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Heart Failure as a Risk Factor for Stroke
Woohyeun Kim,Eung Ju Kim 대한뇌졸중학회 2018 Journal of stroke Vol.20 No.1
Heart failure (HF) is one of the major causes of death worldwide. Despite the high incidence of stroke in patients with HF, there has been a controversy as to whether HF itself is a risk factor for stroke. Recently, there is a great deal of evidence that HF itself increases the risk of stroke. In previous studies, the benefit of warfarin for stroke prevention in patients with HF was offset by the risk of bleeding. In the era of non-vitamin K antagonist oral anticoagulants with low bleeding profiles, we can expect a more effective stroke prevention in patients with HF by selective anticoagulation. The purpose of this review is to describe the relationship between stroke and HF, which could be an unconventional risk factor and a potential intervention target for stroke prevention.
Retrieval of a Partially Degloved Stent Strut During Percutaneous Coronary Intervention
Woohyeun Kim,Yong Hyun Kim,임상엽,김성환,Jeong Chun Ahn,송우혁 전남대학교 의과학연구소 2012 전남의대학술지 Vol.48 No.2
Although stent entrapment is a rare event during percutaneous coronary intervention,stent entrapment can cause stent breakage or loss, which results in fatal complications such as stent embolism or acute myocardial infarction. We report one case of stent entrapment that was successfully treated by a snare via a contralateral transfemoral approach
Two Cases of High Output Heart Failure Caused by Hereditary Hemorrhagic Telangiectasia
조동혁,김수아,Mina Kim,Young Ho Seo,Woohyeun Kim,Seong Hee Kang,Sung Mi Park,심완주 대한심장학회 2012 Korean Circulation Journal Vol.42 No.12
High-output cardiac failure is a rare complication of hereditary hemorrhagic telangiectasia (HHT) usually caused by shunting of blood through atriovenous malformations (AVMs) in the liver. We describe two cases of high output heart failure due to large hepatic AVMs. Clini-cal suspicion of HHT based on detailed history taking and physical examination is essential for early detection and proper management of heart failure associated with HHT.
Dae-Hee Kim,In-Jeong Cho,Woohyeun Kim,Chan Joo Lee,Hyeon-Chang Kim,Jeong-Hun Shin,Si-Hyuck Kang,Mi-Hyang Jung,Chang Hee Kwon,Ju-Hee Lee,Hack Lyoung Kim,Hyue Mee Kim,Iksung Cho,Dae Ryong Kang,Hae-Young 대한심장학회 2022 Korean Circulation Journal Vol.52 No.6
Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05–1.24) but not in those by the 2017 ACC/AHA definition. Elevated on-treatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18–1.70) and stroke (aHR, 1.19; 95% CI, 1.08–1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10; 95% CI, 1.04–1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion: Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.
Unusual Polymorphic Ventricular Tachycardia Originating from the Pulmonary Artery
이대인,Sang Weon Park,국형돈,Woohyeun Kim,김동혁,이선기,Suk-Kyu Oh,Young-Hoon Kim 대한심장학회 2013 Korean Circulation Journal Vol.43 No.2
We report a case about a 27-year-old healthy young male who developed syncope during exercise, which was subsequently identified to be attributable to non-sustained polymorphic ventricular tachycardia (VT). Occurrence of polymorphic VT was neither related to a pro-longed QT interval nor a fixed short coupling interval. Standard examinations including echocardiography, coronary angiography, isopro -terenol infusion study, and cardiac MRI showed no structural heart disease. On the electrophysiology study, activation mapping revealed that a discrete potential preceded the premature ventricular complex (PVC) triggered polymorphic VT, which was recorded just above the pulmonary valve. After radiofrequency ablation at this area, PVC and polymorphic VT disappeared and did not recur after a 2 month fol-low up.
Nam, Purumeh,Choi, Byoung Geol,Choi, Se Yeon,Byun, Jae Kyeong,Mashaly, Ahmed,Park, Yoonjee,Jang, Won Young,Kim, Woohyeun,Choi, Jah Yeon,Park, Eun Jin,Na, Jin Oh,Choi, Cheol Ung,Lim, Hong Euy,Kim, Eung Elsevier 2018 Atherosclerosis Vol.270 No.-
<P><B>Abstract</B></P> <P><B>Background and aims</B></P> <P>Myocardial bridge (MB) and coronary artery spasm (CAS) can induce a sustained chest pain, acute coronary syndrome (ACS) and even sudden cardiac death. The aim of this study is to evaluate the relationship between MB and CAS and its impact on long-term clinical outcomes.</P> <P><B>Methods</B></P> <P>A total of 812 patients with MB without significant coronary artery disease (CAD), who underwent acetylcholine (ACH) provocation test, were enrolled. Significant CAS was defined as ≥70% temporary narrowing by ACH test, and MB was defined as the characteristic phasic systolic compression of the coronary artery with a decrease of more than 30% in diameter on the angiogram after intracoronary nitroglycerin infusion. To adjust baseline confounders, logistic regression analysis was performed. The primary endpoint was incidence of CAS, and secondary endpoints were major adverse cardiac events (MACE) and recurrent angina requiring repeat coronary angiography (CAG) at 5 years.</P> <P><B>Results</B></P> <P>MB is closely implicated in a high incidence of CAS, spontaneous spasm, ischemic ECG change and chest pain during ACH provocation test. In addition, MB of various severity and reference vessel size was substantially implicated in CAS incidence, and severe MB was a strong risk factor of CAS. MB patients with CAS were shown to have a higher rate of recurrent angina compared with MB patients without CAS, up to a 5-year follow-up. However, there were no differences regarding the incidence of MACE.</P> <P><B>Conclusions</B></P> <P>Severe MB was associated with high incidence of CAS, and MB patients with CAS were likely to have a higher incidence of recurrent angina. Intensive medical therapy and close clinical follow-up are needed for better clinical outcomes in MB patients with CAS.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The aim of this study is to evaluate the relationship between myocardial bridge (MB) and coronary artery spasm (CAS). </LI> <LI> A total of 812 patients with MB without significant coronary artery disease who underwent acetylcholine test were enrolled. </LI> <LI> Severe MB was associated with high incidence of CAS, and MB patients with CAS had a higher incidence of recurrent angina. </LI> </UL> </P>
A Case of Successful Bare Metal Stenting for Aortic Coarctation in an Adult
국형돈,나승운,Dong Hyeok Kim,이선기,Suk-Kyu Oh,Tae Hoon Ahn,Won Heum Shim,Woohyeun Kim 대한심장학회 2013 Korean Circulation Journal Vol.43 No.4
Aortic coarctation is a correctable hypertensive disease. For safety reasons and due to the invasiveness of surgical techniques, percutane-ous interventions have become drastically more popular in recent times. In elderly patients with aortic coarctation who are at risk of an aortic wall aneurysm and rupture, covered stents are preferred but in younger patients, bare metal stenting may be sufficient for long-term safety. Herein we present a 47-year-old typical aortic coarctation patient who was successfully treated with a bare metal stent.