Report

  • Ju, Jae-Beom;Kim, Keon;Park, Hee-Myung;Lee, Chang-Min
    • Journal of Veterinary Clinics
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    • v.36 no.6
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    • pp.336-339
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    • 2019
  • A castrated, 6-year-old, male Turkish Angora cat with a history of respiratory distress was referred to the hospital. Physical examination revealed a cardiac murmur, and thoracic radiographic findings revealed pleural effusion and cardiomegaly. Echocardiography showed abnormality of the tricuspid and mitral valve, and color-flow Doppler imaging revealed regurgitation between both atrium and ventricle. Based on the echocardiographic examination, tricuspid valve dysplasia concurrent with mitral valve dysplasia was diagnosed. However, the patient died a week after treatment. In necropsy, bilateral atrioventricular valve dysplasia and left ventricular hypertrophy were confirmed. This is the first report to describe a middle age Turkish angora cat having bilateral atrioventricular valve dysplasia which has high mortality and only been reported rarely in cats. This case report also describes its clinical signs, diagnostic imaging findings, treatment and discussions how the patient could live long.

A case of Becker muscular dystrophy with early manifestation of cardiomyopathy

  • Doo, Ki-Hyun;Ryu, Hye-Won;Kim, Seung-Soo;Lim, Byung-Chan;Hwang, Hui;Kim, Ki-Joong;Hwang, Yong-Seung;Chae, Jong-Hee
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.350-353
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    • 2012
  • An 18-year-old boy was admitted with chest discomfort, nausea, and dyspnea at rest. At the age of 3 years, he underwent muscle biopsy and dystrophin gene analysis owing to an enlarged calf muscle and elevated serum kinase level (6,378 U/L) without overt weakness; based on the results, Becker muscular dystrophy (BMD) was diagnosed. The dystrophin gene showed deletion of exons 45 to 49. He remained ambulant and could step upstairs without significant difficulties. A chest roentgenogram showed cardiomegaly (cardiothoracic ratio, 54%), and his electrocardiogram (ECG) showed abnormal ST-T wave, biatrial enlargement, and left ventricular hypertrophy. The 2-dimensional and M-mode ECGs showed a severely dilated left ventricular cavity with diffuse hypokinesis. The systolic indices were reduced, including fractional shortening (9%) and ejection fraction (19%). Despite receiving intensive medical treatment, he died from congestive heart failure 5 months after the initial cardiac symptoms. We report a case of BMD with early-onset dilated cardiomyopathy associated with deletion of exons 45 to 49. Early cardiomyopathy can occur in BMD patients with certain genotypes; therefore, careful follow-up is required even in patients with mild phenotypes of BMD.

Influence of Prosthesis Size on Change in Left Ventricular Hypertrophy Following Aortic Valve Replacement (대동맥판막협착증 환자에서 판막치환 후 좌심실 심근비후의 변화에 대한 판막크기의 영향)

  • 이희성;지현근;김건일;홍기우;신윤철
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.57-63
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    • 2001
  • 배경: 대동맥판막협착증 환자는 판막질환으로 인한 만성적인 후부하의 증가에 대한 보상성 좌심실 심근비후가 일어나게 된다. 대동맥 판막 치환 후 좌심실 심근 비후의 감소가 이루어지는 것으로 알려져 있으나 21mm이하의 작은 인공판막으로 치환시 좌심실 심근 변화에 대해 논란이 있다. 대상 및 방법: 1994년 9월부터 1998년 7월까지 한림대학교 강동성심병원 흉부외과에서 대동맥판막협착증으로 진단받고 판막치환술을 시행한 20명을 대상으로 하였다. 환자는 남녀 각각 13명, 7명이며 평균나이 61$\pm$13.8세 체표면적은 평균 1.57$\pm$0.14m$m^2$이었다. 환자의 추적관찰은 수술 전, 수술 후 초기(평균 10.4일) 및 수술 후 만기(평균 29.9개월)에 심초음파로 시행하였다. 환자들은 사용된 판막에 따라 2개의 군(1군;21mm 이하, 2군;23mm이상)으로 나누었다. 결과: 모든 군에서 NYHA Functional class의 유의한 감소가 있었다. 좌심실 구추률은 수술 전후 1군은 유의한 차이가 없었으나 2군에서는 유의한 차이가 있었다. 그러나 수술 전 좌심실 구출률이 2군에서 1군에 비해 유의하게 감소되어 있었다(p=0.044). 좌심실근량지수는 1군은 수술후 초기에 유의한 감소가 없었으나 수술후 만기에는 유의한 감소를 보여주었다. 그러나 2군은 수술후 초기와 만기에 모두 유의한 감소를 보여주었다. 결론: 21 mm이하 군과 23 mm이상 군 모두 임상적 호전이 있었다. 그러나 19 mm판막군이 2례로 적어 19 mm 판막의 사용시 환자의 나이와 체표면적, 운동량을 고려하여 신중한 판막선택이 고려된다.

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Apoptosis and remodeling in adriamycin-induced cardiomyopathy rat model

  • Hong, Young Mi;Lee, Hyeryon;Cho, Min-Sun;Kim, Kwan Chang
    • Clinical and Experimental Pediatrics
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    • v.60 no.11
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    • pp.365-372
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    • 2017
  • Purpose: The mechanism for the pathogenesis of adriamycin (ADR)-induced cardiomyopathy is not yet known. Different hypotheses include the production of free radicals, an interaction between ADR and nuclear components, and a disruption in cardiac-specific gene expression. Apoptosis has also been proposed as being involved in cardiac dysfunction. The purpose of this study was to determine if apoptosis might play a role in ADR-induced cardiomyopathy. Methods: Male Sprague-Dawley rats were separated into 2 groups: the control group (C group) and the experimental group (ADR 5 mg/wk for 3 weeks through intraperitoneal injections; A group). Echocardiographic images were obtained at week 3. Changes in caspase-3, B-cell leukemia/lymphoma (Bcl)-2, Bcl-2-associated X (Bax), interleukin (IL)-6, tumor necrosis $factor-{\alpha}$, brain natriuretic peptide (BNP), troponin I, collagen 1, and collagen 3 protein expression from the left ventricle tissues of C and A group rats were determined by Western blot. Results: Ascites and heart failure as well as left ventricular hypertrophy were noted in the A group. Ejection fraction and shortening fraction were significantly lower in the A group by echocardiography. The expression of caspase-3, Bax, IL-6, BNP, collagen 1, and collagen 3 were significantly higher in the A group as compared with the C group. Protein expression of Bcl-2 decreased significantly in the A group compared with the C group. Conclusion: ADR induced an upregulation of caspase-3, Bax, IL-6, and collagen, as well as a depression in Bcl-2. Thus, apoptosis and fibrosis may play an important role in ADR-induced cardiomyopathy.

The Role of Cardiac MRI in the Diagnosis of Fabry Disease (파브리병에서의 심장 자기공명영상의 역할)

  • Yoo Jin Hong;Young Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.302-309
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    • 2020
  • Fabry disease is a rare X-linked metabolic disorder that is characterized by the accumulation of glycosphingolipids in various organs, resulting from the deficiency of alpha-galactosidase A. Cardiac involvement is relatively common; myocardial inflammation, left ventricular hypertrophy, and myocardial fibrosis secondary to abnormal lipid deposition in myocytes are often observed. Hence, the diagnosis of cardiac involvement is crucial for evaluating patient prognosis. Cardiac MRI is the standard technique for measuring the function, volume, and mass of the ventricles. It is also useful for myocardial tissue characterizations. The evaluation of native myocardial T1 values can facilitate early diagnosis of cardiac involvement, while measurements of left ventricular myocardial mass can be used to monitor treatment outcomes, in patients with Fabry disease. Consequently, cardiac MRI can provide useful information for diagnosing, monitoring, and treating patients with Fabry disease.

Midterm Results of Aortic Valve Replacement Using Tissue Valve (조직판막을 이용한 대동맥판막치환술의 중기성적)

  • Moon, Duk-Hwan;Lee, Jae-Won;Kim, Yun-Seok;Cho, Won-Chul;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.627-634
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    • 2010
  • Background: The durability of the tissue valve is important in choice between a mechanical valve and a tissue valve in cardiac surgery. We studied the mid-term results of tissue valve in the aortic position. Material and Method: The subjects were 380 patients who had undergone aortic prosthesis replacement between May 1990 and March 2009. We retrospectively analyzed hospital and outpatient records: the mean age was $69{\pm}9$ years; the male to female ratio was 227 : 162; and the mean follow-up duration was $46.7{\pm}40.8$ months (range 0~196 months). Result: 389 surgical cases in total had been taken with 380 patients. Early death occurred in 15 patients (3.9%). Overall survival rate at 1, 5 and 10 years were 92.3%, 78.1% and 54.2% respectively. Freedom from reoperation at 1, 5 and 10 years were 98.4%, 97.1% and 91.7% respectively. Freedom from structural valvular deterioration at 1, 5 and 10 years were 96.1%, 92.3% and 88.0% respectively. In the multivariate analysis of preoperative risk factors, young age (p<0.001) was significant risk factor for reoperation. High peak velocity in the postoperative period (p=0.034) and young age (p=0.029) were significant risk factors for structural valvular deterioration. Old age (p=0.001), long bypass time (p=0.035), concomitant coronary artery bypass graft surgery (p=0.003) and preoperative low left ventricular ejection fraction (p=0.003) were significant factors for early mortality. Preoperative estimated glomerular filtration rate (< 60 mL/min) (p=0.025) and persistent left ventricular hypertrophy (p=0.032) were the risk factors for late mortality. Conclusion: This study showed that the freedom from reoperation and the freedom from structural valvular deterioration in aortic tissue valve replacement were acceptable. It will be necessary to conduct further studies with long-term follow-up and more patients.

Aortic Unfolding Measurement Using Non-Contrast Cardiac CT: Normal Range of Low-Risk Subjects (관상동맥 석회화 CT에서 측정한 대동맥 전개: 저위험 환자군에서의 정상 범위)

  • Ji Won Lee;Byoung Wook Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.360-371
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    • 2022
  • Purpose This study aimed to assess the factors influencing aortic unfolding (AU) defined by aortic width on coronary artery calcium (CAC) scan and determine the normal limits for AU. Materials and Methods In this retrospective study, we measured AU in 924 asymptomatic subjects who underwent CAC scanning during routine health screening from June 2015 to June 2018. Multivariate regression analysis was used to evaluate the factors influencing AU. After the exclusion of subjects with risk factors associated with AU, 283 subjects were included in the analysis of normal values of AU. Mean AU, standard deviation, and upper normal limit were calculated. Results Sex, age, CAC score, body mass index, body surface area, hypertension, left ventricular hypertrophy, plasma creatinine, and smoking were significantly associated with AU. The mean AU was 102.2 ± 12.8 mm for men and 93.1 ± 10.7 mm for women. AU increased with advancing age (9.6 mm per decade). Conclusion AU determined from a single measurement on CAC scans was associated with cardiovascular risk factors. The normal limits of AU were defined by age, sex, and body surface area in low-risk subjects in this study.

Echocardiographic Diagnosis of Mitral Valve Dysplasia Concurrent with Mitral Stenosis and Tricuspid Valve Dysplasia in a Dog (개에서 승모판 이형성증과 병발한 승모판 협착증 및 삼첨판 이형성증의 심초음파적 특징 1례)

  • Choi, Soo-Young;Lee, Jung-Woo;Lee, Young-Won;Choi, Ho-Jung
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.101-104
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    • 2015
  • A 4-years-old, intact male Golden retriever dog was presented with abdominal distension and dyspnea. Physical examination revealed arrhythmia and cardiac murmur. Generalized cardiomegaly, pleural effusion and ascites were shown on thoracic and abdominal radiographs. Two-dimensional echocardiography revealed abnormal mitral and tricuspid valve motion, mitral and tricuspid regurgitation, left ventricular eccentric hypertrophy and left atrial dilation. Color-flow Doppler imaging revealed turbulent flow extending into the left ventricle during diastole from the mitral valve orifice, and into the left atrium during systole. Spectral Doppler recordings revealed highly increased early diastolic mitral valve inflow and prolonged pressure half-time of mitral inflow. Based on the echocardiographic examination, the diagnosis was made as the mitral valve dysplasia concurrent with mitral valve stenosis and tricuspid valve dysplasia.