• Title/Summary/Keyword: cardiovascular events

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Triglyceride-Rich Lipoproteins and Novel Targets for Anti-atherosclerotic Therapy

  • Reiner, Zeljko
    • Korean Circulation Journal
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    • v.48 no.12
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    • pp.1097-1119
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    • 2018
  • Although elevated serum low-density lipoprotein-cholesterol (LDL-C) is without any doubts accepted as an important risk factor for cardiovascular disease (CVD), the role of elevated triglycerides (TGs)-rich lipoproteins as an independent risk factor has until recently been quite controversial. Recent data strongly suggest that elevated TG-rich lipoproteins are an independent risk factor for CVD and that therapeutic targeting of them could possibly provide further benefit in reducing CVD morbidity, events and mortality, apart from LDL-C lowering. Today elevated TGs are treated with lifestyle interventions, and with fibrates which could be combined with omega-3 fatty acids. There are also some new drugs. Volanesorsen, is an antisense oligonucleotid that inhibits the production of the Apo C-III which is crucial in regulating TGs metabolism because it inhibits lipoprotein lipase (LPL) and hepatic lipase activity but also hepatic uptake of TGs-rich particles. Evinacumab is a monoclonal antibody against angiopoietin-like protein 3 (ANGPTL3) and it seems that it can substantially lower elevated TGs levels because ANGPTL3 also regulates TGs metabolism. Pemafibrate is a selective peroxisome proliferator-activated receptor alpha modulator which also decreases TGs, and improves other lipid parameters. It seems that it also has some other possible antiatherogenic effects. Alipogene tiparvovec is a nonreplicating adeno-associated viral vector that delivers copies of the LPL gene to muscle tissue which accelerates the clearance of TG-rich lipoproteins thus decreasing extremely high TGs levels. Pradigastat is a novel diacylglycerol acyltransferase 1 inhibitor which substantially reduces extremely high TGs levels and appears to be promising in treatment of the rare familial chylomicronemia syndrome.

Panax ginseng: Inflammation, platelet aggregation, thrombus formation, and atherosclerosis crosstalk

  • Lee, Yuan Yee;Kim, Sung Dae;Park, Seung-Chun;Rhee, Man Hee
    • Journal of Ginseng Research
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    • v.46 no.1
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    • pp.54-61
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    • 2022
  • Ginseng has been widely studied due to its various therapeutic properties on various diseases such as cardiovascular disease (CVD). Cardiovascular disease has been canonically known to be caused by high levels of low-density lipoproteins (LDL) in the bloodstream, in addition to the impaired vasodilatory effects of cholesterol. However, current research on CVD has revealed a cascade of mechanisms involving a series of events that contribute to the progression of CVD. Although this has been elucidated and summarized in previous studies the detailed correlation between platelet aggregation and innate immunity that plays an important role in CVD progression has not been thoroughly summarized. Furthermore, immune cell subtypes also contribute to the progression of plaque formation in the subendothelial layer. Thrombus formation and the coagulation cascade also have a vital role in the progression of atherosclerosis. Hence, in this mini review we aim to elucidate, summarize, and propose the potent therapeutic effect of ginseng on CVD, mainly on platelet aggregation, plaque formation, and thrombus formation.

Application of Quantitative Assessment of Coronary Atherosclerosis by Coronary Computed Tomographic Angiography

  • Su Nam Lee;Andrew Lin;Damini Dey;Daniel S. Berman;Donghee Han
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.518-539
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    • 2024
  • Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

  • Notara, Venetia;Panagiotakos, Demosthenes B.;Kogias, Yannis;Stravopodis, Petros;Antonoulas, Antonis;Zombolos, Spyros;Mantas, Yannis;Pitsavos, Christos
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.4
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    • pp.220-229
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    • 2016
  • Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

Psychophysiological Response by Imagination and Talking about Anger-Provoked Event in Hwa-byung:Cardiovascular Response (소위 '홧병'에서 분노유발사건의 상상과 이야기작업에 의한 정신생리반응:심혈관계 반응)

  • Chung, Sang-Keun;Shin, Jun-Ho;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.109-114
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    • 2000
  • Objectives: This study was performed to examine the characteristic cardiovascular response patterns associated with the imagination and discussion of anger-provoked events in patients with hwa-byung. Methods: Forty-three female patients with hwa-byung were evaluated with the Korean version of the State-Trait Anger Expression Inventory, the State-Trait Anxiety Inventory, Hamilton Rating Scale for Anxiety, Beck Depression Inventory, and Hamilton Rating Scale for Depression just before the task. Subjective Units of Distress (SUDS) and Vividness of the event (VIVID) during the imagination and discussion of the event were evaluated immediately after tasks. Blood pressure (BP) and heart rate (HR) during baseline, rest, and tasks were also evaluated. Results: Both startle and recovery responses of BP, startle response of HR, SUDS, and VIVID in discussion task were significantly larger than in the imagination task. Conclusion: Results suggest that it is undesirable for the patients to excessively and repeatedly recall and talk about the anger events.

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A Clinical Study of Isolated Aortic Valve Replacement with CarboMedics and St. Jude Prosthesis (카보메딕스 대동맥판막과 쎈트쥬드 대동맥판막의 임상성적)

  • Kim, Wook-Sung;Kim, Ki-Bong;Anh, Hyuk;Chae, Hurn;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.781-786
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    • 1998
  • Materials and methods: Between 1984 to 1994, 136 patients underwent primary and isolated aortic valve replacement with 79 Carbomedics and 57 St. Jude prostheses. Results: Age ranged from 16 to 67 year(mean : 44.5${\pm}$12.7 years). Statistically significant differences in preoperative clinical characteristics between two groups were not found. There was one early death in the St. Jude group and none in the Carbomedics group. Early prosthetic valve-related complications including death were not significantly different between the two groups(p value= 0.572). One hundred thirty five early survivors were followed for a total of 354.2 patient-years(mean=31.5${\pm}$16 months). In the CarboMedics group, actuarial survial rate at 5 years was 97.1${\pm}$1.9%, and in the St. Jude group, it was 95.9${\pm}$2.8%. In the CarboMedics group, actuarial free rate from all valve-related events at 5 years was 92.1${\pm}$3.1%, and in St. Jude group, it was 89.8${\pm}$5.0%. Conclusion: We conclude that early and late results after performing isolated aortic valve replacement with CarboMedics and St. Jude valve are not significantlly different.

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A prospective study to assess the efficacy and safety of oral propranolol as first-line treatment for infantile superficial hemangioma

  • Yun, Yeong Ju;Gyon, Yun Hee;Yang, Sohyoung;Lee, Youn Kyung;Park, Joohyun;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.484-490
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    • 2015
  • Purpose: To determine the efficacy and safety of oral propranolol as a first-line treatment for superficially located infantile hemangioma (IH) and propose an assessment tool to measure treatment response. Methods: Patients with superficial IH under 1 year of age were prospectively recruited between May 2012 and December 2013 at the Department of Pediatrics of Chungbuk National University Hospital. Propranolol was administered to 12 infants (median age, 3.8 months) while monitoring cardiovascular and adverse metabolic effects. If a patient showed no adverse events, the dosage was gradually increased up to 3 mg/kg/day and maintained for 1 year. We used our own scoring system to assess treatment response using parameters like change in color, and longest diameter, and thickness of the IH. Results: Eleven out of 12 patients completed the protocol with consistent improvement of hemangiomas during therapy. Patients on propranolol showed a more than 50% involution in the first 3 months, with additional steady involution until 1 year. Patients with the highest scores at 1 month maintained their score and showed better responses until treatment termination. The patient with the lowest score at 1 month did not show any further regression and stopped propranolol treatment 4 months after initiation. In two children with recurrences after successful therapeutic regression, propranolol was effective after being reintroduced. Propranolol treatment was not interrupted in any patient due to adverse events. Conclusion: Oral propranolol at 3 mg/kg/day showed a consistent, rapid, and therapeutic effect on superficial IHs without significant adverse events.

Electrospray-Mass Spectrometric Analysis of Plasma Pyrophosphates Separated on a Multi-Modal Liquid Chromatographic Column

  • Lee, Su-Hyeon;Lee, Jeong-Ae;Lee, Won-Yong;Chung, Bong-Chul;Choi, Man-Ho
    • Mass Spectrometry Letters
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    • v.2 no.4
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    • pp.92-95
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    • 2011
  • Pyrophosphates are the key intermediates in the biosynthesis of isoprenoids, and their concentrations could reveal the benefits of statins in cardiovascular diseases. Quantitative analysis of five pyrophosphates, including isopentenyl pyrophosphate (IPP), dimethylallyl pyrophosphate (DMAPP), geranyl pyrophosphate (GPP), farnesyl pyrophosphate (FPP), and geranylgeranyl pyrophosphate (GGPP), was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in negative ionization mode. After dilution with methanol, samples were separated on a 3 ${\mu}m$ particle multi-modal $C_{18}$ column ($50{\times}2$ mm) and quantified within 10 min. The gradient elution consists of 10 mM ammonium bicarbonate and 0.5% triethylamine (TEA) in water and 0.1% TEA in 80% acetonitrile was used at the flow rate of 0.4 mL/min. Overall recoveries were 51.4-106.6%, while the limit of quantification was 0.05 ${\mu}g$/mL for GPP and FPP and 0.1 ${\mu}g$/mL for IPP, DMAPP, and GGPP. The precision (% CV) and accuracy (% bias) of the assay were 1.9-12.3% and 89.6-111.8%, respectively, in 0.05-10 ${\mu}g$/mL calibration ranges ($R^2$ > 0.993). The devised LC-MS/MS technique with the multi-modal $C_{18}$ column can be used to estimate the biological activity of pyrophosphates in plasma and may be applicable to cardiovascular events with cholesterol metabolism as well as the drug efficacy of statins.

Wearable Intelligent Systems for E-Health

  • Poon, Carmen C.Y.;Liu, Qing;Gao, Hui;Lin, Wan-Hua;Zhang, Yuan-Ting
    • Journal of Computing Science and Engineering
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    • v.5 no.3
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    • pp.246-256
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    • 2011
  • Due to the increasingly aging population, there is a rising demand for assistive living technologies for the elderly to ensure their health and well-being. The elderly are mostly chronic patients who require frequent check-ups of multiple vital signs, some of which (e.g., blood pressure and blood glucose) vary greatly according to the daily activities that the elderly are involved in. Therefore, the development of novel wearable intelligent systems to effectively monitor the vital signs continuously over a 24 hour period is in some cases crucial for understanding the progression of chronic symptoms in the elderly. In this paper, recent development of Wearable Intelligent Systems for e-Health (WISEs) is reviewed, including breakthrough technologies and technical challenges that remain to be solved. A novel application of wearable technologies for transient cardiovascular monitoring during water drinking is also reported. In particular, our latest results found that heart rate increased by 9 bpm (P < 0.001) and pulse transit time was reduced by 5 ms (P < 0.001), indicating a possible rise in blood pressure, during swallowing. In addition to monitoring physiological conditions during daily activities, it is anticipated that WISEs will have a number of other potentially viable applications, including the real-time risk prediction of sudden cardiovascular events and deaths.

Interhospital Transport System for Critically Ill Patients: Mobile Extracorporeal Membrane Oxygenation without a Ventilator

  • Yeo, Hye Ju;Cho, Woo Hyun;Park, Jong Myung;Kim, Dohyung
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.8-13
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    • 2017
  • Background: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services. Methods: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015. We retrospectively analyzed the indications for ECMO, the patient status during transport, and the patient outcomes. Results: All transport was conducted on the ground by ambulance. The distances covered ranged from 26 to 408 km (mean, $65.9{\pm}88.1km$) and the average transport time was $56.1{\pm}57.3minutes$ (range, 30 to 280 minutes). All patients were transported without adverse events. After transport, 4 patients (22.2%) underwent lung transplantation because of interstitial lung disease. Eight patients who had severe acute respiratory distress syndrome showed recovery of heart and lung function after ECMO therapy. A total of 13 patients (70.6%) were successfully taken off ECMO, and 11 patients (61.1%) survived. Conclusion: Our ECMO transport system without mechanical ventilation can be considered a safe and useful method for interhospital transport and could be a good alternative option for ECMO transport in Korean hospitals with limited resources.