• 대한영상의학회지
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• 제83권1호
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• pp.28-41
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• 2022

급성 관상동맥 증후군은 관상동맥 경화반의 갑작스러운 파열과 관련된 3가지 유형의 관상동맥 질환을 의미하며 임상적으로는 ST 분절 상승 심근경색에서 비 ST 분절 상승 심근경색 또는 불안정성 협심증 등으로 표현된다. 심장 CT의 기술 발전을 통해 심장 CT는 관상동맥 내 죽상동맥경화반의 정량화 및 특성을 평가할 수 있게 되었으며, 현재까지 낮은 감쇠의 경화반, 냅킨 반지 표시, 양성 리모델링, 점상 석회화 및 증가된 혈관 주변 지방 감쇠가 심장 CT에서 경화반 파열을 의미하는 것으로 알려져 있다. 따라서 심장 CT는 관상동맥의 혈관협착정도를 진단하는 것을 넘어 급성 관상동맥 증후군을 진단하는데도 많은 기여를 하고 있다.

• 대한핵의학회지
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• 제25권2호
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• pp.177-185
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• 1991

Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1362-1368
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• 1992

Between March 1986 and November 1992, thirty-one patients with left main coronary artery stenosis[LMCAS, over 50% of cross sectional area] were revascularized at Seoul National University Hospital. The incidence of LMCAS was 20.8%[31/149]. The male:female ratio was 15:16. Age ranged from 39 to 70 years, with a mean age of 51 years. The anginal syndrome was composed of 23 unstable, 6 stable and 2 post-infarction angina preoperatively. There were sixteen isolated LMCAS, four ostial stenosis and eleven combined distal and /or right coronary artery stenosis. The degree of LMCAS was 50-74% in 21 patients[67.7%], 75-89% in one[3.6%] and 90-99% in 9[29.1%]. There was no case with 100% obstruction. Of the total patients with LMCAS, 11 patients received 4 distal anastomoses, another 11 patients had 3 distal anastomoses, and 8 patients needed 2 distal anastomoses. The overall operative mortality was 12.9%[4 /31], and the incidence of which was higher than the remaing group [6.8%, 8/118]. The causes of death were myocardial infarction[2 patients], ventricular arrhythmia[1 patient] and brain damage[1 patient]. All patients have been followed-up for average 28.9 months[1-76 months]. There was no late death. But one patients experinced anginal recurrence. In conclusion, making allowance for its notorious clinical results and relatively higher incidence in Korea, aggressive surgical techniques such as retrograce myocardial perfusion may be mandatory while we are in a learning phase.

• 한국치위생학회지
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• 제18권5호
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• pp.653-664
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• 2018

Objectives: The purpose of this study was to examine the association between two major oral diseases and cardiovascular diseases. Methods: Data from the 6th Korean National Health and Nutrition Examination Survey (2013-2015) were used. The study included 12,754 adults, aged ${\geq}19years$, who participated in the questionnaire survey of health related to hypertension, stroke, myocardial infarction, and angina pectoris as well as completed blood tests, anthropometry, and oral examination. Statistical analyses included complex sample frequency, complex sample general linear, complex sample cross-tabulation, and complex sample logistic regression analyses. Results: With respect to the number of Decayed-Missing-Filled-Teeth(DMFT ), patients with hypertension (DMFT 8.05), stroke (DMFT 8.66), and angina pectoris (DMFT 8.24) showed a DMFT score of >2, compared with those who did not have these diseases (p<0.05). Patients with hypertension, stroke, myocardial infarction, and angina pectoris presented an approximately 2.7, 3.5, 4, and 3 times higher incidence of periodontal diseases, respectively, than those who did not (p<0.05). Based on the analysis of the relationship between the number of DMFT and cardiovascular diseases, patients with cardiovascular diseases had a risk of 1.033 higher DMFT than those who did not (p<0.05). As per the analysis of the relationship between periodontal diseases and cardiovascular diseases, patients with cardiovascular diseases had a 2.969 higher risk of periodontaldiseasesthanthosewithout them (p<0.05). Conclusions: Two major oral diseases were found to be associated with cardiovascular diseases. Therefore, to prevent these major oral diseases in patients with cardiovascular diseases, oral hygiene management must be actively performed.

• Preventive Nutrition and Food Science
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• 제19권4호
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• pp.333-342
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• 2014

Limited epidemiologic data is available regarding the cardiovascular effects of mercury exposure. The purpose of this study was to determine the relationship between mercury exposure from fish consumption and cardiovascular disease in a nationally representative sample of Korean adults using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV 2008~2009). Survey logistic regression models accounting for the complex sampling were used to estimate the odds ratios (OR) adjusted for fish consumption frequency, age, education, individual annual income, household annual income, body mass index (BMI), waist circumference (WC), alcohol consumption status, and smoking status. The mean blood mercury level in the population was $5.44{\mu}g/L$. Trends toward increased blood mercury levels were seen for increased education level (P=0.0011), BMI (P<0.0001), WC (P<0.0001), and fish (i.e., anchovy) consumption frequency (P=0.0007). The unadjusted OR for hypertension in the highest blood mercury quartile was 1.450 [95% confidential interval (CI): 1.106~1.901] times higher than that of the lowest quartile. The fish consumption-adjusted OR for hypertension in the highest blood mercury quartile was 1.550 (95% CI: 1.131~2.123) times higher than that of the lowest quartile, and the OR for myocardial infarction or angina in the highest blood mercury quartile was 3.334 (95% CI: 1.338~8.308) times higher than that of the lowest quartile. No associations were observed between blood mercury levels and stroke. These findings suggest that mercury in the blood may be associated with an increased risk of hypertension and myocardial infarction or angina in the general Korean population.

• International Journal of Stem Cells
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• 제10권1호
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• pp.1-11
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• 2017

Human cardiomyocytes (CMs) cease to proliferate and remain terminally differentiated thereafter, when humans reach the mid-20s. Thus, any damages sustained by myocardium tissue are irreversible, and they require medical interventions to regain functionality. To date, new surgical procedures and drugs have been developed, albeit with limited success, to treat various heart diseases including myocardial infarction. Hence, there is a pressing need to develop more effective treatment methods to address the increasing mortality rate of the heart diseases. Functional CMs are not only an important in vitro cellular tool to model various types of heart diseases for drug development, but they are also a promising therapeutic agent for cell therapy. However, the limited proliferative capacity entails difficulties in acquiring functional CMs in the scale that is required for pathological studies and cell therapy development. Stem cells, human pluripotent stem cells (hPSCs) in particular, have been considered as an unlimited cellular source for providing functional CMs for various applications. Notable progress has already been made: the first clinical trials of hPSCs derived CMs (hPSC-CMs) for treating myocardial infarction was approved in 2015, and their potential use in disease modeling and drug discovery is being fully explored. This concise review gives an account of current development of differentiation, purification and maturation techniques for hPSC-CMs, and their application in cell therapy development and pharmaceutical industries will be discussed with the latest experimental evidence.

• Korean Circulation Journal
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• 제48권12호
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• 융합정보논문지
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• 제11권3호
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• pp.87-94
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• 2021

본 연구는 2016년~2018년도에 수집된 국민건강영양조사 7기 자료의 2차 분석을 통해 심혈관질환자의 활동 제한 여부에 의한 정신 건강과 삶의 질을 확인하였다. 연구대상자는 자료대상자 총 24,269명 중 협심증이나 심근경색 진단 병력이 있는 530명의 성인에서 변수의 누락이 없는 521명이다. SAS 9.4 version으로 활동 제한 유무에 따른 정신 건강과 삶의 질 차이를 Chi-square방법, 활동 제한에 의한 정신 건강과 삶의 질 영향을 Logistic regression 통계 방법으로 분석하였다. 분석 결과 활동 제한이 있을 때 스트레스 정도, 최근 2주간 우울감과 자살 생각 정도가 높아 정신 건강에 유의한 영향이 있었다. 활동 제한이 있을 때 운동능력, 자기관리, 일상활동에 더욱 지장이 있다고 느꼈고, 통증/불편감과 불안/우울감이 증가하여 삶의 질 역시 유의한 영향이 있었다. 따라서 심혈관질환자의 정신 건강 및 삶의 질 증진을 위해 활동 제한을 최소화할 수 있는 효과적인 신체 활동 증진프로그램의 개발 및 운영이 필요함을 제언한다.

• Journal of Chest Surgery
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• 제24권7호
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• pp.647-655
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• 1991

The efficacy of cold blood potassium cardioplegia during periods of ischemic arrest was assessed in 88 patients undergoing open heart surgical procedures at Chonnam National University Medical School from December, 1987 to January, 1989. The purpose of this study was to determine if the aortic cross clamping time[ACCT] over 120 minutes correlated with operative mortality, incidence of postoperative ventricular tachyarrhythmias, needs of postoperative inotropic support and serum enzyme levels. The patients were divided according to aortic cross clamping time[less than 120 minutes and 120 minutes or greater]. The results were as follows: 1. The operative mortality was 3.2% in ACCT<120min group and 7.7% in ACCT>120 min group. 2. The incidence of postoperative ventricular tachyarrhythmia was 1.6% in ACCT <120min group and 11.5% in ACCT>120min group[p<0.05]. 3. The incidence of postoperative inotropic support in congenital heart disease was 13.0Fo in ACCT<120min group and 45.0%o in ACCT>120min group[p<0.05]. The incidence in acquired heart disease was 26.0% in ACCT<120min group and 40.0% in ACCT> 120min group. 4. After cardiopulmonary bypass, serum GOT, LDH, CPK and CPK - MB were elevated prominently. Children showed higher value of the enzymes examined than adults did before and after cardiopulmonary bypass. In congenital heart diseases, postoperative serum GOT, LDH, CPK and CPK - MB levels of ACCT>120min group were significantly higher than those of ACCT<120min group. Postoperative serum GOT, LDH and CPK - MB levels of ACCT>=120min group were significantly higher than those of ACCT<120min group also in acquired heart diseases. The results suggest that the myocardial protective effect with cold blood potassium cardioplegic solutions was not sufficient when the aortic cross clamping time was over 120 minutes.

• Korean Circulation Journal
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• 제52권5호
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• pp.354-364
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• 2022

Background and objectives: To compare the safety and efficacy of a new everolimus-eluting stent with an abluminal-coated biodegradable polymer (Osstem Cardiotec Centum) with those of the Xience Alpine stent (Xience). Methods: This randomized, prospective, multicenter, parallel-designed, single-blind trial was conducted among patients with myocardial ischemia undergoing percutaneous coronary intervention (PCI) from 21st September 2018 until 3rd July 2020. The primary efficacy endpoint was in-segment late lumen loss (LLL) at 270 days after the procedure and the primary safety endpoints were major adverse cardiac events (MACE), composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: We enrolled 121 patients and analyzed 113 patients who finished 270 days of follow-up for the primary efficacy endpoint. The mean age of the participants was 66.8 years. As for the primary efficacy endpoint, LLL of the Osstem Cardiotec Centum group was 0.09±0.13 mm and that of the Xience group was 0.12±0.14 mm (upper limit of 1-sided 95% confidence interval, 0.02; p for non-inferiority, 0.0084). This result demonstrates the non-inferiority of the Osstem Cardiotec Centum. As for the primary safety endpoint, MACE occurred in one patient (1.59% of the Xience group). Meanwhile, no MACE occurred in the Osstem Cardiotec Centum group. Conclusions: The Osstem Cardiotec Centum is non-inferior to the Xience Alpine^® stent and is confirmed to be safe. It could be safely and effectively applied to patients with coronary artery disease undergoing PCI.