• Title/Summary/Keyword: diastolic

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Cardiac diastolic dysfunction predicts poor prognosis in patients with decompensated liver cirrhosis

  • Lee, Soon Kyu;Song, Myeong Jun;Kim, Seok Hwan;Ahn, Hyo Jun
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.409-416
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    • 2018
  • Background/Aims: Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cardiac dysfunction in patients with liver cirrhosis (LC). However, the effect of LVDD on survival has not been clarified, especially in decompensated LC. Methods: We prospectively enrolled 70 patients with decompensated LC, including ascites or variceal bleeding, at Daejeon St. Mary's Hospital from April 2013 to April 2015. The cardiac function of these patients was evaluated using 2D echocardiography with tissue Doppler imaging. The diagnosis of LVDD was based on the American Society of Echocardiography guidelines. The primary endpoint was overall survival. Results: Forty-four patients (62.9%) had LVDD. During follow-up (22.3 months), 18 patients died (16 with LVDD and 2 without LVDD). The survival rate was significantly lower in patients with LVDD than in those without LVDD (31.1 months vs. 42.6 months, P=0.01). In a multivariate analysis, the Child-Pugh score and LVDD were independent predictors of survival. Moreover, patients with a ratio of early filling velocity to early diastolic mitral annular velocity (E/e') ${\geq}10$ (LVDD grade 2) had lower survival than patients with E/e' ratio < 10. Conclusions: The presence of LVDD is associated with poor survival in patients with decompensated LC. Therefore, it may be important to monitor and closely follow LVDD patients.

Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis

  • Lee, Sun Hee;Chae, Young Ran
    • Journal of Korean Academy of Nursing
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    • v.50 no.6
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    • pp.740-756
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. Methods: The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. Results: A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. Conclusion: Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

Evaluation of Classification Models of Mild Left Ventricular Diastolic Dysfunction by Tei Index (Tei Index를 이용한 경도의 좌심실 이완 기능 장애 분류 모델 평가)

  • Su-Min Kim;Soo-Young Ye
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.761-766
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    • 2023
  • In this paper, TI was measured to classify the presence or absence of mild left ventricular diastolic dysfunction. Of the total 306 data, 206 were used as training data and 100 were used as test data, and the machine learning models used for classification used SVM and KNN. As a result, it was confirmed that SVM showed relatively higher accuracy than KNN and was more useful in diagnosing the presence of left ventricular diastolic dysfunction. In future research, it is expected that classification performance can be further improved by adding various indicators that evaluate not only TI but also cardiac function and securing more data. Furthermore, it is expected to be used as basic data to predict and classify other diseases and solve the problem of insufficient medical manpower compared to the increasing number of tests.

Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

Clinical Evaluation of the Accuracy of Electronic Home Blood Pressure Measuring Devices (가정용 전자식 혈압계의 정확도에 대한 임상적 평가)

  • Choo Ji-Na
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.1
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    • pp.101-112
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    • 2002
  • Purpose: This study evaluated the accuracy of electronic devices compared with mercury sphygmomanometer. Of 132 outpatients with electronic devices. 77 who possessed oscillometric cuff devices participated in this study. Method: When the blood pressure was measured, all electronic devices were connected by means of a Y-connector to a mercury sphygmomanometer. Using the simultaneous same arm approach, each comparison was carried out three times at 2-minute intervals. Results: Compared with the mercury sphygmomanometer, the electronic devices underestimated systolic and diastolic blood pressure, respectively by $4.0{\pm}5.8mmHg$ and $2.5{\pm}67mmHg$, which satisfies the standard error range of the American Association for the Advancement of Medical Instrumentation. According to the British Hypertension Society criteria, these differences achieved C grade for both systolic and diastolic pressure. For the graphical analysis, the differences had a tendency to fulfill the permitted error limits in both diastolic and systolic blood pressure. Moreover, the purchase duration was not correlated with the accuracy of electronic devices. Conclusion: These results indicate that difference in blood pressure between electronic devices and mercury sphygmomanometer is within the standard error. Therefore, electronic blood pressure measuring devices may be useful for therapeutic self-management of hypertension.

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Automatic blood pressure measurement device using oscillometric method and Korotkoff sounds

  • Wei, Ran;Lim, Young Chul;Im, Jae Joong
    • International journal of advanced smart convergence
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    • v.1 no.2
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    • pp.20-25
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    • 2012
  • The oscillometric method and Korotkoff sound method are the most common ways to measure the blood pressure. A new automatic blood pressure measurement device, which uses both oscillometric method and Korotkoff method, was developed. A pressure sensor was used to obtain cuff pressure and oscillation signal, and a microphone was used to detect Korotkoff sounds. Forty-five measurements from fifteen subjects were used for analysis. Correlation coefficients between the traditional auscultatory method and Korotkoff sound method were 0.9820 and 0.9721 for the systolic and diastolic blood pressure values, respectively. Standard deviations of differences for the systolic and diastolic blood pressure values were 1.3019 and 1.4495, respectively. Correspondingly, correlation coefficients between the traditional auscultatory method and oscillometric method using newly developed algorithm were 0.9651 and 0.9136 for the systolic and diastolic blood pressure values, with the standard deviations of 1.42 and 1.73, respectively. The results showed that the newly developed algorithm for oscillometirc method provide accurate blood pressure values, moreover, Korotkoff sound method using microphone provides even higher accuracy. Therefore, a new automatic device which utilizes both oscillometric method and Korotkoff sound method would provide the accurate and reliable blood pressure values.

The Investigation on Results from Mass Health Examination of Partial Healthy Public Officials -First Health Examination Results- (일부 공무원을 대상으로 한 집단건강진단 결과 분석 -1차 결과를 중심으로-)

  • Sohn, Seok-Joon;Kim, Byong-Woo
    • Journal of agricultural medicine and community health
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    • v.18 no.1
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    • pp.65-75
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    • 1993
  • This study was conducted to compare the frequency and to find epidemiologic characteristics of the diseases by analyzing the results of routine first health examination for partial healthy public officials. The total number of the examined was 1.128(876 male, 252 female) The results were as follow; 1. The prevalence rate of suspicious disease was liver disease 5.9% hypertension 5.4%, hyperlipemic disease 3.8%, pulmonary tuberculosis 1.2% by order. 2. The mean systolic blood pressure and diastolic blood pressure showed increasing trend by age increasing. The mean of blood pressure in man was rather higher than that in woman. 3. The prevalence rate of suspicious borderline hypertension increased by aging. And the distribution of high cholesterol group and over than overweight group increased by aging. 4. In male, significant relation among age, systolic blood pressure, diastolic blood pressure, relative body weight was found. And significant relation between total cholesterol level and relative body weight was found. In female, age and relative body weight was related to systolic blood pressure, diastolic blood pressure and total cholesterol level. 5. According to the retrospective follow-up for those who had suspicious disease, correspondence rate of results was 5.2% in circulatory disease and 1.5% in liver disease.

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The Development of a Cuff for the Accuracy Enhancement of the Sphygmomanometer

  • Kim, Won-Ki;Shin, Ki-Young;Mun, Joung-Hwan
    • International Journal of Precision Engineering and Manufacturing
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    • v.7 no.2
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    • pp.30-35
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    • 2006
  • The purpose of this study is to develop a new cuff to improve the accuracy of blood pressure measurement, and to evaluate the performance of the developed system. We added a small bladder to the normal cuff, which we refer to as the double bladder system. The system that we developed for blood pressure measurement was based on the oscillometric method using a double bladder. This system was developed in order to reduce the oscillation noise and to amplify the signal of pure blood pressure. An oscillometric signal database based on the developed system was evaluated according to the ANSI/AAMI/SP10-1992 standard. The correlation coefficients between the cuff of the double bladder and the normal cuff were 0.98 for systolic pressure and 0.94 for diastolic pressure. The mean differences and the standard deviations between the average blood pressure obtained from a mercury manometer and that obtained from an automated sphygmomanometer were -0.7mmHg and 4.9mmHg for systolic, and -1.4mmHg and 5.4mmHg for diastolic pressure. We conclude that the proposed double bladder-based cuff system improves the accuracy of oscillometric blood pressure measurement. The developed system reduces the range of error by about $44{\sim}62%$ for systolic pressure and about $6{\sim}21%$ for diastolic pressure compared to the most recently developed, commercially available sphygmomanometers.

Evaluation of echocardiographic markers in dogs with patent ductus arteriosus after ductal closure

  • Park, Jong-In;Suh, Sang-IL;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.56 no.4
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    • pp.209-213
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    • 2016
  • This study evaluated several known echocardiographic markers related to the assessment of severity in dogs with patent ductus arteriosus (PDA) after the closure of ductus arteriosus (DA). Forty-two dogs with patent ductus arteriosus were enrolled in this study. Evaluated echocardiographic markers were left atrial to aortic root ratio, left ventricular end-diastolic dimension to aortic root ratio, indexed left ventricular end-diastolic and end-systolic dimensions, end-diastolic and end systolic volume index, pulmonic flow to systemic flow (Qp/Qs) ratio, velocities of pulmonary regurgitant and systolic jets, pulmonary flow profiles and the presence of mitral regurgitation. Those markers were evaluated before, 1 day, and 30 days after the closure of DA. Statistically significant changes in some echocardiographic markers (i.e., Qp/Qs) were observed. Although several studies in human and dogs have evaluated the clinical outcome of PDA occlusion using several echocardiographic markers, this study has firstly evaluated all echocardiographic markers known to be useful for assessing the clinical outcome of PDA occlusion in human, and has demonstrated that those markers including the Qp/Qs and pulmonary flow profiles were useful in evaluating of clinical outcome of PDA in dogs and the reduction of LA and LV preload after ductal closure could dramatically reduce after successful ductal occlusion of PDA in dogs.

Effects of subtraction meditation on perceived stress, self-efficacy, systolic pressure, diastolic pressure, and pulse rate in paramedic students (마음수련명상 프로그램이 응급구조학과 학생의 지각된 스트레스, 자기효능감, 혈압, 및 맥박수에 미치는 효과)

  • Lee, In-Soo;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.21 no.2
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    • pp.89-102
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    • 2017
  • Purpose: The purpose of the study was to investigate the effects of subtraction meditation on perceived stress, self-efficacy, blood pressure, and pulse rate in paramedic students. Methods: A quasi-experimental study with non-equivalent comparison groups using pre and post-test design was performed. The experimental group consisted of 27 participants who attended the meditation program, and the control group consisted of 26 non-participants of the program. The data were analyzed using SPSS/WIN 24.0. Results: There were a statistically significant differences between the experimental group and the control group in perceived stress(t=2.301, p=.026), systolic pressure(F=18.531, p=.000), diastolic pressure(F=9.745, p=.003), and pulse rate(F=33.869, p=.000) between pretest and posttest results. Conclusion: The subtraction meditation program can help reduce perceived stress, systolic pressure, diastolic pressure, and pulse rate.