• Title/Summary/Keyword: Myocardial infarctions

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Predictors of Weight Reduction and Smoking Cessation in Overweight and Obese Patients with Acute Myocardial infarctions

  • Kang, Jung-Kyu;Lee, Jang-Hoon;Ha, Su-Young;Bae, Myung-Hwan;Yang, Dong-Heon;Park, Hun-Sik;Cho, Yong-Keun;Chae, Shung-Chull;Jun, Jae-Eun
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.20-30
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    • 2011
  • Background: Little IS known about predictors of lifestyle modification in overweight or obese patients with acute myocardial infarctions. Methods: Between October 2005 and May 2007, 311 overweight or obese patients with an AMI visited Kyungpook National University Hospital. Among them, 216 patients ($63{\pm}11$ years old, 144 males) with ${\geq}1$ year of follow-up were included. Results: Body weight of all patients showed a significant decrease and 20% showed a >3% weight reduction at 1 year of follow-up. Ninety-six (44%) patients were smoking at baseline, and 52% of them had quit by 1 year of follow-up. Only six smokers were successful with both a >3% weight reduction and smoking cessation. In multivariate analysis, age (OR 1.084, 95% CI 1.028-1.144, p=0.003) and smoking cessation (OR 0.167, 95% CI 0.048-0.575, p=0.005) were independent predictors of weight reduction. Abdominal circumference was a negative predictor of smoking cessation (OR 0.903, 95% CI 0.820-0.994, p=0.037). Conclusions: Mean body weight of all patients showed a significant decrease at follow-up. Smoking cessation and age were independent predictors of weight reduction, and abdominal circumference was a negative predictor of smoking cessation.

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Early Surgical Revascularization for Acute Myocardial Infarction (급성 심근 경색후 관상 동맥 우회술의 조기 적용)

  • 지현근;이원용
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1077-1082
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    • 1997
  • To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

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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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Effects of anesthesia on echocardiograms in myocardial infarcted dogs (심근경색 유발견에서 마취가 심초음파에 미치는 영향)

  • Yoon, Jung-hee;Sung, Jai-ki
    • Korean Journal of Veterinary Research
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    • v.37 no.3
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    • pp.669-685
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    • 1997
  • The present study was performed to evaluate the effects of xylazine and tiletamine + zolazepam on echocardiograms before and after experimental myocardial infarctions in clinically normal dogs taken preliminary examinations related to cardiac function. The results are as follows. With xylazine administration, left ventricle end-diastolic dimension, left ventricle end-systolic dimension, left atrium/aorta, ejection time and velocity of circumferential fiber shortening increased and mitral valve CD slope, % delta D decreased(p<0.01). In tiletamine+zolazepam administered group, interventricular septum amplitude(p<0.01), mitral valve DE slope(p<0.05) and ejection time(p<0.01) decreased and left atrium/aorta, ejection time also decreased compared with xylazine group(p<0.01). In 48 hours after experimental myocardial infarction group, anterior aortic wall amplitude decreased compared with control, xylazine, tiletamine + zolazepam group, respectively(p<0.01). Posterior aortic wall amplitude decreased compared with control(p<0.01). Left ventricle end systolic dimension increased compared with control and tiletamine + zolazepam group, respectively(p<0.01). Left ventricular posterior wall end systolic dimension decreased compared with control(p<0.01). Left ventricular posterior wall amplitude decreased compared with control and tiletamine+zolazepam group(p<0.01). Left atrium/aorta decreased compared with xylazine group(p<0.01). % thickening left ventricular posterior wall decreased compared with control(p<0.05). % delta D decreased compared with control and tiletamine+zolazepam group(p<0.01). Ejection time decreased compared with xylazine(p<0.01). Velocity of circumferential fiber shortening increased compared with control and tiletamine + zolazepam group(p<0.01). With xylazine administration 48 hours after experimental myocardial infarction, anterior aortic wall amplitude, posterior aortic wall amplitude decreased compared with control(p<0.01). Left ventricle end-diastolic dimension increased compared with control(p<0.01). Left ventricle end-systolic dimension increased compared with control and tiletamine + zolazepam group, respectively(p<0.01). Left ventricular posterior wall end-systolic dimension and left ventricular posterior wall end-diastolic dimension decreased compared with control(p<0.01). Left atrium/aorta decreased compared with xylazine group(p<0.01). % thickening left ventricular posterior. wall(p<0.05) and % delta D(p<0.01) decreased compared with control. Velocity of circumferential fiber shortening increased compared with tiletamine + zolazepam group(p<0.01). With tiletamine + zolazepam administration 48 hours after experimental myocardial infarction, anterior aortic wall amplitude decreased compared with control, xylazine and tiletamine+zolazepam group, respectively(p<0.01). Posterior aortic wall amplitude decreased compared with control(p<0.01). Left ventricle end-systolic dimension increased compared with control and tiletamine+zolazepam group(p<0.01). Left ventricular posterior wall end-systolic dimension, left ventricular posterior wall end-diastolic dimension and interventricular septum amplitude decreased compared with control(p<0.01). Left atrium/aorta decreased compared with xylazine group(p<0.01). % delta D decreased compared with control and tiletamine + zolazepam group(p<0.01). Ejection time decreased compared with xylazine group and velocity of circumferential fiber shortening increased compared withtiletamine+zolazepam group(p<0.01). Conclusively, echocardiography was proved to be a useful, diagnostic, non-invasive and simple method for establishing the diagnosis of myocardial infarction and evaluating the effects of drug on cardiac function before and after myocardial infarction.

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Surgical Outcomes of a Modified Infarct Exclusion Technique for Post-Infarction Ventricular Septal Defects

  • Kim, In Sook;Lee, Jung Hee;Lee, Dae-Sang;Cho, Yang Hyun;Kim, Wook Sung;Jeong, Dong Seop;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.381-386
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    • 2015
  • Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

Left Ventricular Ejection Fraction Predicts Poststroke Cardiovascular Events and Mortality in Patients without Atrial Fibrillation and Coronary Heart Disease

  • Lee, Jeong-Yoon;Sunwoo, Jun-Sang;Kwon, Kyum-Yil;Roh, Hakjae;Ahn, Moo-Young;Lee, Min-Ho;Park, Byoung-Won;Hyon, Min Su;Lee, Kyung Bok
    • Korean Circulation Journal
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    • v.48 no.12
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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.

Evaluation of Regional Wall Motion by Phase Analysis of Radionuclide Cardiac Blood Pool Scintigrams in Coronary Artery Disease Patients (관상동맥질환 환자에서 방사성동위원소 위상분석에 의한 심근 국소 운동 평가)

  • Yi, Gang-Wook;Chung, June-Key;Oh, Byeong-Hui;Park, Young-Bae;Lee, Myung-Chul;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.167-174
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    • 1987
  • Among noninvasive approaches for the evaluation of left ventricular performance, radionuclide ventriculography (RVG) has been shown to be of particular values. Phase analysis, recently introduced as more objective means for evaluating the temporal sequence of systolic ventricular wall motion than cine image of RVG comprises a pixel by pixel Fourier transformation of the time activity curve of a multiple gated acquisition equilibrium blood pool study. To examine the regional wall motion of ventricles in myocardial infarctions, we evaluated the phase image and histogram constructed for each ventricle by total phase angle range and full width of half maximum (FWHM). This study consisted of 7 normal subjects and 23 subjects with acute myocardial infarction. Contrast ventriculography and coronary angiography was performed in all partients with myocardial infarction. And we compared the result of phase analysis with cine image of RVG and examined the interrelationship between phase analysis and contrast ventriculography with coronary angiography. The results were as follows; 1) The total phase angle range and FWHM of LV phase histogram in myocardial infarction ($86^{\circ}\;and\;32^{\circ}$, repectively) were wider than those in normal control ($38^{\circ}\;and\;18^{\circ}$, respectively p<0.01). 2) RV phase angle range and FWHM in patients with right coronary artery (RCA) occlusion ($79^{\circ}\;and\;37^{\circ}$, respectively) were wider than those in normal control ($39^{\circ}\;and\;18^{\circ}$, respectively p<0.001) and the patients without RCA occlusion ($52^{\circ}\;and\;19^{\circ}$, respectively p<0.01). 3) Phase analysis was more sensitive (95%) than cine image of RVG (70%) for the detection of regional wall motion abnormality of LV.

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Quantitative Label-free Biodetection of Acute Disease Related Proteins Based on Nanomechanical Dynamic Microcantilevers

  • Hwang, Kyo-Seon;Cha, Byung-Hak;Kim, Sang-Kyung;Park, Jung-Ho;Kim, Tae-Song
    • JSTS:Journal of Semiconductor Technology and Science
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    • v.7 no.3
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    • pp.151-160
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    • 2007
  • We report the label-free biomolecules detection based on nanomechanical micro cantilevers operated in dynamic mode for detection of two marker proteins (myoglobin and creatin kinase-MB (CK-MB)) of acute myocardical infarctions. When the specific binding between the antigen and its antibody occurred on the fuctionalized microcantilever surface, mechanical response (i.e. resonant frequency) of microcantilevers was changed in lower frequency range. We performed the label-free biomolecules detection of myoglobin and CK-MB antigen in the low concentration (clinical threshold concentration range) as much as 1 ng/ml from measuring the dynamic response change of micro cantilevers caused by the intermolecular force. Moreover, we estimate the surface stress on the dynamic microcantilevers generated by specific antibody-antigen binding. It is suggested that our dynamic microcantilevers may enable one to use the sensitive label-free biomolecules detection for application to the disease diagnosis system based on mechanical immuno-sensor.

Prognostic Implication of Normal Myocardial Perfusion Scintigraphy in Patients with Chest Pain (정상 심근관류신티그라피 소견을 보인 흉통환자의 예후)

  • Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.67-72
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    • 1997
  • Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age $53{\pm}12$ years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% Per Year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary artery disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of. cardiac event rates between patients with normal and abnormal coronary angiograms.

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Salvianolic Acid B Inhibits Hand-Foot-Mouth Disease Enterovirus 71 Replication through Enhancement of AKT Signaling Pathway

  • Kim, So-Hee;Lee, Jihye;Jung, Ye Lin;Hong, Areum;Nam, Sang-Jip;Lim, Byung-Kwan
    • Journal of Microbiology and Biotechnology
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    • v.30 no.1
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    • pp.38-43
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    • 2020
  • Hand, foot, and mouth disease (HFMD) is caused by enterovirus 71 (EV71) in infants and children under six years of age. HFMD is characterized by fever, mouth ulcers, and vesicular rashes on the palms and feet. EV71 also causes severe neurological manifestations, such as brainstem encephalitis and aseptic meningitis. Recently, frequent outbreaks of EV71 have occurred in the Asia-Pacific region, but currently, no effective antiviral drugs have been developed to treat the disease. In this study, we investigated the antiviral effect of salvianolic acid B (SalB) on EV71. SalB is a major component of the Salvia miltiorrhiza root and has been shown to be an effective treatment for subarachnoid hemorrhages and myocardial infarctions. HeLa cells were cultured in 12-well plates and treated with SalB (100 or 10 ㎍/ml) and 106 PFU/ml of EV71. SalB treatment (100 ㎍/ml) significantly decreased the cleavage of the eukaryotic eIF4G1 protein and reduced the expression of the EV71 capsid protein VP1. In addition, SalB treatment showed a dramatic decrease in viral infection, measured by immunofluorescence staining. The Akt signaling pathway, a key component of cell survival and proliferation, was significantly increased in EV71-infected HeLa cells treated with 100 ㎍/ml SalB. RT-PCR results showed that the mRNA for anti-apoptotic protein Bcl-2 and the cell cycle regulator Cyclin-D1 were significantly increased by SalB treatment. These results indicate that SalB activates Akt/PKB signaling and inhibits apoptosis in infected HeLa cells. Taken together, these results suggest that SalB could be used to develop a new therapeutic drug for EV71-induced HFMD.