• Title/Summary/Keyword: Sudden cardiac death

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In silico Analysis on hERG Channel Blocking Effect of a Series of T-type Calcium Channel Blockers

  • Jang, Jae-Wan;Song, Chi-Man;Choi, Kee-Hyun;Cho, Yong-Seo;Baek, Du-Jong;Shin, Kye-Jung;Pae, Ae-Nim
    • Bulletin of the Korean Chemical Society
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    • v.32 no.1
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    • pp.251-262
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    • 2011
  • Human ether-a-go-go related gene (hERG) potassium channel blockade, an undesirable side effect which might cause sudden cardiac death, is one of the major concerns facing the pharmaceutical industry. The purpose of this study is to develop an in silico QSAR model which uncovers the structural parameters of T-type calcium channel blockers to reduce hERG blockade. Comparative molecular similarity indices analysis (CoMSIA) was conducted on a series of piperazine and benzimidazole derivatives bearing methyl 5-(ethyl(methyl)amino)-2-isopropyl-2-phenylpentanoate moieties, which was synthesized by our group. Three different alignment methods were applied to obtain a reliable model: ligand based alignment, pharmacophore based alignment, and receptor guided alignment. The CoMSIA model with receptor guided alignment yielded the best results : $r^2$ = 0.955, $q^2$ = 0.781, $r^2_{pred}$ = 0.758. The generated CoMSIA contour maps using electrostatic, hydrophobic, H-bond donor, and acceptor fields explain well the structural requirements for hERG nonblockers and also correlate with the lipophilic potential map of the hERG channel pore.

Arrhythmia Classification using Hybrid Combination Model of CNN-LSTM (합성곱-장단기 기억 신경망의 하이브리드 결합 모델을 이용한 부정맥 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.1
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    • pp.76-84
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    • 2022
  • Arrhythmia is a condition in which the heart beats abnormally or irregularly, early detection is very important because it can cause dangerous situations such as fainting or sudden cardiac death. However, performance degradation occurs due to personalized differences in ECG signals. In this paper, we propose arrhythmia classification using hybrid combination model of CNN-LSTM. For this purpose, the R wave is detected from noise removed signal and a single bit segment was extracted. It consisted of eight convolutional layers to extract the features of the arrhythmia in detail, used them as the input of the LSTM. The weights were learned through deep learning and the model was evaluated by the verification data. The performance was compared in terms of the accuracy, precision, recall, F1 score through MIT-BIH arrhythmia database. The achieved scores indicate 92.3%, 90.98%, 92.20%, 90.72% in terms of the accuracy, precision, recall, F1 score, respectively.

Use of Coronary CT Angiography as a Screening Tool for Coronary Artery Disease in Asymptomatic Healthy Individuals or Patients (무증상 정상인 또는 환자의 관상동맥 질환 선별 검사로서 관상동맥 전산화단층촬영 혈관조영술의 유용성)

  • Gong Yong Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.54-69
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    • 2022
  • Early detection of potential asymptomatic coronary artery disease is very important, as patients with sudden cardiac death often do not show symptoms such as chest pain or motor dyspnea. Coronary CT angiography (CCTA) has long been unjustified as a screening tool for asymptomatic patients because of the risks posed by radiation exposure. However, there are still various opinions regarding the usefulness of CCTA for screening for coronary artery disease (CAD) in asymptomatic healthy individuals or patients. This review investigated the usefulness of coronary artery calcium score and CCTA as screening tests for CAD in asymptomatic healthy individuals or patients through various literature reviews. With the development of CT technology, recent studies have been conducted in asymptomatic CAD patients with a reduced radiation dose of less than 1 mSv. A total of 2.6% of asymptomatic subjects on CCTA found significant CAD over 70%, and it was concluded that screening CCTA for CAD showed prognostic power in predicting the future occurrence of CAD in asymptomatic people. However, after the completion of the current NIH SCOT-HEART 2 study, it may be possible to determine whether CCTA is appropriate as a screening tool for CAD in asymptomatic healthy individuals.

Surgical Treatment of Cardiac Myxoma: A 20 Years of Experiences (심장 점액종의 외과적 치료: 20년 임상경험)

  • Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Yie, Kil-Soo;Baek, Man-Jong;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.288-291
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    • 2007
  • Background: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment, Material and Method: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. Result: The mean age of the patients was $53.5{\pm}14.0$ years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases, The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: $84.0{\pm}71.3$ months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. Conclusion: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.

Results of Extracardiac Pericardial-flap Lateral Tunnel Fontan Operation (자가심낭막절편을 이용한 심외외측통로 Fontan 수술의 결과)

  • Park Han-Ki;Youn Young-Nam;Yang Hong-Seok;Yoo Byoung-Won;Choi Jae-Young;Park Young-Hwan
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.281-288
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    • 2006
  • Background: Extracardiac pericardial-flap lateral tunnel Fontan operation has theoretical advantage of growth potentiality of the extracardiac tunnels. The mid-term results of this technique and morphologic change of the lateral tunnel were studied. Material and Method: Clinical data was reviewed in 42 patients who underwent extracardiac pericardial-flap lateral tunnel Fontan operation between November 1993 and December 2004. The age was $2.8{\pm}1.5$ years and the body weight was $12.3{\pm}3.2$ kg. Extracardiac tunnel was constructed using the pedicled pericardium with the base undetached. By reviewing the follow-up cardiac angiograms, the diameter and the cross-sectional area of the lateral tunnel was compared to those of inferior vena cava. Result: There were four operative mortality cases (9.8%) and the causes of death were low cardiac output for all four cases. Postoperatively, five patients had prolonged pleural effusion longer than two weeks and one patient required a permanent pacemaker due to complete heart block. Follow-up was possible in 37 patients and the follow up duration was $3.8{\pm}2.2$ years. During that period, one patient died, of upper gastrointestional bleeding combined with heart failure and one patient died a sudden death of unknown cause. Two patients required reoperation due to subaortic stenosis and anastomosis site stenosis between inferior vena cava and lateral tunnel. In one patient, bradyarrhythmia was anew but there was no thromboembolic complication. The lateral tunnel showed growth in proportion to the size of the inferior vena cava. Conclusion: Extracardiac pericardial-flap lateral tunnel Fontan operation is relatively simple and safe. The mid-term result was favorable and the extracardiac tunnel showed potential for growth.

A Case of Persistent Hiccup in a Patient with Non-small Cell Lung Cancer (비소세포폐암 환자에서 발생한 지속성 딸꾹질 1예)

  • Park, Hye Sung;Sim, Yun Su;Lim, So Yeon;Jo, Jung Youn;Kwon, Sung Shin;Roh, Sun Hee;Kim, Yoo Ri;Chun, Eun Mi;Lee, Jin Hwa;Ryu, Yon Ju;Song, Dong Eun;Moon, Jin Wook
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.1
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    • pp.39-43
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    • 2008
  • A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.

Clinical Characteristics of Acute Dichlorvos Poisoning in Korea (국내 급성 dichlorvos 중독 현황과 임상상 분석)

  • Lee, Mi-Jin;Park, Joon-Seok;Kwon, Woon-Yong;Eo, Eun-Kyung;Oh, Bum-Jin;Lee, Sung-Woo;Suh, Joo-Hyun;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.1
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    • pp.9-15
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    • 2008
  • Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

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SVM Classifier for the Detection of Ventricular Fibrillation (SVM 분류기를 통한 심실세동 검출)

  • Song, Mi-Hye;Lee, Jeon;Cho, Sung-Pil;Lee, Kyoung-Joung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.42 no.5 s.305
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    • pp.27-34
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    • 2005
  • Ventricular fibrillation(VF) is generally caused by chaotic behavior of electrical propagation in heart and may result in sudden cardiac death. In this study, we proposed a ventricular fibrillation detection algorithm based on support vector machine classifier, which could offer benefits to reduce the teaming costs as well as good classification performance. Before the extraction of input features, raw ECG signal was applied to preprocessing procedures, as like wavelet transform based bandpass filtering, R peak detection and segment assignment for feature extraction. We selected input features which of some are related to the rhythm information and of others are related to wavelet coefficients that could describe the morphology of ventricular fibrillation well. Parameters for SVM classifier, C and ${\alpha}$, were chosen as 10 and 1 respectively by trial and error experiments. Each average performance for normal sinus rhythm ventricular tachycardia and VF, was 98.39%, 96.92% and 99.88%. And, when the VF detection performance of SVM classifier was compared to that of multi-layer perceptron and fuzzy inference methods, it showed similar or higher values. Consequently, we could find that the proposed input features and SVM classifier would one of the most useful algorithm for VF detection.

2D-QSAR analysis for hERG ion channel inhibitors (hERG 이온채널 저해제에 대한 2D-QSAR 분석)

  • Jeon, Eul-Hye;Park, Ji-Hyeon;Jeong, Jin-Hee;Lee, Sung-Kwang
    • Analytical Science and Technology
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    • v.24 no.6
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    • pp.533-543
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    • 2011
  • The hERG (human ether-a-go-go related gene) ion channel is a main factor for cardiac repolarization, and the blockade of this channel could induce arrhythmia and sudden death. Therefore, potential hERG ion channel inhibitors are now a primary concern in the drug discovery process, and lots of efforts are focused on the minimizing the cardiotoxic side effect. In this study, $IC_{50}$ data of 202 organic compounds in HEK (human embryonic kidney) cell from literatures were used to develop predictive 2D-QSAR model. Multiple linear regression (MLR), Support Vector Machine (SVM), and artificial neural network (ANN) were utilized to predict inhibition concentration of hERG ion channel as machine learning methods. Population based-forward selection method with cross-validation procedure was combined with each learning method and used to select best subset descriptors for each learning algorithm. The best model was ANN model based on 14 descriptors ($R^2_{CV}$=0.617, RMSECV=0.762, MAECV=0.583) and the MLR model could describe the structural characteristics of inhibitors and interaction with hERG receptors. The validation of QSAR models was evaluated through the 5-fold cross-validation and Y-scrambling test.

Detection of Obstructive Sleep Apnea Using Heart Rate Variability (심박변화율을 이용한 폐쇄성 수면무호흡 검출)

  • Choi Ho-Seon;Cho Sung-Pil
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.42 no.3 s.303
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    • pp.47-52
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    • 2005
  • Obstructive Sleep Apnea (OSA) is a representative symptom of sleep disorder caused by the obstruction of upper airway. Because OSA causes not only excessive daytime sleepiness and fatigue, hypertension and arrhythmia but also cardiac arrest and sudden death during sleep in the severe case, it is very important to detect the occurrence and the frequency of OSA. OSA is usually diagnosed through the laboratory-based Polysomnography (PSG) which is uncomfortable and expensive. Therefore researches to improve the disadvantages of PSG are needed and studies for the detection of OSA using only one or two parameters are being made as alternatives to PSG. In this paper, we developed an algorithm for the detection of OSA based on Heart Rate Variability (HRV). The proposed method is applied to the ECG data sets provided from PhysioNet which consist of learning set and training set. We extracted features for the detection of OSA such as average and standard deviation of 1 minute R-R interval, power spectrum of R-R interval and S-peak amplitude from data sets. These features are applied to the input of neural network. As a result, we obtained sensitivity of $89.66\%$ and specificity of $95.25\%$. It shows that the features suggested in this study are useful to detect OSA.