Case Reports : A Case of Pulmonary Vein Tumor Presenting as a Left Atrial Mass

Hyo Keun Jeon,Jung Ho Kim,Gwon Hyun Cho,Sun Young Kyung,Sung Hwan Jeong,Wook Jin Chung,Na Rae Kim 대한내과학회 2007 The Korean Journal of Internal Medicine Vol.22 No.1

Primary cardiac tumors are extremely rare and can originate within the heart or be the result of tumor spread from other sites. We report a female patient with a pulmonary vein tumor extending into the left atrium that had a suspicious primary malignant origin with a sacral metastatic carcinoma. The patient was admitted complaining of pain in her buttock area as a result of a sacral tumor. It was believed that the sacral tumor was a metastasis from the imaging study and clinical manifestation. The primary malignant origin was evaluated. The chest CT showed a left atrium thrombus-like lesion without a pulmonary abnormality. After a transesophageal echocardiogram, the patient was diagnosed with a pulmonary vein tumor extending to the left atrium. The patient was given palliative radiotherapy for the sacral pain. Initially, the clinical impression was a metastatic sacral tumor with a thromboembolism of the left atrium. However, this patient was finally diagnosed with a pulmonary vein tumor with a left atrium extension by a transesophageal echocardiogram.

Left Atrial Mass with Stalk: Thrombus or Myxoma?

장경희,신대희,이창근,장진근,정상식,유상용 한국심초음파학회 2010 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.18 No.4

A 63-year-old female was presented to emergency room with an abdominal pain. The patient had moderate mitral valve stenosis and atrial fibrillation. Abdominal computed tomography revealed right renal infarction. Transthoracic echocardiography showed a large mobile mass in the left atrium. Transesophageal two-and three-dimensional echocardiography showed a large mobile ovoid mass with a narrow stalk attached to the left atrial septum. It was thought to be a myxoma rather than thrombus. Anticoagulation with heparin was continued. When the operation was performed, there was no mass in the left atrium. It must be a thrombus and melt away.

Direct Communication with Fistula between the Left Main Pulmonary Artery and the Left Atrium: A Case Report

고연지,김성수,김진환,박재형,이재환 대한영상의학회 2012 대한영상의학회지 Vol.66 No.3

We report a rare case of a direct communication-forming fistula between the left main pulmonary artery and left atrial appendage detected on computed tomography and color Doppler echocardiography.

Mirror Image Gerbode or Partial Atrioventricular Canal Defect?

Cem Ariturk, Ass.Prof.,Ahmet Umit Gullu, Ass.Prof.,Sahin Senay, Ass.Prof.,Eyup Murat Okten, M.D.,Fevzi Toraman,E. Hasan Karabulut, Prof.,Letisya Melengic, M.S.,Cem Alhan, Prof. 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.6

Gebode defect, that can accurately be treated surgical repair, is defined as a true communication between left ventricle and right atrium. A 74-year-old woman with a worsening history of ortophnea and peripheral edema was hospitalised. A communication between right atrium and left ventricle was diagnosed using transeusophageal echocardiography. The defect was repaired and mitral valve was replaced with a biologic valve. It would be beter to tailor surgical strategy for each case with atrioventricular canal defect after preoperative transeusophageal echocardiography and peroperative direct sight.

Factors Associated with Cheyne-Stokes Respiration in Acute Ischemic Stroke

김유나,김성헌,류동열,이서영,임경빈 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.4

Background and Purpose Cheyne-Stokes respiration (CSR) is frequently observed in patients with acute stroke. There have been conflicting opinions about the associations of CSR with the location and size of the lesion. We aimed to better define the clinical relevance and pathogenesis of CSR in acute stroke. Methods We investigated patients who had been admitted with acute ischemic stroke and received an overnight sleep apnea test. We collected data on demographics, risk factors, etiologic subtypes, initial vital signs, clinical course of the stroke, and parameters associated with respiratory events during the sleep apnea test. We performed a multivariate logistic regression analysis to determine the factors associated with CSR. Results Among 182 patients, 35 patients showed CSR in sleep apnea testing. Large-artery atherosclerosis or cardioembolism, bilateral hemispheric involvement, atrial fibrillation, low left-ventricle ejection fraction (LVEF), and left atrium (LA) enlargement were all associated with the presence of CSR. Multivariate analysis revealed that the previous modified Rankin Scale (mRS) score, bilateral hemispheric involvement, low LVEF, and LA enlargement were significantly associated with CSR. Subgroup analysis with large-artery atherosclerosis without cardiac disease revealed that the previous mRS score is the only independent factor associated with CSR. Conclusions CSR frequently occurs in strokes involving large arteries or due to cardioembolism, regardless of the location and severity of the stroke. Predisposing conditions such as preexisting neurologic disability, low LVEF, and LA enlargement are associated with CSR in acute stroke.

The Influence of the Left Ventricular Geometry on the Left Atrial Size and Left Ventricular Filling Pressure in Hypertensive Patients, as Assessed by Echocardiography

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.

성인의 좌심방과 좌심실 크기변화에 미치는 영향 요인 분석

김선화(Sun-Hwa Kim),양성희(Sung-Hee Yang) 대한방사선과학회(구 대한방사선기술학회) 2024 방사선기술과학 Vol.47 No.2

A Study on the Correlation of Left Atrial Volume Change according to Left Ventricular Contraction in Atrial Fibrillation

Sung Kwan Kim,Hee Chang Chae,Choong Beom Seo,Eun Hee Seo,Chang Min Dae,Tae Eun Kim 대한CT영상기술학회 2022 대한CT영상기술학회지 Vol.24 No.1

The purpose of this study was to increase accuracy and success rate of radiofrequency catheter ablation by analysis of left atrial volume change relative to left ventricular volume change and left atrial diameter change relative to left atrial volume change. 20 patients with normal heart rhythm were set as the control group, and 20 patients with diagnosed atrial fibrillation were set as the experimental group. The cardiac cycle was divided into 10 stages ranging from 0% to 90%, and left ventricular volume, left atrial volume, left atrial diameter, pulmonary vein diameter were measured for each group. the correlation between the left ventricular volume and the left atrial volume was analyzed, and the correlation between the left atrial volume and left atrial diameter was analyzed. The diameter of the pulmonary veins was measured. As a result of analyzing the correlation between left ventricular volume and left atrial volume through Spearman correlation, the control group showed a negative correlation.(P<0.001) The experimental group were not correlated.(P=0.075) As a result of analyzing the correlation between the left atrial volume and the left atrial diameter, both groups showed a positive correlation.(P<0.001) As a result of analyzing the diameter of the pulmonary vein by Wilcoxon signed-rank test, both groups showed a significant difference in the maximum diameter and the minimum diameter.(P<0.001) Because the volume and diameter of the left atrium in patients with atrial fibrillation change irregularly, the radiologist check all cardiac cycle and reconstruct to increase the accuracy and success rate of radiofrequency catheter ablation.

Evaluation of the Relationship between Circadian Blood Pressure Variation and Left Atrial Function Using Strain Imaging

박찬석,안건희,김영운,박윤정,김미정,조은주,임상현,정해억,김희열,전희경,윤호중,김재형 한국심초음파학회 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.4

Background: Non-dippers were reported as showing different left atrial function, compared to dippers, but no study to date investigated the changes in the left atrial function according to the diurnal blood pressure pattern, using tissue Doppler and strain imaging. Methods: Forty never treated hypertensive patients between 30 and 80 years of age were enrolled in this study. Patients were classified as non-dippers when, during night time, they had a blood pressure decrease of less than 10%. Strain of the left atrium was measured during late systole, and peak strain rates of the left atrium were measured during systole, early and late diastolic periods. Results: The left atrial expansion index, left atrial active emptying volume and left atrial active emptying fraction were all significantly increased in non-dippers. They also had increased values of mean peak left atrial strain (dippers = 21.26 ± 4.23% vs. non-dippers = 24.91 ± 5.20%, p = 0.02), strain rate during reservoir (dippers = 1.29 ± 0.23 s-1 vs. non-dippers =1.52 ± 0.27 s-1,p = 0.01) and contractile period (dippers = -1.38 ± 0.24 s-1 vs. non-dippers = -1.68 ± 0.32 s-1, p < 0.01). Conclusion: Strain and strain rate acquired from color Doppler tissue imaging demonstrate exaggerated reservoir and booster pump function in never-treated, non-dipper hypertensive patients. These methods are simple and sensitive for the early detection of subtle changes in the left atrial function.

Evaluation of the Relationship between Circadian Blood Pressure Variation and Left Atrial Function Using Strain Imaging

Park, Chan Seok,An, Gun-Hee,Kim, Young-Woon,Park, Youn-Jung,Kim, Mi-Jeong,Cho, Eun Joo,Ihm, Sang-Hyun,Jung, Hae-Ok,Kim, Hee-Yeol,Jeon, Hui-Kyung,Youn, Ho-Joong,Kim, Jae-Hyung Korean Society of Echocardiography 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.4

<P><B>Background</B></P><P>Non-dippers were reported as showing different left atrial function, compared to dippers, but no study to date investigated the changes in the left atrial function according to the diurnal blood pressure pattern, using tissue Doppler and strain imaging.</P><P><B>Methods</B></P><P>Forty never treated hypertensive patients between 30 and 80 years of age were enrolled in this study. Patients were classified as non-dippers when, during night time, they had a blood pressure decrease of less than 10%. Strain of the left atrium was measured during late systole, and peak strain rates of the left atrium were measured during systole, early and late diastolic periods.</P><P><B>Results</B></P><P>The left atrial expansion index, left atrial active emptying volume and left atrial active emptying fraction were all significantly increased in non-dippers. They also had increased values of mean peak left atrial strain (dippers = 21.26 ± 4.23% vs. non-dippers = 24.91 ± 5.20%, <I>p</I> = 0.02), strain rate during reservoir (dippers = 1.29 ± 0.23 s<SUP>-1</SUP> vs. non-dippers =1.52 ± 0.27 s<SUP>-1</SUP>, <I>p</I> = 0.01) and contractile period (dippers = -1.38 ± 0.24 s<SUP>-1</SUP> vs. non-dippers = -1.68 ± 0.32 s<SUP>-1</SUP>, <I>p</I> < 0.01).</P><P><B>Conclusion</B></P><P>Strain and strain rate acquired from color Doppler tissue imaging demonstrate exaggerated reservoir and booster pump function in never-treated, non-dipper hypertensive patients. These methods are simple and sensitive for the early detection of subtle changes in the left atrial function.</P>