초음파와 새로운 소프트웨어를 이용한 경동맥 내막,중막, 내중막 두께측정

현대우,배장호,김기영,황인경,김원식 대한심장학회 2005 Korean Circulation Journal Vol.35 No.8

Background and Objectives:We performed this study to evaluate the feasibility and accuracy of the newly developedKorean software (KS) for measurement of the carotid intima-media thickness (IMT), which was comparedwith the commercial software. Subjects and Methods:The study population consisted of 60 consecutivepatients (mean of 59 years old, 27 males) undergoing transthoracic echocardiography. We measured the carotidIMT using both software packages, and also measured the intima thickness (IT) and media thickness (MT),separately, using the KS package. Results:Measurement of the IMT was possible in all the study subjects withboth software packages, but the separate measurements of the IT and MT was possible in only 24 patients usingthe KS package. The mean IMT using the commercial and KS packages were 0.727±0.157 and 0.733±0.156 mm,respectively, which were found to correlate (r=0.985, p=0.000). The mean IMT, IT and MT of the 24 patientswere 0.841±0.138, 0.340±0.033 and 0.505±0.124 mm, respectively. The carotid IMT was correlated with theIT and MT and also with the IT/IMT, MT/IMT and IT/MT ratios (r=0.562, p=0.004; r=0.934, p=0.000; r=-0.809, p=0.000; r=0.591, p=0.002; r=-0.754, p=0.000, respectively). The IT was found not to correlate withthe MT (r=0.369, p=0.076). Age was found to correlate with the IMT using both the commercial and KSpackages (r=0.616, p=0.000; r=0.583, p=0.000, respectively), and with the MT and IT/IMT and IT/MT ratios(r=0.504, p=0.012; r=-0.538, p=0.007; r=-0.428, p=0.037), but not with the IT (r=0.300, p=0.154).Conclusion:The newly developed KS was feasible and accurate in measuring the carotid IMT, which can alsobe used to separately measure the IT and MT. 배경 및 목적:경동맥 내중막 두께를 측정할 수 있는 새로운 소프트웨어(Korean software)를 개발하여 기존의 소프트웨어(M ’ATHsoftware, version 2.01, METRIS Co. Argenteuil, France)와 비교하여 유용성과 정확성을 알아 보고자 하였다.방 법:경흉부 심초음파 검사를 시행 받는 연속적인 60명의 환자(평균연령 59세, 남자 27명)를 대상으로 하였다. M ’ATHsoftware로 경동맥 내중막 두께를 측정하고 동일 영상으로Korean software를 이용하여 내막, 중막, 내중막 두께를 측정하여 이를 서로 비교해 보았다. 결 과: 대상군 모두에서 M ’ATH software와 Korean software 를 이용한 내중막 두께측정이 가능하였고, Korean software를 이용한 내막과 중막의 두께측정은 24명에서 가능하였다.M’ATH software와 Korean software를 이용한 내중막 평균두께는 각각 0.727±0.157 mm, 0.733±0.156 mm 이었고 이들은 유의한 상관관계가 있었다(r=0.985, p=0.000).Korean software를 이용한 내막과 중막의 두께측정이 가능하였던 24명 환자의 내중막, 내막, 중막의 평균두께는 각각0.841±0.138 mm, 0.340±0.033 mm, 0.505±0.124 mm 이었다. 내중막 두께에서 내막이 평균 41%, 중막이 59%를 차지하였다. Korean software를 이용한 내중막 두께와 내막 두께, 중막 두께, 내막-내중막 비, 중막-내중막 비, 내막-중막의 비와 각각 유의한 상관관계가 있었다(r=0.562,p=0.004; r=0.934, p=0.000; r=-0.809, p=0.000; r=0.591,p=0.002; r=-0.754, p=0.000). 내막과 중막의 두께는 유의한 상관관계가 관찰되지 않았다(r=0.369, p=0.076). M’ATH software와 Korean software를 이용한 내중막 두께와 연령은 유의한 상관관계가 있었다(r=0.616, p=0.000; r=0.583,p=0.000). 연령과 내막 두께, 중막-내중막 비는 유의한 상관관계가 없었으나(r=0.300, p=0.154; r=0.230, p=0.279), 중막 두께, 내막-내중막 비, 내막-중막 비와 각각 유의한 상관관계가 있었다(r=0.504, p=0.012; r=-0.538, p=0.007;r=-0.428, p=0.037).결 론:경동맥 내막, 중막, 내중막 두께를 각각 측정할 수 있는 Korean software는 유용하고 정확하였으며 일부환자에서 경동맥 내막과 중막의 두께를 측정할 수 있었다.

Correlation between the Carotid Intima-Media Thickness and the PlaqueBurden of the Left Main Coronary Artery Using Ultrasonography

현대우,김기식,허승호 대한심장학회 2005 Korean Circulation Journal Vol.35 No.11

Background and Objectives:It has been reported that the common carotid artery (CCA) intima-mediathickness (IMT) correlates to angiographically determined coronary artery stenosis. The aim of this study was toevaluate the correlation between the carotid IMT and left main (LM) plaque using ultrasonography. Subjectsand Methods:In fifty patients (mean age 59.6±9.9, males 35 (70%)) with coronary artery disease (CAD), therisk factors of atherosclerosis were evaluated and coronary angiographs obtained. The carotid IMT was measuredin the far wall of both CCAs, with a 10 MHz linear probe, and the value of the IMT was automatically calculatedusing programmed software (M’ATH, METRIS Co., Argenteuil, France). The LM plaque was measured byintravascular ultrasound. The maximal thickness, ratio of the maximal thickness, cross-sectional area (CSA) andburden of the plaque were measured at 2 mm intervals, and the average values calculated. Results:In the rightcommon carotid artery, the maximal IMT significantly correlated with the mean plaque CSA and plaque burdenof the LM (r=0.375. p=0.007, r=0.408. p=0.003, respectively). The mean IMT significantly correlated with theplaque burden of the LM, but not with the mean plaque CSA of the LM (r=0.357. p=0.011, r=0.264. p=0.063,respectively). In the left common carotid artery, the maximal IMT was not significantly correlated with the meanplaque CSA and plaque burden of the LM (p=0.251, p=0.218, respectively). The mean IMT was not correlatedwith the mean plaque CSA and plaque burden of the LM (p=0.249, p=0.078, respectively). Conclusion:Therewas a significant correlation between the right CCA IMT and plaque burden of the LM in patients with CAD

좌회선지 원위부에서 기시하는 우관상동맥(단일 관상동맥) 1예

현대우,허승호,한성욱 대한심장학회 2003 Korean Circulation Journal Vol.33 No.11

Long QT 증후군 한국인 환자의 분자유전학적 특성

현대우,김윤년,한성욱,조용근,신동구,차태준,이상민,김준수,조정관,유관희,유민 대한심장학회 2004 Korean Circulation Journal Vol.34 No.8

Background and Objectives:Congenital long QT syndrome (LQTS) is a genetic disease that brings prolongation of the QT interval on an electrocardiogram and leads to syncope and sudden death by a fatal ventricular arrhythmia. In Korea, there have been studies about the clinical characteristics and treatment of LQTS, but there are no studies for the molecular and biological evaluation of its genetic mutation. Subjects and Methods:Six nationwide university hospitals and laboratories segregated DNA from the blood of 10 patientsdiagnosed with LQTS to analyze the genetic mutation. Results:Nine out of ten individuals were female. Eight showed genetic mutations. Three had an abnormality in the KvLQT1, 6 in the HERG and 2 had abnormalities in both KvLQT1 and HERG. None had abnormalities in KCNE1 and 2 showed no abnormalities in KvLQT1, HERG or KCNE1. Conclusion:Congenital LQTS shows various genetic mutations, and this indicates the necessity for further organized study in more individuals for confirmation of the relationship between the results of clinical diagnosis and genetic analysis. 배경 및 목적: 선천성 LQTS는 심전도 검사상 QT 간격의 연장 및 치명적 심실성부정맥 발생으로 실신, 급사 등의 원인되고 있는 유전적 요인이 관여하는 질환이나 국내에서는 임상적 특성이나 치료에 대한 단편적인 보고는 있으나 분자 생물학적 유전자 변이에 대한 연구는 없다. 방 법: 1999년 전국 6개 대학병원에서 진단된 LQTS 10명 환자의 혈액을 채취하여 DNA를 분리하고 유전자변이를 분석하였다. 결 과: 10명의 환자 중 여자는 9명이였으며, 8명에서 유전자 변이가 있으며 3명은 KvLQT1 유전자에서 6명은 HERG 유전자에 이상이 있었으며 KCNE1 유전자는 전예에서 이상이 없었으며 2명은 KvLQT1과 HERG에 동시에 이상이 있었으며 2예에서는 KvLQT1, HERG, 그리고 KCNE1에 이상이 없었다. 결 론: 선천성 LQTS는 유전자 변이가 다양하여 향후 더 많은 예에서 체계적인 연구가 필요하며 유전자의 변이와 선천성 LQTS의 인과 관계에 대한 연구가 필요하다.

고지방과 저지방식에 따른 관상동맥 혈류와 예비능의 변화

현대우,김기식 한국심초음파학회 2003 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.11 No.1

Toad Venom Poisoning Resembling Digitalis Intoxication and Hyperkalemia: A Case Report

현대우,권택근,김기영,배장호 대한심장학회 2007 Korean Circulation Journal Vol.37 No.6

Toad toxin has digitalis-like cardioactive effects that include bradycardia, varying degrees of atrioventricular block, ventricular tachycardia, ventricular fibrillation and sudden cardiac death. We report here on a 54-year-old man who had varying degrees of atrioventricular block and nonsustained ventricular tachycardia two hours after he ate a bowl of toad soup. (Korean Circulation J 2007;37:283-286)

비후된 심근을 가진 환자의 도플러 심근영상의 특징

현대우,김민정,허승호,한성욱,김윤년,김기식,권상민,박창욱,이영수,김권배 한국심초음파학회 2004 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.12 No.1

Gender Differences in the Role of Serum Uric Acid for Predicting Cardiovascular Events in Patients with Coronary Artery Disease

현대우,김기홍,윤현주,권택근,김기영,배장호 대한심장학회 2007 Korean Circulation Journal Vol.37 No.5

Background and Objectives:Serum uric acid has been reported to be an independent risk factor for coronaryartery disease (CAD) and a predictor of mortality in patients with CAD. Yet there is gender difference for theserum uric acid levels. We evaluated the influence of the uric acid levels on major adverse cardiovascular events(MACEs) in patients with CAD according to their gender. Subjects and Methods:Of the 777 patients withangiographically proven CAD, 660 patients (378 males, 57.3%) were followed up a median of 18 month (maximum:61 month). The MACEs included acute myocardial infarction, cerebral infarction, coronary arterybypass graft, percutaneous coronary intervention due to de novo lesion during follow up, new onset congestiveheart failure and sudden cardiac death. Results:MACEs in men were associated with acute coronary syndrome(ACS)(odds ratio (OR): 2.03, 95% confidence intervals (CI): 1.01 to 3.96, p=0.038), multi-vessel disease (OR:3.68, 95% CI: 1.82 to 7.47, p=0.000) and the serum uric acid levels (OR: 1.23, 95% CI: 1.01 to 1.50, p=0.044),according to multivariate Cox regression analysis. For women, MACEs were associated with multi-vessel disease(OR: 2.43, 95% CI: 1.15 to 5.13, p=0.020) and the highest uric acid quartile (OR: 2.64, 95% CI: 1.31 to 5.30,p=0.006) according to multivariate Cox regression analysis. For all patients, the highest uric acid quartile wasassociated with an increased risk of MACE (p=0.000), and CHF was the major contributor to the observedMACEs (p=0.004). Conclusion:In male patients with CAD, the serum uric acid level is a predictor of cardiovascularevents, and the highest uric acid quartile is a predictor of cardiovascular events in women. (KoreanCirculation J 2007;37:196-201)

Association of a Corrected QT Interval with the Carotid Intima-Media Thickness and the Severity of Coronary Artery Disease in Patients with Coronary Artery Disease

현대우,권택근,김기영,배장호 대한심장학회 2007 Korean Circulation Journal Vol.37 No.11

Background and Objectives: A prolonged heart rate-corrected QT interval (QTc) is known to be related to an increased risk of coronary artery disease (CAD) and suden cardiac death, while the carotid intima-media thick-ness (IMT) is related to CAD. We sought to evaluate the relationship among the QTc, the carotid IMT and the severity of CAD. Subjects and Methods: The QTc and the carotid IMT were measured in 165 consecutive patients TM system (GE Marquete Medical System, Milwaukee, USA) and the carotid IMT was measured by MATH software (METRIS Co., Argenteuil, France). The severity of CAD was divided into minimal disease (90, 54.5%), one-vessel disease (32, 19.4%), and multi-vessel disease (43, 26.1%), acording to the number of vesels that were narrowed by more than 50%. Results: The mean values of the QTc were 415.1± 20.5 msec in the minimal disease group, 411.7± 17.0 msec in the one- ± 46.1 msec in the multi-vesel disease group. The QTc was correlated with age (r= 0.236, p= 0.002), HDL cholesterol (r= -0.160, p= .043), the right carotid IMT (r= 0.17, p=0.026), the left carotid IMT (r= 0.178, p=0.022) and the severity of CAD (r=0.243, p=0.002). On the multiple linear regresion analysis after adjustment for age and HDL cholesterol, the QTc was an independent factor for the severity of CAD. Conclusion: -rity of CAD and they may reflect the severity of the morphologic atherosclerotic surrogates.

상심실성 빈맥환자에서 관상정맥동의 형태비교

현대우,김윤년,박소영,한성욱,허승호,김기식,김권배 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.4