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  • Ovid Technologies (Wolters Kluwer Health)  (39)
  • 1
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    Prognostic impact of left ventricular mass change in patients with ST-elevation myocardial infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Medicine Vol. 97, No. 4 ( 2018-01), p. e9748-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 97, No. 4 ( 2018-01), p. e9748-
    Type of Medium: Online Resource
    ISSN: 0025-7974
    URL: Article
    DOI: 10.1097/MD.0000000000009748
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 2
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    Abstract 2817: The Impact of Exercise-Induced Changes in Intraventricular Dyssynchrony on the Functional Improvement in Patients with Non-Ischemic Cardiomyopathy
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: Background: We studied whether dynamic changes in LV asynchrony may affect the functional improvement of LV in medically treated patients with non-ischemic cardiomyopathy (CMP). Methods: Supine bicycle exercise was performed in 41 patients (age 51±12 years, EF 33±8%). Using tissue Doppler imaging, the average of peak systolic velocities of 6 basal LV segments were obtained at rest (V b ) and peak exercise (V p ). ΔV was calculated by [V p -V b ], reflecting the contractile reserve. Dyssynchrony index (SD 4 ) was defined as the standard deviation of the time to peak systolic velocities at 4 basal & mid segments of septum and lateral wall on apical 4 chamber view. ΔSD 4 was calculated as [peak exercise SD 4 - resting SD 4 ]. Follow-up echocardiography was done in 35 patients after medication for 11.2±4.2 months. Functional changes of LV was assessed by ΔEF FU and %change of ESV (ΔESV FU ). Results: Baseline SD 4 was 24±17 ms. During exercise, SD 4 increased in 24 patients (ΔSD 4 =+14±12 ms), whereas decreased in 17 patients (ΔSD 4 =-17±14 ms). ΔSD 4 correlated with ΔV (r=-0.36, p=0.021) and exercise-induced increase in MR (ΔJet/LA area (%); r=0.31, p=0.05 and ΔPISA radius at 40cm/s of aliasing v; r=0.46, p=0.003). ΔV and ΔPISA were related to the follow-up change of LV function. Especially, ΔSD 4 independently correlated with ΔEF FU (β= -0.82, p 〈 0.001) and also with ΔESV FU (β= 0.40, p=0.021)(Fig ). However, baseline SD 4 didn’t affect ΔEF FU . On ROC curve analysis, sensitivity and specificity of ΔSD 4 〈 4.0 ms were 82% and 78% for predicting ΔEF FU 〉 +5% and 70% and 63% for predicting ΔESV FU 〈 -15%. Conclusion : Exercise-induced changes in dyssynchrony (ΔSD 4 ) can predict the functional improvement in non-ischemic CMP.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_626-c
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 3
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    Extrinsic Compression of the Left Anterior Descending Coronary Artery by Rib in a Patient With Progressive Left Ventricular Remodeling
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Circulation Vol. 125, No. 14 ( 2012-04-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 125, No. 14 ( 2012-04-10)
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.111.058644
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
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  • 4
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    Abstract 4910: Integrated Approach By Using Coronary Flow Velocity Reserve And Coronary Flow Velocity Patterns In Predicting Long-term Adverse Cardiac Events In Acute Myocardial Infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Background: The microvascular function was known to be an useful predictor of left ventricular functional changes and clinical outcomes in ST-segment elevation myocardial infarction (STEMI). We evaluated the usefulness of integrated approach by using coronary flow velocity reserve (CFR) and diastolic deceleration time (DDT) in the prediction of long-term major adverse cardiac events in STEMI. Methods and Results: Using an intracoronary Doppler wire, CFR, DDT and hyperemic microvascular resistance index (MVRI) were evaluated in 202 patients with first STEMI received reperfusion therapy within 24 hours after onset of symptoms. Major adverse cardiac events were the composite of cardiac death, recurrent myocardial infarction, congestive heart failure and stroke during an average follow-up period of 60 ± 39 months. Follow-up echocardiography was performed at 12 ± 9 months. CFR, DDT and MVRI had significant correlations with left ventricular regional wall motion score index at follow-up echocardiography (r =−0.441, p 〈 0.001; r = 0.413, p 〈 0.001; r =−0.485, p 〈 0.001, respectively). Using receiver-operating characteristics analysis, CFR ≤1.3 (sensitivity: 51%, specificity: 78%), DDT ≤577 ms (sensitivity: 72%, specificity: 62%) and MVRI 〉 2.7 (sensitivity: 68%, specificity: 67%) were the best cutoff values in the prediction of occurring the adverse cardiac events. In patients with CFR ≤1.3, DDT ≤577 ms, cardiac events were occurred in 18 patients (40.0 %) of 45 patients, whereas cardiac events were occurred in 12 patients (20.3%) of 59 patients with CFR 〉 1.3 and DDT ≤577 ms or CFR ≤1.3 and DDT 〉 577 ms (p= 0.048), 9 patients (9.1%) of 99 patients with CFR 〉 1.3 and DDT 〉 577 ms (p 〈 0.001). Ejection fraction at admission (p=0.009), MVRI (p =0.002) and DDT (p=0.023) were independent predictors in the prediction of long-term adverse cardiac outcomes during follow-up. Conclusions: Integrated approach by using CFR and DDT was useful in the prediction of long-term adverse cardiac events. MVRI and DDT were strong independent predictors of long-term adverse cardiac events in STEMI patients.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_958-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
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  • 5
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    Abstract 2690: Should We Classify Impaired Relaxation Pattern With Elevated E/e’ As Grade 1 Diastolic Dysfunction?
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: Purpose : Impaired relaxation pattern (grade 1 diastolic dysfunction) by Doppler echocardiography is known to reflect preserved left ventricular filling pressure (LVFP), while increased ratio of early diastolic transmitral flow velocity to mitral annular velocity (E/E’) indicated elevated LVFP. We evaluated the characteristics of impaired relaxation pattern with elevated E/E’ ratio. Methods : Eighty-eight patients (mean age 63 ± 11, 59 males) who had coronary artery disease with impaired relaxation pattern (E/A 〈 1) were enrolled. Echocardiography including tissue Doppler imaging (TDI) was performed. All patients underwent cardiac catheterization to investigate LV pre-A pressure (LVP pre-A ) within 6 hours after echocardiographic measurement. Patients were divided into subjects with E/E’ 〈 10 (n = 71) and E/E’ ≥ 10 (n = 17). Results : LVP pre-A was well correlated with echocardiographic Doppler and hemodynamic parameters (E/E’, r = 0.536, p 〈 0.001; LA volume, r = 0.295, p = 0.008; EF, r = -0.234, p = 0.028). Forty (45% of total) patients had high LVFP, defined as LVP pre-A ≥15 mmHg. Patients with E/E’ ≥10 had a significantly higher incidence of high LVFP, when compared to patients with E/E’ 〈 10 (88% vs 35%, p 〈 0.001). LA volume and LVP pre-A were significantly increased and EF was decreased in patients with E/E’ ≥ 10 (table 1 ). However, there were no significant differences of parameters derived from transmitral inflow and transpulmonary venous flow between two groups. Conclusions : In patients with impaired relaxation pattern, elevated E/E’ has related to elevation of LVFP, regardless of transmitral inflow and transpulmonary indices. Therefore, impaired relaxation pattern with elevated ratio of early diastolic transmitral flow velocity to mitral annular velocity (E/E’) may have been considered as another grade of diastolic dysfunction. Table 1
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_596-b
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 6
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    Abstract 3338: Value of a Novel Index of Microcirculatory Resistance for Invasively Assessing Myocardial Viability After Primary Angioplasty in Acute Myocardial Infarction: Comparison With FDG-PET
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: Background: Despite the prognostic importance of the status of coronary microcirculation, there has been lacking in comparative studies on the most reliable invasive measurement for assessing microvascular integrity and myocardial viability in AMI. We compared a novel Index of Microcirculatory Resistance(IMR) to intracoronary wire-based physiologic parameters for evaluating myocardial viability after primary percutaneous coronary intervention(PCI) in AMI. Methods: After successful primary stenting for 28 patients with AMI, Doppler-derived microvascular resistance index (MVRI) and phasic flow velocity patterns were evaluated. Using a pressure-temperature sensor-tipped coronary wire, thermodilution-derived CFR(CFR thermo ) and coronary wedge pressure(P cw ) were measured and the ratio of P cw and mean aortic pressure(P cw /P a ) was calculated, along with IMR, defined as the distal coronary pressure divided by the inverse of the hyperemic mean transit time. 18 F-fluorodeoxyglucose(FDG) PET was performed after primary PCI to evaluate myocardial viability by regional percentage uptake of FDG in infarct-related segments. Results: Among Doppler-derived parameters, regional FDG uptake showed nice correlation with hyperemic averaged peak velocity(r=0.561, p=0.002), hyperemic MVRI (r= −0.452, p=0.016) and baseline deceleration time of diastolic flow velocity (r=0.505, p=0.006). In the group of pressure-derived parameters CFR thermo , P cw /P a and IMR revealed good correlations with regional FDG uptake (r=0.487, p=0.016; r= −0.469, p=0.012; r= −0.656, p 〈 0.001, respectively). By the receiver operating characteristics curve analysis for prediction of myocardial viability, as defined by the 50% FDG-PET threshold value, the largest area under the curve was acquired by IMR and the best cut-off value of IMR for prediction of myocardial viability was 22U (sensitivity of 79%, specificity of 86% and accuracy of 81%). Conclusions: Wire-based coronary physiologic assessment is useful for the prediction of myocardial viability immediately after primary PCI. IMR, a novel index representing the microvascular integrity, is a reliable parameter for the invasive, on-site assessment of myocardial viability after primary PCI in AMI.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_752-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 7
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    Abstract 15340: Association of Serum Lipoprotein (a) Levels and Lipid Burden by Near Infrared Spectroscopy in Intermediate Coronary Artery Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: The relationship between elevated lipoprotein (a) (Lp(a)) and poor prognosis in coronary artery disease (CAD) has been addressed for decades. However, data of mechanism of increased risk with plaque lipid burden has not been established. Hypothesis: This study aimed to investigate the association between Lp(a) and lipid burden in patients with intermediate CAD by Near Infrared Spectroscopy (NIRS). Methods: We retrospectively analyzed 128 patients with intermediate CAD who performed intravascular ultrasound (IVUS) during coronary angiography and checked Lp(a) level. The lipid core burden index (LCBI) for the 4-mm segments at the target lesion was calculated by NIRS. We divided the patients into 3 groups by calculating baseline Lp(a) tertile level. A mixed model adjusted for baseline sex, age, weight, pre-minimal luminal area, lesion length, apolipoprotein (Apo) E, Apo A1, Apo B100, total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), fasting glucose, past history, current medication including statin use was used to calculate the risk-adjusted target LCBI. Results: We enrolled 128 patients (60 years; male, 114; mean Lp(a) 21.03±20.84 mg/dl, Figure 1) and NIRS was taken in 90 patients among them. Mean and median target LCBI by NIRS were 78.4±60.3 and 62.0. Target LCBI significantly higher in the intermediate Lp(a) group than low Lp(a) group in risk-adjusted analyses (Lp(a) 〈 9; 45.7 versus 9≤Lp(a) 〈 19; 111.48, p =0.026, Table 1). However, between intermediate and high Lp(a) groups, there was no statistical difference (9≤Lp(a) 〈 19; 111.48 versus 19≤Lp(a); 86.41, p =0.774). Conclusions: Elevated Lp(a) level is independently associated with increased lipid burden of target lesion in intermediate CAD, and it’s important for treatment decision. Further investigation is needed to clarify the effect of Lp(a) in various type and severity of plaque.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.15340
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 8
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    Abstract 11809: Sodium Intake is Correlated to Total Calorie Intake and Potassium
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Background: Selecting lower-sodium diets are not successful to reduce sodium intake in general population. If systemic approach is considered lowering sodium intake because of the culinary tendencies, we need to aware of the quantitative relationship between nutrients and sodium in daily usual food of the general population. Hypothesis: We assessed the hypotheses that are the positive correlation between total calorie intake, potassium and sodium intake; the cutoff values for sodium recommendation (≤2300 mg per day). Method: We studied 55,544 individuals who completed health examination and nutrition survey in 168,157 randomly selected participants that could represent the country from the 1998-2013 Korea National Health and Nutrition Examination Survey (KNHANES). The nutrition survey was 24 hours recall method to estimate the amount of standardized Korean food. We analyzed the quantitative relationship, and estimated the cutoff value of the total calories and potassium at the recommendation of the sodium intake. Result: The mean values were total calorie 1922±834 Kcal, sodium 4904±3218 mg, potassium 2935±1563 mg, protein 70±41 g (15% in total calorie), fat 37±31 (18%), and carbohydrate 312±123 (67%) in mean value. The standardized coefficients were potassium 0.309, protein 0.226, fat 0.070, carbohydrate 0.097 in model 1 (R2=0.402); total calorie 0.271 and potassium 0.368 in model 2 (R2=0.384) with cardiovascular risk factors in multiple linear regression analysis (table). The optical cutoff value of the total calorie for sodium 2300mg is 1520 Kcal (74% sensitivity, 74% specificity, 93% positive predictive value, 38% negative predictive value, area under the curve: 0.826, 95% CI: 0.82 to 0.83 ; p 〈 0.001) and the potassium is 1956 mg (82% sensitivity, 69% specificity, 92% PPV, 44% NPV, AUC: 0.825, 95% CI: 0.82 to 0.83 ; p 〈 0.001). Conclusion: In conclusion, the cutoff values for the sodium 2300 mg are the total calorie 1520 Kcal and potassium 1956 mg.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.11809
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 9
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    Abstract 15233: The Lesion Length Gives a Better Effect on the Fractional Flow Reserve Than the Minimal Luminal Area in the Intermediate Coronary Artery Lesion
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Introduction: The pressure gradient of the circulation fluid in a stenosis area depends on minimal luminal area (MLA) of the stenosis, lesion length (LL), and the fluid velocity. However, the correlation of the LL and the MLA; the cutoff values are uncertain. Hypothesis: LL and MLA differently influences the FFR. Methods: We studied 117 patients with intermediate coronary artery disease who underwent FFR and IVUS measurement out of 302 patients in FAVOR study. This study was a prospective, 1:1 randomized, open label multicenter trial to demonstrate the clinical outcomes between FFR and IVUS-guided PCI. Inclusion criteria were as follows: 1)Angina or documented silent ischemia 2) De novo intermediate coronary artery disease (30-70% diameter stenosis) by visual estimation, 3) Reference vessel diameter ≥ 3.0mm by visual estimation. We excluded left main disease, MI, EF 〈 40%, and graft vessel. There were no significant differences in baseline clinical characteristics. The mean values are the QCA (54.3±14.0 %), MLA (3.6±1.4 mm2) and LL (20.6±1.4mm), respectively. We were performed the path analysis using AMOS 18, and estimated the ROC curve in SPSS 18. Results: Standardized estimates were the LL -0.47,QCA -0.28 and MLA -0.21 (R2=0.594, p 〈 0.000) in path analysis. The model is recursive and statistically significant. The FFR was ≤0.80 in 47 lesions (31%). The optimal LL for an FFR of ≤0.80 was 15.8mm (90% sensitivity, 50% specificity, 44% positive predictive value, 87% negative predictive value, area under the curve: 0.75, 95% CI: 0.66 to 0.85; p 〈 0.001) and MLA 3.9mm (sensitivity 86%, specificity 59%, 35% positive predictive value , 94% negative predictive value, area under the curve: 0.78, 95% CI: 0.67 to 0.85; p 〈 0.001) Conclusions: The lesion length influenced more the FFR than MLA. The lesion length ≥ 15.8mm and MLA ≤ 3.9mm are risk zones, which need to be confirm the functional status with FFR because of the low positive predictive value
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.15233
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 10
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    Impact of myocardial perfusion on left atrial remodeling following primary angioplasty for acute myocardial infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2006
    In:  Coronary Artery Disease Vol. 17, No. 7 ( 2006-11), p. 597-603
    Details
    In: Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 17, No. 7 ( 2006-11), p. 597-603
    Type of Medium: Online Resource
    ISSN: 0954-6928
    URL: Article
    DOI: 10.1097/01.mca.0000236281.74361.d4
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2006
    detail.hit.zdb_id: 2042449-8
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