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하상진,유상용,홍명기,홍그루 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.1
Purpose: We aimed to compare the effect of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement(sAVR) on recovery of left ventricular (LV) diastolic function and afterload through serial echocardiographic examinations in patientswith symptomatic high-risk severe aortic stenosis during early follow-up. Materials and Methods: We included 38 patients undergoing TAVR (mean age, 80±6 years; male:female=18:20) and 27 patientsundergoing sAVR (mean age, 78±3 years; male:female=12:15). We compared changes in the LV diastolic function and afterloadbefore, immediately after, and 3 months after the procedure using serial transthoracic echocardiography. Results: Immediately after the procedure, 16 (42%) and 3 (11%) patients in the TAVR and sAVR groups, respectively, showed rapidimprovement in diastolic filling patterns. E wave to e' ratio (E/e') and right ventricular systolic pressure (RVSP) decreased significantlyin the TAVR group (E/e': TAVR, from 24.6±12.9 to 20±9.5, p=0.048 vs. sAVR, from 21.5±9.4 to 20.64±6.4, p=0.361; RVSP: TAVR,38.4±17.2 vs. 34±12.4, p=0.032 vs. sAVR, 32.2±11.7 vs. 30±6.8, p=0.27). After 3 months, diastolic grade distribution, E/e', and RVSPwere similar. Valvuloarterial impedance significantly decreased immediately after the procedure in both groups (TAVR, from5.1±1.4 to 3.1±1.0 vs. sAVR, from 4.5±1.5 to 3.1±0.8 mm Hg . mL−1 . m−2, p=0.001), but after 3 months, decreases were greater in thesAVR group (from 3.1±0.8 to 2.2±1.5 mm Hg . mL−1 . m−2, p=0.093). Conclusion: LV diastolic function improved more rapidly and earlier in patients treatment with TAVR than in patients treated withsAVR. These results might explicate the remarkable clinical improvement in improvements in advanced diastolic dysfunction immediatelyafter the TAVR procedure than sAVR.
혈액 투석 환자에서 포도당 희석법과 초음파 희석법을 이용한 혈관 통로의 혈류 속도 비교
하상진 ( Sang Jin Ha ),이윤정 ( Yoon Jung Lee ),조병현 ( Byung Hyun Cho ),정경환 ( Kyung Hwan Jung ),문주영 ( Joo Yung Moon ),이상호 ( Sang Ho Lee ),이태원 ( Tae Won Lee ),임천규 ( Chun Gyoo Ihm ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.4
Purpose : Vascular access flow (Qa) measurements are important in the surveillance protocol of hemodialysis vascular access stenosis. The glucose pump technique (GPT) is a technique for Qa measurement based on the dilution technique of a constant glucose infusion that was introduced in 1995. The aim of this study is to verify the clinical efficacy of GPT in vascular access surveillance compared with ultrasound dilution technique. Methods : In 31 chronic hemodialysis patients with a AV fistula, we compared Qa measurements performed with GPT in pre-dialysis and the ultrasound dilution technique (Transonic HD01, Transonic System Inc., Ithaca, NY) during hemodialysis. Results : Mean Qa was 1171 ml/min by GPT versus 1028 ml/min by HD01 (p=0.262). There was a strong linear correlation between the two methods (r=0.61; p<0.01). Ultrasound dilution technique HD01 yielded 6 cases of high risk Qa measurements and GPT yielded 4 cases of high risk Qa measurements. The diagnostic accuracy of GPT tested with the ROC curve was similar with ultrasound dilution technique HD01. The specificity and sensitivity was 80% and 66.7% according to Qa=600ml/min. But sensitivity was 83.3% according to Qa=750 ml/min. Conclusion : GPT offers the advantage of a simple and economic bedside procedure easily performed before dialysis and had a similar diagnostic accuracy and efficiency compared with ultrasound dilution technique HD01.
하상진 ( Sang Jin Ha ),하종원 ( Jong Won Ha ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
Mitral regurgitation (MR) is defined as the reflux of blood from the left ventricle into the left atrium during systole, resulting from the loss of adequate closure of the mitral valve. Echocardiography has become the primary noninvasive imaging method for evaluating mitral valvular regurgitation, since it provides structural and hemodynamic information. The echocardiographic assessment of mitral regurgitation should quantify the regurgitation, assess the valve anatomy and function, and evaluate the consequences of mitral regurgitation on the cardiac chambers. In clinical practice, the management of patients with mitral regurgitation is based largely on the echocardiography results. This article describes the echocardiographic assessment of mitral regurgitation, emphasizing the usefulness of echocardiography in primary care. (Korean J Med 2014;87:424-428)
우종신,하상진,김원 대한심장학회 2010 Korean Circulation Journal Vol.40 No.2
As techniques and device technology have improved, the success rates and long patency of ilio-femoral occlusive disease have also improved. In the case of extensive iliac occlusive disease, however, wire passage and handling remain a challenge due to the relatively weak guiding catheter backup support with the contralateral femoral approach. There has been no report on methods to overcome this problem. We performed a successful percutaneous translunimal angioplasty for long ilio-femoral occlusive disease including the iliac ostium by a dual approach including simultaneous brachial and contralateral femoral arteries for subintimal angioplasty.