• Title/Summary/Keyword: cardiac risk factor

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Association between metabolic syndrome components and cardiac autonomic modulation in southern Indian adults with pre-metabolic syndrome: hyperglycemia is the major contributing factor

  • Endukuru Chiranjeevi Kumar;Girwar Singh Gaur;Dhanalakshmi Yerrabelli;Jayaprakash Sahoo;Balasubramaniyan Vairappan;Alladi Charanraj Goud
    • The Korean Journal of Physiology and Pharmacology
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    • v.27 no.1
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    • pp.49-59
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    • 2023
  • Metabolic syndrome (MetS) involves multi-factorial conditions linked to an elevated risk of type 2 diabetes mellitus and cardiovascular disease. Pre-metabolic syndrome (pre-MetS) possesses two MetS components but does not meet the MetS diagnostic criteria. Although cardiac autonomic derangements are evident in MetS, there is little information on their status in pre-MetS subjects. In this study, we sought to examine cardiac autonomic functions in pre-MetS and to determine which MetS component is more responsible for impaired cardiac autonomic functions. A total of 182 subjects were recruited and divided into healthy controls (n=89) and pre-MetS subjects (n=93) based on inclusion and exclusion criteria. We performed biochemical profiles on fasting blood samples to detect pre-MetS. Using standardized protocols, we evaluated anthropometric data, body composition, baroreflex sensitivity (BRS), heart rate variability (HRV), and autonomic function tests (AFTs). We further examined these parameters in pre-MetS subjects for each MetS component. Compared to healthy controls, we observed a significant cardiac autonomic dysfunction (CAD) through reduced BRS, lower overall HRV, and altered AFT parameters in pre-MetS subjects, accompanied by markedly varied anthropometric, clinical and biochemical parameters. Furthermore, all examined BRS, HRV, and AFT parameters exhibited an abnormal trend and significant correlation toward hyperglycemia. This study demonstrates CAD in pre-MetS subjects with reduced BRS, lower overall HRV, and altered AFT parameters. Hyperglycemia was considered an independent determinant of alterations in all the examined BRS, HRV, and AFT parameters. Thus, hyperglycemia may contribute to CAD in pre-MetS subjects before progressing to MetS.

Neurologic Outcomes of Preoperative Acute Silent Cerebral Infarction in Patients with Cardiac Surgery

  • Sim, Hyung Tae;Kim, Sung Ryong;Beom, Min Sun;Chang, Ji Wook;Kim, Na Rae;Jang, Mi Hee;Ryu, Sang Wan
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.510-516
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    • 2014
  • Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI. Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was $68.8{\pm}9.5$ years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies. Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions. Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

Anti-dyslipidemic Effect of ACLL extract (Artemisia capillaris Thunb, Curcuma longa L, Lycium chinense, Ligustrum lucidum Aiton complex extract) on High Cholesterol Diet-induced Dyslipidemia in Mice (인진, 울금, 구기자, 여정자 복합추출물(ACLL)의 항이상지질혈증 효능에 대한 실험적 연구)

  • Kim, Tae Youn;Oh, Jeong Min;Kim, Yoon Sik;Jo, Hyun Kyung;Yoo, Ho Rhyong;Seol, In Chan
    • Journal of Haehwa Medicine
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    • v.25 no.1
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    • pp.133-144
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    • 2016
  • Objectives : This study was aimed to investigate the effect of ACLL extract (Artemisia capillaris Thunb, Curcuma longa L, Lycium chinense, Ligustrum lucidum Aiton complex extract) in a dyslipidemia animal model induced by a high-fat diet. Methods : ACLL extracts was administered at 200 mg/kg, and 400 mg/kg to Apoe mice, where arthritis was induced by high cholesterol diet. After mice were treated with GO for 4 weeks, we measured AST, ALT, BUN and lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride), atherogenic index(AI) and cardiac risk factor(CRF). Results : Serum AST, ALT, creatinine, BUN levels were not changed by ACLL extract do not show any toxic effects. Also, ACLL extract groups were found to have atherogenic Index and cardiac risk factor as well as lipid metabolism improvement (total cholesterol, LDL cholesterol and triglyceride decrease). Conclusions : We suggest that ACLL extract may have the control effects of Dyslipidemia by improving lipid metabolism.

Hypolipidaemic Effect of Hericium erinaceum Grown in Artemisia capillaris on Obese Rats

  • Choi, Won-Sik;Kim, Young-Sun;Park, Byeoung-Soo;Kim, Jang-Eok;Lee, Sung-Eun
    • Mycobiology
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    • v.41 no.2
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    • pp.94-99
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    • 2013
  • In this study, ethanolic extracts from Hericium erinaceum cultivated with Artemisia capillaris (HEAC) were assessed for their ability to lower the cholesterol levels of male Sprague-Dawley rats fed a high-fat diet. Rats were randomly subdivided into seven test groups. Each group contained eight rats fed a high-fat diet during a growth period lasting 4 wk. Supplementation with the extracts was performed once a day for 2 wk after the high-fat diet. The control group (rats fed a high-fat diet) showed a high efficiency ratio (feed efficiency ratio) value compared to the normal group. Biochemical parameters, including total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), and triglyceride (TG) levels dramatically increased in the control group compared to the normal group. High-density lipoprotein-cholesterol (HDL-c) content in the control group was also significantly lower relative to the normal group. Two positive control groups, treated with simvastatin and atorvastatin, had lowered TC, LDL-c, and TG levels, and increased HDL-c content compared to the control group. Treatment with the tested extracts, including HEAC, ethanolic extracts from Hericium erinaceum, and ethanolic extracts from Artemisia capillaris reduced TC, LDL-c, and TG levels and elevated HDL-c content in the hyperlipidemia rats. The atherogenic index and cardiac risk factor values for the HEAC-treated group were 0.95 and 1.95, respectively. Simvastatin- and atorvastatin-treated groups showed atherogenic index values of 1.56 and 1.69, respectively, and cardiac risk factor values of 2.56 and 2.69, respectively. These results show HEAC possesses an ability to cure hyperlipidemia in rats and may serve as an effective natural medicine for treating hyperlipidemia in humans.

The Analysis of Type D Personality Research as a Psychosocial Risk Factor in Cardiovascular Disease for Elders with a Chronic Disease (심혈관질환의 심리사회적 위험요인으로써의 D유형 성격에 관한 논문 분석)

  • Song, Eun-Kyeung;Son, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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    • pp.19-28
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    • 2008
  • Purpose: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. Method: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. Result: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. Conclusion: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

Cardiovascular Disease and Personality Trait (심혈관 질환과 인격 특성)

  • Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.2
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    • pp.81-87
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    • 2006
  • A lot of studies have investigated the role of psychosocial and behavioral risk factors in the etiology and pathogenesis of cardiovascular disease. On the basis of prospective population studies that found a relationship between Type A behavior and cardiac morbidity and mortality independent of traditional risk factors, Type A behavior was declared a risk factor for the development of coronary heart disease. Additionally, recently proposed, a new personality construct, Type D personality have been reported to be associated with the increased risk for cardiovascular morbidity and mortality. In Korea, however, there were few studies about these issues. This article attempts to provide an overview of accumulating evidences on the Type A behavioral pattern and Type D personality related with cardiovascular disease to offer new directions for research.

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N-terminal Pro-B-type Natriuretic Peptide as a Predictive Risk Factor in Fontan Operation (Fontan 수술시 위험 예측인자로서의 N-Terminal Pro-B-type Natriuretic Peptide의 유용성)

  • Jang, Gi Young;Lee, Jae Young;Kim, Soo Jin;Shim, Woo Sup
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1362-1369
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    • 2005
  • Purpose : This study aimed to investigate the correlation between the plasma level of N-terminal pro-B-type natriuretic peptide(pro-BNP) and several known risk factors influencing outcomes after Fontan operations, and to assess whether pro-BNP levels can be used as predictive risk factors in Fontan operations. Methods : Plasma pro-BNP concentrations were measured in 35 patients with complex cardiac anomalies before catheterization. Cardiac catheterization was performed in all subjects. Mean right atrium pressure, mean pulmonary artery pressure(PAP), and ventricular end-diastolic pressure(EDP) were obtained. Cardiac output and pulmonary vascular resistance were calculated by Fick method. Results : Plasma pro-BNP levels exhibited statistically significant positive correlations with mean PAP(r=0.70, P<0.001), pulmonary vascular resistance(r=0.57, P<0.001), RVEDP(r=0.63, P<0.001), LVEDP(r=0.74, P<0.001), and cardiothoracic ratio(r=0.71, P<0.001). The area under the ROC curve using pro-BNP level to differentiate risk groups in Fontan operations was high : 0.868(95 percent CI, 0.712-1.023, P<0.01). The cutoff value of pro-BNP concentrations for the detection of risk groups in Fontan operations was determined to be 332.4 pg/mL(sensitivity 83.3 percent, specificity 82.7 percent). Conclusion : These data suggest that plasma pro-BNP levels may be used as a predictive risk factor in Fontan operations, and as a guide to determine the mode of therapy during follow-up after Fontan operations.

Outcomes after Extracorporeal Membrane Oxygenation in Neonates with Congenital Diaphragmatic Hernia: A Single-Center Experience

  • Choi, Wooseok;Cho, Won Chul;Choi, Eun Seok;Yun, Tae-Jin;Park, Chun Soo
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.348-355
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    • 2021
  • Background: Congenital diaphragmatic hernia (CDH) is a rare disease often requiring mechanical ventilation after birth. In severe cases, extracorporeal membrane oxygenation (ECMO) may be needed. This study analyzed the outcomes of patients with CDH treated with ECMO and investigated factors related to in-hospital mortality. Methods: Among 254 newborns diagnosed with CDH between 2008 and 2020, 51 patients needed ECMO support. At Asan Medical Center, a multidisciplinary team approach has been applied for managing newborns with CDH since 2018. Outcomes were compared between hospital survivors and nonsurvivors. Results: ECMO was established at a median of 17 hours after birth. The mean birth weight was 3.1±0.5 kg. Twenty-three patients (23/51, 45.1%) were weaned from ECMO, and 16 patients (16/51, 31.4%) survived to discharge. The ECMO mode was veno-venous in 24 patients (47.1%) and veno-arterial in 27 patients (52.9%). Most cannulations (50/51, 98%) were accomplished through a transverse cervical incision. No significant between-group differences in baseline characteristics and prenatal indices were observed. The oxygenation index (1 hour before: 90.0 vs. 51.0, p=0.005) and blood lactate level (peak: 7.9 vs. 5.2 mmol/L, p=0.023) before ECMO were higher in nonsurvivors. Major bleeding during ECMO more frequently occurred in nonsurvivors (57.1% vs. 12.5%, p=0.007). In the multivariate analysis, the oxygenation index measured at 1 hour before ECMO initiation was identified as a significant risk factor for in-hospital mortality (odds ratio, 1.02; 95% confidence interval, 1.01-1.04; p=0.05). Conclusion: The survival of neonates after ECMO for CDH is suboptimal. Timely application of ECMO is crucial for better survival outcomes.

Risk Factors for Development of Acute Renal Failure in Patient undergoing Open Heart Surgery (개심술 환자의 수술 후 급성 신부전 발생 위험요인)

  • Jeon, Hyun Rye;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1728-1736
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    • 2013
  • The purpose of this study is to identify prognostic predictors of postoperative acute renal failure(ARF) for the patient undergoing cardiac surgery. Retrospectively review the electronic hospital database at a A hospital from Jan 2008 to Dec. 2011. 483 patients were included in this study. They were divided into a occurrence of ARF group(n=59) and a non occurrence of ARF group(n=424). ARF occurred in 59 cases (12.2%). Multi-variable logistic regression analysis identified that preoperative risk factors include creatinine(OR 3.92, p=<.001), advanced age(OR 2.142, p=.015), female(OR 2.165, p=.015), hypertension(OR 2.513, p=.005), NYHA(New York Heart Association) class II(OR 3.081, p=.003), and III(OR 6.759, p=.004), and intraoperative risk factor includes blood transfusion(OR 3.753, p=<.001), and postoperative factors include bilirubin(OR 4.541, p=.028), creatine(OR 8.554, p=.003), and cardiac output(OR 0.214, p=.033) as a prognostic predictors. The development of postoperative ARF could be a reason for increase in rate of complication and mortality after cardiac surgery. therefore the prevention of ARF is of paramount importance and treatment strategies are urgently needed.

Comparative Study of Risk Factors for Ischemic Stroke in Koreans : Multi-center Study (한국인의 허혈성 뇌졸중의 위험요인에 대한 비교고찰 - 다기관 연구)

  • Kim, Hye-Mi;Lee, In-Whan;Shin, Ae-Sook;Kim, Na-Hee;Shim, So-Ra;Kim, Min-Kyung;Na, Byung-Jo;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.870-879
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    • 2010
  • Objective : This study is about stroke risk factors which may differ between countries. Methods : We recruited 1725 ischemic stroke patients from multiple-centers. We analyzed stroke risk factors: hypertension, diabetes mellitus, dyslipidemia, depression, cardiac source, smoking, waist-to hip ratio, alcohol intake, physical activity, and psychosocial stress. We then compared risk factor results from other countries (the INTERSTROKE study) with this study. Results : 10 risk factors are related to stroke incidence. They were somewhat different between this study and the INTERSTROKE study. Conclusions : Hypertension is the most important risk factor of stroke, and other 9 risk factors also should be managed to prevent stroke incidence. Frequency of risk factors were different from the INTERSTROKE study. I think it could be partly due to differences of ethnicity and age. More studies are needed to describe characteristics of risk factors of Koreans.