• Title/Summary/Keyword: Myocardial disease

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Clinical Experiences of Open Heart Surgery [50 Cases] (개심술 치험 50례)

  • 임진수
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.692-699
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    • 1985
  • Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

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Comparison of $^{99m}Tc$-tetrofosmin and $^{99m}Tc$-sestamibi Myocardial Perfusion SPECT in Detecting Coronary Artery Fisease (부하-휴식 1일 영상법을 이용한 심근관류 SPECT에서 $^{99m}Tc$-tetrofosmin과 $^{99m}Tc$-MIBI의 관동맥질환 진단율 비교)

  • Min, Jung-Jun;Bom, Hee-Seung;Song, Ho-Cheon;Jeoung, Hwan-Jeoung;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.137-142
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    • 1998
  • Purpose: $^{99m}Tc$-tetrofosmin(TF) is a recently proposed myocardial imaging agent which has similar biokinetic characteristics to $^{99m}Tc$-sestamibi(MIBI). The aim of this study was to compare TF and MIBI myocardial perfusion SPECTs in detecting coronary artery disease. Materials and Methods: One hundred and sixty patients(101 males, 59 females, mean age $57{\pm}9yr$) who had undergone both myocardial perfusion SPECT(M-SPECT) and coronary angiography within 1 month were studied. M-SPECT was performed using TF in 115 patients and MIBI in 45 patients. Stress-rest one day protocol was used in all patients. A coronary stenosis was considered significant when the luminal diameter ${\geq}$50% was compromised. The chi square test was used to compare differences in sensitivity and specificity between the two groups. Results: There was no difference in age and diseased coronary artery branches between the two groups. There were more male patients in TF group: Male-to-female ratios of TF and MIBI groups were 78:37 and 23:22, respectively(p<0.05). The overall sensitivity of TF study was 92% and specificity 36%. The overall sensitivity and specificity of MIBI study were 93% and 30%, respectively. There was no difference between TF and MIBI groups in identifying individual diseased coronary artery branches. Conclusion: One day stress-rest myocardial SPECT using either TF or MIBI was comparable and was a very sensitive test in detecting coronary artery disease.

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Repair of Postinfarction Ventricular Septal Defect on a Beating Heart -One case report (심근경색 후 심실중격렬손의 심박동 상태에서의 교정술 -1예 보고-)

  • Kim, Hyuck;Lee, Hyung-Chang;Kim, Young-Hak;Chung, Won-Sang;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.543-545
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    • 2004
  • Postinfarction ventricular septal defect often induces cardiogenic shock and requires operative treatment early after myocardial infarction. Although the operative mortality of this disease has decreased during the past 3 decades, it is still relatively high. In this case, to prevent global myocardial ischemia, we used the technique of repair of postinfarction ventricular septal defect on a beating heart. This approach does not requir aortic cross-clamping and provides superior myocardial protection.

Radiopharmaceuticals Used in Cardiac Imaging (심장영상에 이용되는 방사성의약품)

  • Hwang, Kyung-Hoon;Chung, Yong-An;Lee, Byeong-Il;Lee, Yu-Kyung;Lee, Min-Kyung;Choe, Won-Sick
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.174-178
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    • 2009
  • Many radiopharmaceuticals have been developed and wildy used in the imaging cardiac function. Myocardial perfusion imaging (MPI) is a well established noninvasive method of assessing coronary blood flow and has been widely used in patients diagnosed or suspected with coronary artery diseases. The innovation of radiopharmaceuticals used in the cardiac imaging is one of the most important contributors to the development of nuclear cardiology. Thallium-201 and various technetium-99m agents have been globally used for myocardial perfusion SPEG, and N-13 ammonia (13NH3), rubidium-82 (82Rb), 0-15 water (H2150) for myocardial perfusion PET. As well as the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. Useful information can be obtained for diagnosing coronary artery disease, evaluating patients' condition, or assessing therapeutic effects. In this review, we describe the characteristics and clinical usefulness of radiopharmaceuticals used for cardiac SPEG and PET.

Aortocoronary bypass after PTCA (관상동맥 풍선확장술 후의 개심술)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.32-35
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    • 1993
  • During the period from September 1989 through December 1992, 118 cases of coronary arterial bypass graft were performed at Department of Cardiothoracic Surgery, Asan Medical Center. Twenty-one of these had history of recent or remote percutaneous transluminal coronary angioplasty. They consisted of 13 males[age,58.7 + 5.4 years] and 8 females[age, 63.6 + 2.8years] with the mean age of 60.6. History of old myocardial infarction was noted in 24%[5/21] of the patients and congestive heart failure in 2 cases. The angina by type of presentation is unstable in all of the patients. The patterns of involvement of coronary arterial disease were left main disease[1], single vessel disease[5], double vessel involvement[10], and triple vessel involvement[5]. We performed 4 cases of single bypasses, 7 cases of double, 8 cases of triple, and 2 cases of quadruple bypasses. Total of 51 grafts[LIMA:12, RSVG:39] were inserted in 21 cases with average of 2.4 grafts per patient. The methods of myocardial protection were cold blood cardioplegia[8 cases], intermittent aortic occlusion[11], and continuous coronary perfusion with local coronary sharing[2]. There were no operative or late death. The only cardiac complication was 1 case of low cardiac output required IABP. The other complications were 1 case of sternal wound infection and 1 case of postoperative bleeding required reoperation. And there was no case of perioperative myocardial infarction. Postoperatively, 3 cases of recurrent angina were detected at 5, 7, and 18months after surgery. One of them was managed successfully with repeat PTCA[who was recurred 18 months postoperatively], and the other two with medication. I conclude that we can approach the patients more aggressively with PTCA, because of our acceptable operative risks.

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The Relationship between Parkinson's Disease and Acute Myocardial Infarction in Korea : A Nationwide Longitudinal Cohort Study

  • Sheen, Seung Hun;Hong, Je Beom;Kim, Hakyung;Kim, Jimin;Han, In-bo;Sohn, Seil
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.507-513
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    • 2022
  • Objective : The goal of the following statewide age and gender-coordinated cohort study in Korea is to find out if there is a link between acute myocardial infarction (AMI) and Parkinson's disease (PD). Methods : Utilizing the National Health Insurance Sharing Service cohort, patient data were collected. Six thousand four hundred seventy-five individuals with PD were distinguished by utilizing the International Classification of Diseases 10 code G20 and have enrolled in the PD group. The number of participants decreased to 5259 after excluding 1039 patients who were hospitalized less than one time or who visited an outpatient clinic less than twice. Then, 26295 individuals were selected as part of the control group after case control matching was conducted through 1 : 5 age- and gender-coordinated matching. The Cox proportional hazard regression analysis and Kaplan-Meier method were utilized to analyze the likelihood of AMI in PD. Results : After controlling for age and gender, the hazard ratio of AMI in the PD group was 3.603 (95% confidence interval [CI], 2.837-4.577). After that, the following hazard ratio of AMI in the PD group was modified against for co-morbid medical disorders, resulting in 3.551 (95% CI, 2.795-4.511). According to a subgroup analysis, in males and females aged <65 and aged ≥65 and in the non-diabetes and diabetes, hypertension and non-hypertension, dyslipidemia and non-dyslipidemia subgroups, the AMI incidence rates were dramatically higher in the PD group compared to that of the control. Conclusion : Individuals with PD have a greater chance of AMI, according to this cross-national study.

Clinical Characteristies and Findings of $^{99m}Tc$-MIBI Heart SPECT in Patients with Acute Myocardial Infarction with Normal Coronary Arteriography (정상 관동맥 조영상을 갖는 급성 심근경색증 환자의 임상적 특징 및 $^{99m}Tc$-MIBI심근 SPECT 소견)

  • Park, Myung-Jae;Choi, Tae-Youl;Kim, Deog-Yoon;Kang, Heung-Sun;Choue, Chung-Whee;Kim, Kwon-Sam;Kim, Kwang-Won;Kim, Myung-Shick;Song, Jung-Sang;Bae, Jong-Hoa
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.65-70
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    • 1993
  • Among 64 patients with acute myocardial infarction who underwent coronary angiogrphy, 7 patients (10.9%) showed normal coronary artery. Six patients were men and 1 patient was female. The mean age of patients were $31.1{\pm}3.9$ years. Among the risk factors of coronary heart disease, smoking was most probable factor in patients with acute myocardial infarction with normal coronary angiography. $^{99m}Tc$-MIBI heart SPECT performed 5 of 7 patients and showed that it could be used in diagnosis, localization, extent of infarct area in patients with acute myocardial infarction with normal coronary angiograpy. But follow up $^{99m}Tc$-MIBI heart SPECT study will be needed to define the ability of myocardial viability in this patients.

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A Perspective on Pharmaceutical Industrial Research on Antihypertensive drugs

  • Lee, Jang-Yun;John F. DeBernardis
    • Archives of Pharmacal Research
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    • v.10 no.4
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    • pp.245-249
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    • 1987
  • Cardiovascular disease is at present the leading cause of deth in the United States and other in dustrilized countries. A major contributing factor of cardiovascular disease is essential hypertension. Untreated, essential hypertension is considered a risk factor for sudden death due to myocardial infarctions, as well as a risk factor for cerebral vascular disease, renal failure and congestive heart failure. During the last decade, significant progress has been made in the basic knowledge of the pathogenesis of hypertension as well as in the development of new antihypertensive drugs.

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Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction

  • Jingwei Pan;Mingyuan Yuan;Mengmeng Yu;Yajie Gao;Chengxing Shen;Yining Wang;Bin Lu;Jiayin Zhang
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.709-718
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    • 2019
  • Objective: To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results: The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = -0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = -0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.

Development of Realtime ECG Analysis and Monitoring System (실시간 심전도 분석 및 모니터링 시스템 개발)

  • Jeong, Gu-Young;Yoon, Myoung-Jong;Yu, Kee-Ho
    • Journal of Institute of Control, Robotics and Systems
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    • v.15 no.4
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    • pp.406-412
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    • 2009
  • ECG is used on purpose to keep good health or monitor cardiac function of aged person as well as on purpose to diagnose the disease of heart patients. The ambulatory ECG monitoring system under guarantee of safety and accuracy is very efficient to prevent the progress of heart disease and sudden death. These systems can detect the temporary change of ECG that is very significant to diagnose heart disease such as myocardial ischemia, arrhyamia and cardiac infarction. In this paper, we describe the ECG signal analysis algorithm and measurement device for ECG monitoring. The authors designed a small-size portable ECG device that consisted of instrumentation amplifier, micro-controller, filter and RF module. The device measures ECG with four electrodes on the body and detects QRS complex and ST level change in realtime. Also it transmits the measured signals to the personal computer. The developed software for ECG analysis in personal computer has the function to detect the feature points and ST level changes.