• Korean Journal of Radiology
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• v.22 no.6
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• pp.901-911
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• 2021

Objective: To evaluate the technical applicability of a semiautomatic three-dimensional (3D) hybrid CT segmentation method for the quantification of right ventricular mass in patients with cardiovascular disease. Materials and Methods: Cardiac CT (270 cardiac phases) was used to quantify right ventricular mass using a semiautomatic 3D hybrid segmentation method in 195 patients with cardiovascular disease. Data from 270 cardiac phases were divided into subgroups based on the extent of the segmentation error (no error; ≤ 10% error; > 10% error [technical failure]), defined as discontinuous areas in the right ventricular myocardium. The reproducibility of the right ventricular mass quantification was assessed. In patients with no error or < 10% error, the right ventricular mass was compared and correlated between paired end-systolic and end-diastolic data. The error rate and right ventricular mass were compared based on right ventricular hypertrophy groups. Results: The quantification of right ventricular mass was technically applicable in 96.3% (260/270) of CT data, with no error in 54.4% (147/270) and ≤ 10% error in 41.9% (113/270) of cases. Technical failure was observed in 3.7% (10/270) of cases. The reproducibility of the quantification was high (intraclass correlation coefficient = 0.999, p < 0.001). The indexed mass was significantly greater at end-systole than at end-diastole (45.9 ± 22.1 g/m² vs. 39.7 ± 20.2 g/m², p < 0.001), and paired values were highly correlated (r = 0.96, p < 0.001). Fewer errors were observed in severe right ventricular hypertrophy and at the end-systolic phase. The indexed right ventricular mass was significantly higher in severe right ventricular hypertrophy (p < 0.02), except in the comparison of the end-diastolic data between no hypertrophy and mild hypertrophy groups (p > 0.1). Conclusion: CT quantification of right ventricular mass using a semiautomatic 3D hybrid segmentation is technically applicable with high reproducibility in most patients with cardiovascular disease.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.20-26
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• 2002

Background: Due to the concern of flow competition or retrograde steal, it has been generally suggested that the right gastroepiploic artery(RGEA) pedicled graft should be used in critical coronary stenosis lesion. The study was designed to evaluate the potential of retrograde flow competition in the RGEA pedicled graft by measuring the native pressure differences(PD) between the normal coronary artery and celiac arterial pressure, which would be compared with trans-stenosis pressure gradients(TSPG) in coronary artery occlusive disease. Material and Method: Between July, 1998 and February, 1999, pressures of the right coronary artery and the right gastroepiploic artery(or the celiac artery) were measured in patients with the patent right coronary artery(n=12). The PD between the arteries was compared with the TSPG in the occlusive coronary arteries(n=32). Result: The pressures of the normal right coronary artery and celiac artery were 143$\pm$23 vs. 134$\pm$17mmHg in systole(p<0.005), 74$\pm$13 vs. 73$\pm$14mmHg in diastole(p=NS), and 100$\pm$16 vs. 97$\pm$15mmHg in mean (p<0.05). The PD between the arteries were -8~25mmHg in systole, -4~7mmHg in diastole, and -1~10mmHg in mean. The TSPG measured in the occlusive coronary arteries were -4~19(7$\pm$5.8)mmHg in the lesion less than 75% stenosis vs. 7~74(27$\pm$18.3)mmHg in the 75% or over stenosis lesion(p<0.005). The normally existing pressure difference between the coronary arteries and RGEA(15~20mmHg) was significantlyless than the TSPG in .the occlusive coronary artery with 75% or over stenosis(p<0.001). Conclusion: If the pressure gradient between the RGEA and the coronary artery distal to the stenosis is the main determinant of development of retrograde flow competiton in the RGEA pedicled graft, the above data suggests that there will be little chance of competition when It is used in the coronary lesion with 75% or over stenosis.

• Journal of Life Science
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• v.22 no.2
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• pp.148-155
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• 2012

A cross-sectional analysis of blood pressure (BP) changes and the current prevalence and distribution of hypertension among age groups in Korea were conducted. Systolic (SBP), diastolic (DBP), and pulse (PP) pressures were evaluated. Residents visiting a local Community Health Center for a health check-up and/or participating in the Health Promotion Program were included for the analyses. A total of 6,570 subjects (2,809 men, 3,761 women) were divided into five age groups: 30-39, 40-49, 50-59, 60-69, and $70\leq$ years. Comparisons were made between sex and among age groups. SBP and DBP were continuously elevated, while men showed higher levels than women until their mid-60s; then, the trend was reversed. DBP in men became elevated from their 30s, reaching the highest in the 40s then slowly decreasing. DBP in women increased up to their 40s and 50s, then reached a plateau. PP increased rapidly from the 50s in both sexes. The major contributor of age-related BP elevation may be large artery stiffness in men, particularly from their 50s, while the blood pressure elevation of women may relate to diverse factors including large artery stiffness, stroke volume, and ventricular ejection rate. The rapid elevation of PP after the 50s in both men and women could represent a risk of cardiovascular or coronary mortality, particularly with increasing age. The current data showed a higher rate of hypertension in both sexes compared to previous reports. When those with both high-normal BP and hypertension are looked at in combination, BP management of the target population should be drastically elevated.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.422-425
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• 2015

This study evaluated the myocardial performance on echocardiography after the sedation/anesthesia of medetomidine (D), the combination of medetomidine and tiletamine/zolazepam (DZ), and the combination of medetomidine, tiletamine/zolazepam and tramadol (DZT) in Beagle dogs. Ten healthy adult Beagle dogs (weighing $8.6{\pm}1.0kg$) were enrolled in this study. Heart rate (HR), fractional shortening (%FS), left ventricular ejection fraction (%LVEF), stroke volume (SV), cardiac output (CO), left ventricular internal diameter in systole (LVIDs) and left ventricular internal diameter in diastole (LVIDd) using M-mode echocardiography were measured prior to anesthesia, then every 10 min for 60 min. The HR, %FS, %LVEF, SV and CO were significantly decreased during sedation/anesthesia with D, DZ and DZT combination of anesthesia. Although those anesthetic protocols provided acceptable quality of sedation/anesthesia, levels of cardiovascular suppression were substantial and persistent and thus the continuous monitoring on vital signs should be accompanied in any situation. Close attention is required for dogs with pre-existing heart diseases, when those anesthetic protocols were applied.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.52-61
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• 1994

Background : The demand for refinement in noninvasive and quantitative assessment of left ventricular (LV) function is increasing. Purpose : To assess normal values of left ventricular functional parameters during both systole and diastole by scintigraphic method using computerized triple-head gamma camera and to evaluate correlations between these parameters. Methods : ECG gated blood pool scan with $^{99m}Tc$-Human serum albumin was performed in 94 normal Korean subjects. Ejection fraction (EF), systolic parameters [peak emptying rate (PER), average emptying rate (AER), time to peak emptying rate (TPER)], and diastolic parameters [peak filling rate (PFR), average filling rate (AFR), time to peak filling rate (TPFR)] were obtained by analysis of LV time-activity curve, the correlation of these parameters to the age and sex, and the correlation between these parameters were evaluated. Results : 1) Mean value of ejection fraction in study subjects was $59.6{\pm}5.25%$ and showed no significant correlation to age (r=-0.08) and sex but showed most pronounced correlation to PFR (r=0.46, p<0.001), PER (r=0.41, p<0.001), AFR (r=0.34, p<0.001) and AER (r=0.28, p<0.01). 2) Mean values of systolic parameters were as follows: $PER=3.22{\pm}0.50$ end-diastolic volume/sec, $AER=2.22{\pm}0.45$ end-diastolic volume/sec, $TPER=103.5{\pm}29.30$ msec. They showed no significant correlation to age and sex. 3) Mean values of diastolic parameters were as follows: $PFR=2.71{\pm}0.51$ end-diastolic volume/sec, $AFR=1.83{\pm}0.44$ end-diastolic volume/sec, $TPFR=132.1{\pm}33.45$ msec. They showed strong correlation to age (r=0.70, -0.64, 0.37, p<0.001). Conclusions : Left ventricular functional parameters in normal Korean subjects were obtained reliably by computerized scintigraphic method and may be applied to the evaluation of cardiac function in diseased patients.

• Journal of Veterinary Clinics
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• v.36 no.1
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• pp.46-52
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• 2019

Pimobendan has inotropic and vasodilating effects on cardiovascular system, and pentoxifylline is known to decrease blood viscosity and improve blood flow to the heart. This study investigated the pharmacokinetics and pharmacodynamics following oral administration of pimobendan-pentoxifylline powder mixture in dogs. Eight healthy dogs were included and were divided into control (n = 4) and experimental (n = 4) groups. Vehicle powder and pimobendan-pentoxifylline powder mixture (pimobendane 0.25 mg/kg, pentoxifylline 15 mg/kg) were administrated orally to control and experimental groups, respectively. Plasma samples and measurement of echocardiographic indices were obtained for 24 hours following administration. Pimobendan and pentoxifylline concentrations were investigated using liquid chromatography-mass spectrometer (LC-MS) assay. The elimination half-life ($T_{1/2}$) were $2.65{\pm}1.42hours$ for pimobendan and $0.29{\pm}0.23hours$ for pentoxifylline. The time to reach maximum concentration ($T_{max}$) were $1.08{\pm}0.72hours$ for pimobendan and $0.29{\pm}0.14hours$ for pentoxifylline. The maximum blood concentration ($C_{max}$) were $2.83{\pm}1.50ng/mL$ for pimobendan and $1184.33{\pm}932.37ng/mL$ for pentoxifylline. Among echocardiographic indices, fractional shortening (FS), left ventricular internal diameter at end systole (LVIDs), and pre-ejection period (PEP) showed significant changes at 1-4 hours after the administration of pimobendan-pentoxifylline powder mixture. No adverse effects were observed during the investigation. This study demonstrates that pimobendan-pentoxifylline powder mixture can be used to control cardiovascular diseases in dogs.

• Journal of Veterinary Clinics
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• v.38 no.3
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• pp.163-168
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• 2021

A 6-year-old, spayed female, Maltese dog with tachypnea and dry cough was presented to Gyeongsang National University Veterinary Medical Teaching hospital. On physical examination, its respiration rate was 132 per minute. Decreased partial pressure of oxygen, partial pressure of carbon dioxide, and hyperlactatemia were found on arterial blood gas analysis. Its diastolic blood pressure was 80 mmHg. Auscultation revealed arrhythmia. Electrocardiogram revealed P pulmonale, P mitrale, and ventricular premature complexes. Thoracic radiographs revealed mild enlargement of both atrium and moderate enlargement of the left ventricular. There was also a moderate alveolar pattern in the right and caudal part of the left cranial lung lobe. Two-dimensional echocardiography showed enlargement of generalized four chambers without remarkable findings of valvular degeneration. M-mode echocardiography showed decreased left ventricular fractional shortening and enlarged left ventricular internal diameter at both end-systolic and end-diastolic. Color-flow Doppler imaging revealed eccentric turbulent flow starting below the left ventricular outflow tract and extending into the left atrium during systole. Spectral Doppler recordings revealed a high velocity flow through the mitral, tricuspid, aorta, and pulmonic regurgitation. Restrictive transmitral flow revealed high E-wave velocity, short E-wave deceleration time, and reduced A-wave velocity. There was also low ejection velocity thorough left ventricular out tract flow. Based on echocardiographic examination, dilated cardiomyopathy was the tentative diagnosis. The dog was medicated with inotropes, angiotensin converting enzyme inhibitor, and diuretics. At the 10-day following-up, the dog died suddenly. This report describes echocardiographic diagnosis and prognosis of dilated cardiomyopathy rarely reported in small breed dogs.

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1266-1278
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• 2021

Objective: We aimed to compare the aortic valve area (AVA) calculated using fast high-resolution three-dimensional (3D) magnetic resonance (MR) image acquisition with that of the conventional two-dimensional (2D) cine MR technique. Materials and Methods: We included 139 consecutive patients (mean age ± standard deviation [SD], 68.5 ± 9.4 years) with aortic valvular stenosis (AS) and 21 asymptomatic controls (52.3 ± 14.2 years). High-resolution T2-prepared 3D steady-state free precession (SSFP) images (2.0 mm slice thickness, 10 contiguous slices) for 3D planimetry (3DP) were acquired with a single breath hold during mid-systole. 2D SSFP cine MR images (6.0 mm slice thickness) for 2D planimetry (2DP) were also obtained at three aortic valve levels. The calculations for the effective AVA based on the MR images were compared with the transthoracic echocardiographic (TTE) measurements using the continuity equation. Results: The mean AVA ± SD derived by 3DP, 2DP, and TTE in the AS group were 0.81 ± 0.26 cm², 0.82 ± 0.34 cm², and 0.80 ± 0.26 cm², respectively (p = 0.366). The intra-observer agreement was higher for 3DP than 2DP in one observer: intraclass correlation coefficient (ICC) of 0.95 (95% confidence interval [CI], 0.94-0.97) and 0.87 (95% CI, 0.82-0.91), respectively, for observer 1 and 0.97 (95% CI, 0.96-0.98) and 0.98 (95% CI, 0.97-0.99), respectively, for observer 2. Inter-observer agreement was similar between 3DP and 2DP, with the ICC of 0.92 (95% CI, 0.89-0.94) and 0.91 (95% CI, 0.88-0.93), respectively. 3DP-derived AVA showed a slightly higher agreement with AVA measured by TTE than the 2DP-derived AVA, with the ICC of 0.87 (95% CI, 0.82-0.91) vs. 0.85 (95% CI, 0.79-0.89). Conclusion: High-resolution 3D MR image acquisition, with single-breath-hold SSFP sequences, gave AVA measurement with low observer variability that correlated highly with those obtained by TTE.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.511-516
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• 2002

Background: This study was undertaken in infant patients with isolated ventricular septal defect(VSD) to determine the effect of surgical closure on ventricular systolic time interval, as a parameter for ventricular performance, by echocardiography. Material and Method: Thirty patients were enrolled. Mean age of patients at operation was 6.5$\pm$3.2 months and all patients had non-restrictive VSD. We checked the left atrium/aorta(LA/Ao) ratio, left ventricle ejection fraction(EF), left ventricular systolic time interval(LVSTI), and right ventricular systolic time interval(RVSTI). Echocardiographic studies were done before surgical correction and postoperative periods(postopl: within 2 weeks, postop2: between 4 and 6 months, postop3: between 1 and 2 years). Result: LA/Ao ratio decreased significantly at immediate postoperative period compared to preoperative period and sustained during further follow-up period(from 1.74$\pm$0.37 to 1.36$\pm$0.24＊, 1.32$\pm$0.22＊, and 1.27$\pm$0.19＊, p<0.01). LV EF had not changed during follow-up periods(from 65.1$\pm$7.0 to 62.3$\pm$9.5, 62.8$\pm$5.7, and 64.1$\pm$6.9). LVSTI decreased significantly at postop2 and sustained during further follow-up period (from 0.46$\pm$0.13 to 0.46$\pm$0.11, 0.37$\pm$0.08＊, and 0.34$\pm$0.07＊, p<0.01). RVSTI decreased significantly at postop3(0.33$\pm$0.08 to 0.32$\pm$0.08, 0.31$\pm$0.07, and 0.27$\pm$0.05＊, p<0.01). Conclusion: We found that right and left ventricular systolic time intervals had decreased over the period of 1 year after surgical correction of VSD. Therefore, it is necessary to observe the change of ventricular function during that period.