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조인정,편욱범,신길자 대한심장학회 2009 Korean Circulation Journal Vol.39 No.4
Background and Objectives: It is not well understood whether the left ventricular geometry is associated with such diastolic parameters as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods: 181 patients (mean age: 63±9 years old, 62 males) with hypertension were included for echocardiographic analysis. The hypertensive patients were classified into four groups according to the left ventricular mass index and the relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy. We excluded all the individuals with established cardiovascular disease, atrial fibrillation, significant aortic and/ or mitral valve disease, or an ejection fraction <50%. Results: By definition, the left ventricular mass was increased in the patients with eccentric and concentric hypertrophy. Both the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were reduced in the concentric remodeling group, whereas the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Conclusion: This study demonstrates that in a patient population with hypertension and who are without systolic dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Background and Objectives: It is not well understood whether the left ventricular geometry is associated with such diastolic parameters as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods: 181 patients (mean age: 63±9 years old, 62 males) with hypertension were included for echocardiographic analysis. The hypertensive patients were classified into four groups according to the left ventricular mass index and the relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy. We excluded all the individuals with established cardiovascular disease, atrial fibrillation, significant aortic and/ or mitral valve disease, or an ejection fraction <50%. Results: By definition, the left ventricular mass was increased in the patients with eccentric and concentric hypertrophy. Both the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were reduced in the concentric remodeling group, whereas the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Conclusion: This study demonstrates that in a patient population with hypertension and who are without systolic dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy.
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조인정,장성열,장혁재,신상훈,심지영,홍그루,정남식 대한심장학회 2014 Korean Circulation Journal Vol.44 No.3
Background and Objectives: Screening strategies for aortic aneurysm (AA) according to risk factors and ethnicity are controversial. This study explored the prevalence of AA and determined whether screening is necessary in a population of multiple risk factors. Subjects and Methods: From June, 2012 to April, 2013, 542 consecutive elderly (≥65 years) male hypertensive patients without a history of AA were prospectively enrolled. After excluding 15 patients (2.8%) with aortic valve surgery, 30 patients (5.5%) with suboptimal computed tomography (CT) images, the remaining 496 patients (age 73±5 years) comprised the study population. Maximal diameters of the thoracic and abdominal aorta were measured using non-contrast CT. Results: The prevalence of thoracic AA (TAA, diameter ≥40 mm) and abdominal AA (AAA, diameter ≥30 mm) was 36.5% (181/496) and 6.0% (30/496), respectively. In the multivariate logistic regression analysis, determinants for TAA were age {odds ratio (OR) 1.059, 95% confidence interval (CI) 1.018–1.101, p=0.005}, dyslipidemia (OR 0.621, 95% CI 0.418–0.923, p=0.018), body surface area (OR 11.92, 95% CI 2.787–50.97, p=0.001), diastolic blood pressure (OR 1.029, 95% CI 1.009–1.049, p=0.004) and AAA (OR 3.070, 95% CI 1.398–6.754, p=0.005). In contrast, AAA was independently associated with dysplipidemia (OR 2.792, 95% CI 1.091–7.143, p=0.032), current/past smokers (OR 4.074, 95% CI 1.160–14.31, p=0.028), and TAA (OR 3.367, 95% CI 1.550–7.313, p=0.002). Conclusion: The prevalence of AA was significant and TAA was more prevalent than AAA in elderly Korean males with hypertension. Future research should establish distinct screening strategies for TAA and AAA according to risk factors and ethnicity.
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조인정,김진선,김용진,이상철,최정현,신상훈,심지영,홍그루,하종원,정남식,장혁재 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.3
Background: Hemorrhagic transformation (HT) of stroke is a disastrous complication in patients with infective endocarditis (IE). In patients with mechanical heart valves complicated by IE, physicians struggle with the appropriateness of anticoagulation administration given the risk of thromboembolism and HT of stroke. In this study, we aimed to define predictive parameters of HT of stroke in patients with prosthetic valve endocarditis (PVE). Methods: This study was a multicenter, retrospective design. We recruited from 7 institutions a total of 111 patients diagnosed with PVE during May, 2011 to April, 2012. Results: Complication of stroke was seen in 26/111 patients (23%), and HT of stroke was seen in 11/111 patients (10%). Most patients with HT (9/11, 82%) had supratherapeutic prothrombin times. However, there were no significant differences in clinical and laboratory values between PVE patients without stroke and those patients who had a stroke and with or without concurrent HT. Furthermore, echocardiographic parameters also did not show significant between-group differences. Conclusion: Even though this was a multicenter study, a limited number of patients was identified and may explain the negative results seen here. However, a large number of PVE patients with stroke also developed HT. Therefore, further studies to define predictive parameters of HT should be implemented in a larger population.
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조인정,장혁재,이상은,심지영,홍그루,정남식 대한심장학회 2017 Korean Circulation Journal Vol.47 No.6
Background and Objectives: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. Methods: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aortic calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm3). LVH obtained from echocardiography was defined as LV mass index >115 g/m2 for men and >95 g/m2 for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. Results: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17–89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71–11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). Conclusion: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
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pxn-1 and pxn-2 May Interact Negatively during Neuronal Development and Aging in C. elegans
조인정,황규진,조정훈 한국분자세포생물학회 2015 Molecules and cells Vol.38 No.8
C. elegans has two functional peroxidasins (PXN), PXN-1 and PXN-2. PXN-2 is essential to consolidate the extracellular matrix during development and is suggested to interact with PXN-1 antagonistically. pxn-1 is involved in neuronal development and possibly maintenance; therefore, we investigated the relationship between pxn-1 and pxn-2 in neuronal development and in aging. During neuronal development, defects caused by pxn-1 overexpression were suppressed by overexpression of both pxn-1 and pxn-2. In neuronal aging process, pxn-1 mutants showed less age-related neuronal defects, such as neuronal outgrowth, neuronal wavy processes, and enhanced short-term memory performance. In addition, pxn-2 overexpressing animals retained an intact neuronal morphology when compared with age-matched controls. Consistent with these results, overexpression of both pxn-1 and pxn-2 restored the severe neuronal defects present with pxn-1 overexpression. These results implied that there is a negative relationship between pxn-1 and pxn-2 via pxn-1 regulating pxn-2. Therefore, pxn-1 may function in neuronal development and age-related neuronal maintenance through pxn-2.
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