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- 저자 : 안영근 ( Yo) (검색결과 2 건)
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정은아(Eun A Chung),이승현(Seung Hyun Lee),홍영준(Young Joon Hong),박옥영(Ok Young Park),정우곤(Woo Kon Jeong),이상록(Sang Rok Lee),이상현(Sang Hyun Lee),강경태(Kyung Tae Kang),류제영(Jay Young Rhew),박종철(Jong Cheol Park),안영근(Yo 대한내과학회 2001 대한내과학회지 Vol.61 No.2
N/A Background : Vasovagal syncope has been believed to account for the majority of syncope of unknown origin (SUO). Head-up tilt test (HUT) has been well recognized as a useful test in the evaluation of SUO. The purpose of this study was to determine the predictors of HUT to develop a less time-consuming test protocol and get an information on the pathophysiology of vasovagal syncope. Methods : Eighty five patients (mean age, 43±18 years: 47 men, 38 women) underwent a 80 degree HUT without or with isoproterenol infusion (2 μg/min and 5 μg/min, each for 6 minutes) for unexplained syncope or pre-syncope. Positive HUT was defined as symptomatic hypotension (systolic blood pressure ≤80 mm Hg) and/or symptomatic bradycardia (≤45/min for ≥10 seconds) or asystole ≥3 seconds. The patients were divided into two groups according to the result of the HUT: Group I included 47 patients (M:F=25:22) with positive result, Group II, 38 patients (M:F=22:16) with negative result. Results : Group I patients had more episodes of syncope than Group II (3.1±2.5/year vs. 2.0±2.1/year, p<0.05). There were no significant differences between the 2 groups in the heart rate (HR), systolic and diastolic blood pressure (BP) at the baseline supine position. BP after tilt was not significantly different between 2 groups except for systolic BP at 6 minutes after tilt, which was significantly lower in Group I than Group II (109.5±17.5 mm Hg vs. 118.1±18.2 mm Hg, p<0.05). However, HR after tilt was significantly faster in Group I than Group II (81.1±15.1/min vs. 74.2±14.9/min, p<0.05 at 2 minutes after tilt; 83.7±14.4/min vs. 74.6±14.7/min, p<0.01 at 4 minutes after tilt). The increase in HR was greater in Group I than Group II (19.9±12.6/min vs. 12.8±10.6/min, p<0.001). In the prediction of positive HUT with HR rise above 14/min during the early 6 minutes of baseline head-up tilting, the specificity, sensitivity, and positive predictive value were 63.2%, 70.2%, and 70.2%, respectively. Conclusion : In patients with SUO, positive HUT can be predicted with the early HR response during head-up tilt. This result shows that vasovagal syncope is triggered by exaggerated HR response to the decreased venous return and allow us to develop a less time-consuming HUT protocol.(Korean J Med 61:133-140, 2001)
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급성 심근경색증 환자의 입원 중 합병증과 1년간 임상경과의 예측인자
윤현주 ( Hyun Ju Yoon ),정명호 ( Myung Ho Jeong ),김계훈 ( Kye Hun Kim ),박근호 ( Keun Ho Park ),심두선 ( Doo Sun Sim ),박형욱 ( Hyun Wook Park ),윤남식 ( Nam Sik Yoon ),홍영준 ( Young Joon Hong ),김주한 ( Ju Han Kim ),안영근 ( Yo 대한내과학회 2009 대한내과학회지 Vol.77 No.6
Background/Aims: This study evaluated the predictors of in-hospital early complications and 1-year clinical events in patients with acute myocardial infarction (AMI). Methods: A total of 1,000 consecutive patients (63.4±12 years, 705 males) with AMI were divided into two groups according to the presence of in-hospital events (IHE): group I had IHEs (n=175, 65.6±12 years, 115 males), and group II had no events (n=825, 62.8±12 years, 590 males). IHE included death, cardiogenic shock, pacemaker implantation, ventricular arrhythmia, and mechanical ventilation. Results: The levels of glucose, creatinine, maximal creatine kinase (CK), troponin-I, hs-CRP, and NT-proBNP were higher in group I than in group II. Increased left ventricular dimension, a low ejection fraction, mitral regurgitation (MR), diastolic dysfunction, and a high wall motion score index were more common in group I compared with group II. The initial Killip class, ST-elevation AMI, and high levels of glucose, creatinine, CK-MB, troponin I, hs-CRP, NT-proBNP, and MR were significant independent predictors of IHE on multivariate analysis. During the 1-year follow-up, the major adverse cardiac event (MACE) rate was higher in group I than in group II. IHE, especially cardiopulmonary resuscitation, cardiogenic shock, and respiratory failure, were independent predictors of MACE during the 1-year clinical follow-up. Conclusions: High levels of glucose, creatinine, CK-MB, troponin I, hs-CRP, NT-proBNP, and MR were predictors of IHE, and the 1-year MACE-free survival was lower in AMI patients with IHE. (Korean J Med 77:723-733, 2009)
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