Multiple Fistula Emptying into the Left Ventricle through the Entire Left Ventricular Wall

이동엽,박선희,배명환,이장훈,양동헌,박헌식,조용근,채성철,전재은 한국심초음파학회 2012 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.20 No.2

Coronary artery fistulae are usually identified during invasive coronary angiographies. However, in this case, we made the early detection of coronary artery fistulae during non-invasive transthoracic echocardiography, by demonstrating diastolic multiple abnormal color Doppler flows on the entire left ventricular walls including left ventricular free wall, interventricular septum and apex, which were mimicking firecracker on the whole left ventricle. Fistulous communication from the coronary artery to the left ventricle is rare. Moreover, a case of multiple coronary fistulae emptying into the left ventricle through the entire left ventricular walls including left ventricular free wall, interventricular septum and apex is uncommon. We report a case of a 31-year-old woman who was diagnosed with multiple fistula communicating with entire left ventricular wall.

이면성 및 도플러 심초음파도를 이용하여 진단한 선천성 거대 좌회선지-좌심실 관동맥루

진승원,박준철,이영중,유병현,박현옥,김용주,윤호중,김재형,홍순조,최규보,권종범,원용순,박건 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

Papillary Fibroelastoma Presenting as a Left Ventricular Mass

박진한,설상훈,조환진,박시형,김동기,김웅,양태현,김대경,김두일,김동수 한국심초음파학회 2010 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.18 No.2

Cardiac papillary fibroelastoma (CPF) is a benign cardiac tumor that usually affects cardiac valves. It is usually discovered incidentally on routine echocardiography. However, left ventricular CPF is rare. This report describes the case of a 73-year-old female, referred to a cardiology department for evaluation of a mass of the left ventricle. The mass was found routine echocardiography. The transthoracic echocardiography revealed a 2.2×1.3 cm highly oscillating mass, attached by stalk on the inferior wall of the left ventricle. Cardiac magnetic resonance imaging demonstrated a non-enhanced, 1.8×1.0 cm mass on the inferior wall of the left ventricle. The patient underwent surgical resection of the mass, histopathologic examination of the mass confirmed the diagnosis of a CPF.

Computed Tomography-Based Ventricular Volumes and Morphometric Parameters for Deciding the Treatment Strategy in Children with a Hypoplastic Left Ventricle: Preliminary Results

구현우,박상협 대한영상의학회 2018 Korean Journal of Radiology Vol.19 No.6

Objective: To determine the utility of computed tomography (CT) ventricular volumes and morphometric parameters for deciding the treatment strategy in children with a hypoplastic left ventricle (LV). Materials and Methods: Ninety-four consecutive children were included in this study and divided into small LV single ventricle repair (SVR) (n = 28), small LV biventricular repair (BVR) (n = 6), disease-matched control (n = 19), and control (n = 41) groups. The CT-based indexed LV volumes, LV-to-right-ventricular (LV/RV) volume ratio, left-to-right atrioventricular valve (AVV) area ratio, left-to-right AVV diameter ratio, and LV/RV long dimension ratio were compared between groups. Proportions of preferred SVR in the small LV SVR group suggested by the parameters were evaluated. Results: Indexed LV end-systolic (ES) and end-diastolic (ED) volumes in the small LV SVR group (6.3 ± 4.0 mL/m2 and 14.4 ± 10.2 mL/m2, respectively) were significantly smaller than those in the disease-matched control group (16.0 ± 4.7 mL/m2 and 37.7 ± 12.0 mL/m2, respectively; p < 0.001) and the control group (16.0 ± 5.5 mL/m2 and 46.3 ± 10.8 mL/m2, respectively; p < 0.001). These volumes were 8.3 ± 2.4 mL/m2 and 21.4 ± 5.3 mL/m2, respectively, in the small LV BVR group. ES and ED indexed LV volumes of < 7 mL/m2 and < 17 mL/m2, LV/RV volume ratios of < 0.22 and < 0.25, AVV area ratios of < 0.33 and < 0.24, and AVV diameter ratios of < 0.52 and < 0.46, respectively, enabled the differentiation of a subset of patients in the small LV SVR group from those in the two control groups. One patient in the small LV biventricular group died after BVR, indicating that this patient might not have been a good candidate based on the suggested cut-off values. Conclusion: CT-based ventricular volumes and morphometric parameters can suggest cut-off values for SVR in children with a hypoplastic LV.

정상 좌심실을 가진 대동맥 판막 폐쇄증에서의 일차성 완전교정술

김욱성,김용진,Kim, Uk-Seong,Kim, Yong-Jin 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.9

Four to seven percent of infants born with aortic atresia have a normal-sized left ventricle in association with a ventricular septal defect and a normal mitral valve. In contrast to the more common group of infants with aortic atresia whose left ventricle is hypoplastic, this important subgroup has potential for complete operative correction involving both the right and left ventricle. Our approach was to perform complete repair at one stage. The patient who underwent single-stage repair was discharged from the hospital in good condition. Achieving a physiologically normal circulation simplifies the postoperative management of this condition.

Biomechanics of infarcted left ventricle: a review of modelling

Wenguang Li 대한의용생체공학회 2020 Biomedical Engineering Letters (BMEL) Vol.10 No.3

Mathematical modelling in biomechanics of infarcted left ventricle (LV) serves as an indispensable tool for remodellingmechanism exploration, LV biomechanical property estimation and therapy assessment after myocardial infarction (MI). However, a review of mathematical modelling after MI has not been seen in the literature so far. In the paper, a systematicreview of mathematical models in biomechanics of infarcted LV was established. The models include comprehensive cardiovascularsystem model, essential LV pressure–volume and stress-stretch models, constitutive laws for passive myocardiumand scars, tension models for active myocardium, collagen fi bre orientation optimization models, fi broblast and collagenfi bre growth/degradation models and integrated growth-electro-mechanical model after MI. The primary idea, unique characteristicsand key equations of each model were identifi ed and extracted. Discussions on the models were provided andfollowed research issues on them were addressed. Considerable improvements in the cardiovascular system model, LV aneurysmmodel, coupled agent-based models and integrated electro-mechanical-growth LV model are encouraged. Substantialattention should be paid to new constitutive laws with respect to stress-stretch curve and strain energy function for infarctedpassive myocardium, collagen fi bre orientation optimization in scar, cardiac rupture and tissue damage and viscoelasticeff ect post-MI in the future.

Supplementary Diagnostic Landmarks of Left Ventricular Non-Compaction on Magnetic Resonance Imaging

Marko Boban,Vladimir Pesa,Natko Beck,Sime Manola,Marinko Zulj,Ante Rotim,Aleksandar Vcev 연세대학교의과대학 2018 Yonsei medical journal Vol.59 No.1

Purpose: Diagnostic criteria for left ventricular non-compaction (LVNC) are still a matter of dispute. The aim of our present study was to test the diagnostic value of two novel diagnostic cardiac magnetic resonance (CMR) parameters: proof of non-compact (NC) myocardium blood flow using T2 sequences and changes in geometry of the left ventricle. Materials and Methods: The study included cases with LVNC and controls, from a data base formed in a period of 3.5 years (n= 1890 exams), in which CMR protocol included T2 sequences. Measurement of perpendicular maximal and minimal end diastolic dimensions in the region with NC myocardium from short axis plane was recorded, and calculated as a ratio (MaxMinEDDR), while flow through trabecula was proven by intracavital T2-weighted hyperintensity (ICT2HI). LVNC diagnosis met the following three criteria: thickening of compact (C) layer, NC:C>2.3:1 and NC>20%LV. Results: The study included 200 patients; 71 with LVNC (35.5%; i.e., 3.76% of CMRs) and 129 (64.5%) controls. MaxMinEDDR in patients with LVNC was significantly different from that in controls (1.17±0.08 vs. 1.06±0.04, respectively; p<0.001). MaxMinEDDR>1.10 had sensitivity of 91.6% [95% confidence intervals (CI) 82.5–96.8], specificity of 85.3% (95% CI 78.0–90.0), and area undercurve (AUC) 0.919 (95% CI 0.872–0.953; p<0.001) for LVNC. Existence of ICT2HI had sensitivity of 100.0% (95% CI 94.9–100.0), specificity of 91.5% (95% CI 85.3–95.7), and AUC 0.957 (95% CI 0.919–0.981; p<0.001) for LVNC. Conclusion: Two additional diagnostic parameters for LVNC were identified in this study. ICT2HI and geometric eccentricity of the ventricle both had relatively high sensitivity and specificity for diagnosing LVNC.

Left Ventricular Remodeling After Catheter Ablation of Atrial Fibrillation: Changes of Myocardial Extracellular Volume Fraction by Cardiac MRI

Kim Sang-Un,Park Soojung,Cho Hyungjoon,Cho Yongwon,Oh Yu-Whan,Kim Yun Gi,Shim Jaemin,Choi Jong-il,Kim Young-Hoon,Paek Mun Young,Hwang Sung Ho 대한자기공명의과학회 2022 Investigative Magnetic Resonance Imaging Vol.26 No.3

Purpose: The aim of this study is to demonstrate the association between recurrent atrial fibrillation (AF) and left ventricular (LV) adverse remodeling after catheter ablation and to evaluate the change of myocardial extracellular volume fraction (ECV) by catheter ablation outcomes. Materials and Methods: We retrospectively recruited 60 patients (44 men and 16 women) with a median age of 57 years (range, 32–78 years) who underwent cardiac MRI before and at 6–12 months after catheter ablation of AF. Cardiac MRI quantified myocardial ECV (%) in the left ventricle. Depending on myocardial ECV after catheter ablation, patients were divided into two groups: 1) LV adverse remodeling with ECV ≥ 28%; and 2) no adverse LV remodeling with ECV < 28%. Multivariable analysis was performed to assess the association between recurrent AF and LV remodeling. Results: Of 60 patients, 21 (35%) were in the LV adverse remodeling group (mean ECV ± standard deviation [SD]: 29.8% ± 1.4%) and 39 (65%) were in the no adverse LV remodeling group (mean ECV ± SD: 24.7% ± 1.5%). The incidence of recurrent AF was significantly greater in the LV adverse remodeling group than in the no adverse LV remodeling group (81% vs. 13%, p < 0.001). In patients with recurrent AF, mean myocardial ECV significantly increased from 27.7% ± 2.3% to 29.2% ± 2.3% (p = 0.004) after catheter ablation. In a multivariable analysis after adjusting sex, age, and myocardial ECV before catheter ablation, recurrent AF was independently associated with LV adverse remodeling after catheter ablation (odds ratio: 28.9, 95% confidence interval: 6.8–121.7, p < 0.001). Conclusion: When monitoring with cardiac MRI, sustained AF was significantly associated with LV adverse remodeling through an increase in myocardial ECV after catheter ablation of AF.

Dor 술식 후 좌심실 혈전증에서의 항응고제의 역할

백만종 대한흉부외과학회 2003 Journal of Chest Surgery (J Chest Surg) Vol.36 No.7

심근경색 후 좌심실 혈전증은 빈번하며 색전의 위험성이 있지만, 허혈성 심근증 환자에서 Dor 술식 후 좌심실 혈전증의 발생이나 치료법은 잘 알려져 있지 않다. 저자들은 45세 남자에서 관상동맥우회술과 Dor 술식 및 좌심실 혈전 제거술 후 좌심실 혈전이 재발하여 정맥내 헤파린 주사 및 경구 쿠마딘을 투여하여 좌심실 혈전의 소실이 있었기에 보고하고자 한다. 본 증례를 통해 저자들은 심첨부 심실벽의 이상운동을 가진 좌심실류가 동반된 좌심실 기능부전 환자들에서 Dor 술식 후 항응고제의 투여가 좌심실 혈전 발생의 예방 및 치료에 도움이 될 수 있을 것으로 사료된다.

Ginseng Total Saponin Attenuate Cardiac Hypertrophy Induced by Homocysteine in Rats

Kim, Jong-Hoon The Korean Society of Ginseng 2009 Journal of Ginseng Research Vol.33 No.4

Recent studies have shown that Panax ginseng has a variety of beneficial effects on the cardiovascular system. Homocysteine (Hcy), which is derived from methionine, has been closely associated with the increased risk of cardiovascular diseases. In the present study, whether the in-vivo long-term co-administration of ginseng total saponins (GTS), active ingredients of Panax ginseng, with L-methionine (Met) inhibits methionine-induced hyperhomocysteine (HHcy) and H-Hcy-induced cardiovascular dysfunctions was investigated, and it was found that the plasma Hcy level, which was measured after 30 and 60 days, in the GTS+Met co-administration group was more significantly reduced than in the Metalone-treatment group. The left-ventricle (LV) wall thickness of the heart was likewise examined in each treatment group, and it was found that the co-administration of GTS with Met significantly reduced the Met-induced LV wall thickness. The results of the study indicate that the in-vivo long-term co-administration of GTS with Met not only inhibited H-Hcy induced by long-term Met-alone administration but also attenuated the H-Hcy-induced cardiovascular dysfunctions in rats.