• 제목/요약/키워드: cardiovascular events

검색결과 254건 처리시간 0.024초

Anti-VEGF Therapy with Bevacizumab - Limited Cardiovascular Toxicity

  • Yu, Jing;Cao, Xu-Fen;Zheng, Ye;Zhao, Rong-Cheng;Yan, Li-Qiu;Zhao, Lei;Wang, Jia-Wang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10769-10772
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    • 2015
  • Purpose: This analysis was conducted to evaluate cardiovascular toxicity of commonly used anti-VEGF therapeutic agent, bevacizumab, in treating patients with cancer. Methods: Clinical studies evaluating the efficacy and safety of bevacizumab-based regimens on response and safety for patients with cancer were identified using a predefined search strategy, allowing cardiovascular toxicity and other side effects of treatment to be estimated. Results: In bevacizumab based regimens, 4 clinical studies including 282 patients with advanced cancer (including gliomas, cervical, breast and ovarian cancer) were considered eligible for inclusion. These bevacizumab-based regimens included docetaxel, irinitecan and carboplatin. Systematic analysis suggested that, of 282 patients treated by bevacizumab based regimens, hypertension and thrombo-embolism occurred in 2.5% (7/282), while only 3 patients reported cardiovascular events (1.1%). No treatment related death occurred in bevacizumab based treatment. Conclusion: This systemic analysis suggests that bevacizumab based regimens are associated with reasonable and accepted cardiovascular toxicity when treating patients with gliomas, cervical, breast and ovarian cancer.

N-Terminal Pro-B-type Natriuretic Peptide Is Useful to Predict Cardiac Complications Following Lung Resection Surgery

  • Lee, Chang-Young;Bae, Mi-Kyung;Lee, Jin-Gu;Kim, Kwan-Wook;Park, In-Kyu;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • 제44권1호
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    • pp.44-50
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    • 2011
  • Background: Cardiovascular complications are major causes of morbidity and mortality following non-cardiac thoracic operations. Recent studies have demonstrated that elevation of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) levels can predict cardiac complications following non-cardiac major surgery as well as cardiac surgery. However, there is little information on the correlation between lung resection surgery and NT-proBNP levels. We evaluated the role of NT-proBNP as a potential marker for the risk stratification of cardiac complications following lung resection surgery. Material and Methods: Prospectively collected data of 98 patients, who underwent elective lung resection from August 2007 to February 2008, were analyzed. Postoperative adverse cardiac events were categorized as myocardial injury, ECG evidence of ischemia or arrhythmia, heart failure, or cardiac death. Results: Postoperative cardiac complications were documented in 9 patients (9/98, 9.2%): Atrial fibrillation in 3, ECG-evidenced ischemia in 2 and heart failure in 4. Preoperative median NT-proBNP levels was significantly higher in patients who developed postoperative cardiac complications than in the rest (200.2 ng/L versus 45.0 ng/L, p=0.009). NT-proBNP levels predicted adverse cardiac events with an area under the receiver operating characteristic curve of 0.76 [95% confidence interval (CI) 0.545~0.988, p=0.01]. A preoperative NT-proBNP value of 160 ng/L was found to be the best cut-off value for detecting postoperative cardiac complication with a positive predictive value of 0.857 and a negative predictive value of 0.978. Other factors related to cardiac complications by univariate analysis were a higher American Society of Anesthesiologists grade, a higher NYHA functional class and a history of hypertension. In multivariate analysis, however, high preoperative NT-proBNP level (>160 ng/L) only remained significant. Conclusion: An elevated preoperative NT-proBNP level is identified as an independent predictor of cardiac complications following lung resection surgery.

The Treatment of Left Atrial Appendage Aneurysm by a Minimally Invasive Approach

  • Kim, Young Woong;Kim, Ho Jin;Ju, Min Ho;Lee, Jae Won
    • Journal of Chest Surgery
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    • 제51권2호
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    • pp.146-148
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    • 2018
  • Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA). However, follow-up computed tomography showed residual communication, so the patient is still taking warfarin. We report that a minimally invasive strategy for treating LAA aneurysm can be considered, but incomplete closure may occur; thus, caution is needed.

Pulmonary Embolism Caused by Popliteal Venous Aneurysm

  • Hong, Daejin;Song, Suk-Won
    • Journal of Chest Surgery
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    • 제46권1호
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    • pp.76-79
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    • 2013
  • Venous aneurysms are uncommon in the lower limb and are more frequently found in the neck and thoracic and visceral veins. However, they have been reported to cause thrombosis, pulmonary thromboembolism, and other related complications. Popliteal venous aneurysms are often undetected because they are usually asymptomatic, but they may cause pulmonary thromboembolic events. We experienced a case of a 44-year-old man who was referred for recurrent pulmonary thromboembolism. He showed no other symptoms or signs except shortness of breath. A popliteal venous aneurysm was diagnosed incidentally because the examinations were performed to detect a deep vein thrombosis in relationship to the patient's history of pulmonary thromboembolism. We report a case of surgical treatment for a popliteal venous aneurysm that was complicated by pulmonary thromboembolism.

Total Occlusion of the Abdominal Aorta Caused by Detachment of Cardiac Myxoma

  • Hong, Sung-Yong;Park, Kyung-Taek;Choe, Hyun-Min
    • Journal of Chest Surgery
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    • 제45권3호
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    • pp.183-185
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    • 2012
  • Abdominal aortic occlusion (AAO) caused by detachment of cardiac myxoma (CM) is a very rare complication in patients with CM. Although the nature of CMs has been well established, detachment of CM may cause unexpected serious complications such as vicious embolic events. Actually, in several cases of AAO caused by detachment of CM, it has been reported that CM fragments easily migrated to the brain, heart, and lungs, and caused lifelong neurological complications despite appropriate surgical therapy. Herein, we report a case of a patient with AAO caused by detachment of CM who underwent CM excision and abdominal aortic thromboembolectomy. Additionally, we have presented the preoperative and postoperative images using 64-multidetector computed tomography.

세포-시스템 차원의 혈류역학적 심혈관 시스템 모델의 개발 (Development of an integrative cardiovascular system model including cell-system and arterial network)

  • 심은보;전형민
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2008년도 춘계학술대회논문집
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    • pp.542-546
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    • 2008
  • In this study, we developed a whole cardiovascular system model combined with a Laplace heart based on the numerical cardiac cell model and a detailed arterial network structure. The present model incorporates the Laplace heart model and pulmonary model using the lumped parameter model with the distributed arterial system model. The Laplace heart plays a role of the pump consisted of the atrium and ventricle. We applied a cellular contraction model modulated by calcium concentration and action potential in the single cell. The numerical arterial model is based upon a numerical solution of the one-dimensional momentum equations and continuity equation of flow and vessel wall motion in a geometrically accurate branching network of the arterial system including energy losses at bifurcations. For validation of the present method, the computed pressure waves are compared with the existing experimental observations. Using the cell-system-arterial network combined model, the pathophysiological events from cells to arterial network are delineated.

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Effect of Postoperative Constrictive Physiology on Early Outcomes after Off-Pump Coronary Artery Bypass Grafting

  • Kim, Jung-Hwan;Hwang, Yoo-Hwa;Youn, Young-Nam;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • 제46권1호
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    • pp.22-26
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    • 2013
  • Background: Constrictive pericarditis after coronary artery bypass surgery has been known to affect cardiac output by limiting diastolic ventricular filling. We aimed to assess the influence of postoperative constrictive physiology on the early outcomes of patients undergoing off-pump coronary artery bypass grafting (OPCAB). Materials and Methods: Between January 2008 and July 2011, 903 patients underwent an isolated OPCAB and postoperative transthoracic-echocardiography. The patient cohort was classified into two groups: group A, constrictive physiology and group B, control group without constrictive physiology. Early outcomes were analyzed between the two groups. Results: Of the total 903 patients, group A consisted of 153 patients (16.9%). The amount of blood loss in group A during the postoperative 24 hours was greater than that of group B, but this was not statistically significant (p=0.20). No significant differences were found in the mortality rates (group A, 0.6%; group B, 1.4%; p=0.40) and 30-day major adverse cardiac and cerebrovascular events (MACCEs; group A, 3.3%; group B, 6.1%; p=0.42). Conclusion: Postoperative constrictive physiology does not affect 30-day MACCEs or other major complications after OPCAB. The results of this study suggest that patients with early postoperative constrictive physiology do not need medical or surgical treatment, and that conservative care is sufficient.

KSP inhibitor SB743921 induces death of multiple myeloma cells via inhibition of the NF-κB signaling pathway

  • Song, In-Sung;Jeong, Yu Jeong;Nyamaa, Bayalagmaa;Jeong, Seung Hun;Kim, Hyoung Kyu;Kim, Nari;Ko, Kyung Soo;Rhee, Byoung Doo;Han, Jin
    • BMB Reports
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    • 제48권10호
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    • pp.571-576
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    • 2015
  • SB743921 is a potent inhibitor of the spindle protein kinesin and is being investigated in ongoing clinical trials for the treatment of myeloma. However, little is known about the molecular events underlying the induction of cell death in multiple myeloma (MM) by SB743921, alone or in combination treatment. Here, we report that SB743921 induces mitochondria-mediated cell death via inhibition of the $NF-{\kappa}B$ signaling pathway, but does not cause cell cycle arrest in KMS20 MM cells. SB743921-mediated inhibition of the $NF-{\kappa}B$ pathway results in reduced expression of SOD2 and Mcl-1, leading to mitochondrial dysfunction. We also found that combination treatment with SB743921 and bortezomib induces death in bortezomib-resistant KMS20 cells. Altogether, these data suggest that treatment with SB743921 alone or in combination with bortezomib offers excellent translational potential and promises to be a novel MM therapy.

Antihyperlipidemic and Antioxidant Effects of the Mixture of Ginseng Radix and Crataegi Fructus: Experimental Study and Preliminary Clinical Results

  • Ko, Chang-Nam;Park, Seong-Uk;Chang, Gyu-Tae;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Jung-Mi;Cho, Ki-Ho
    • Journal of Ginseng Research
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    • 제35권2호
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    • pp.162-169
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    • 2011
  • The mixture of Ginseng Radix and Crataegi Fructus (Gen-CF) was developed to increase the pharmacological effect of ginseng in the treatment of hypercholesterolemia and prevention of cardiovascular disease. This study evaluated the effects of Gen-CF on serum lipids of hypercholesterolemic rats in vivo, as well as its antioxidant activities in vitro, and explored its clinical effects on patients with hypercholesterolemia. In vitro, Gen-CF displayed 1,1-diphenyl-2-picrylhydrasyl and superoxide radical scavenging activities, and inhibited hemolysis induced by 2,2'-azobis-2-amidinopropane dihydrochloride in a dose-dependent manner. In vivo, Gen-CF significantly inhibited the increases of total cholesterol, low-density lipoprotein cholesterol and triglyceride in high cholesterol-diet and Triton WR-1339 models. It also significantly inhibited the decrease of high-density lipoprotein cholesterol in these models. In the clinical trial, Gen-CF significantly lowered total cholesterol, low-density lipoprotein cholesterol, triglyceride, total lipid and phospholipid, with no adverse events, including hepatic or renal toxicity. The data suggest that Gen-CF has the potential to treat hypercholesterolemia and prevent cardiovascular disease.

Mid-Term Results of Minimally Invasive Direct Coronary Artery Bypass Grafting

  • Seo, Dong Hyun;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong;Chung, Su Ryeun;Kim, Dong Jung
    • Journal of Chest Surgery
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    • 제51권1호
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    • pp.8-14
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    • 2018
  • Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data - including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention - were collected. Results: The mean age of the patients was $69.4{\pm}11.1years$ and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in the intensive care u nit and in the hospital were 1.5 and 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of $85.3%{\pm}0.09%$ and a 5-year MACCE-free survival rate of $72.8%{\pm}0.1%$. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at $9.7{\pm}10.8months$ postoperatively. Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.