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복잡성 심실성 부정맥과 좌심실 비후의 상관관계 및 예후에 관한 연구
이광제(Kwang Je Lee),정유석(Yoo Suk Chung),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),김치정(Chee Jeong Kim),류왕성(Wang Seong Ryoo),유언호(Un Ho Yoo) 대한내과학회 1997 대한내과학회지 Vol.53 No.1
N/A Objectives: Echocardiographically determined left ventricular hypertrophy is associated with increased risk for sudden cardiae death and for complex ventricular arrhythmias in 24-hour ambulatory electrocardiographic monitoring. In subjects with left ventricular hypertrophy, the presence of asymptomatic complex ventricular arrhythmias is associated with higher incidence of sudden cardiac death and higher cardiovascular mortality. However, their accurate relationship and prognostic significances have been remained to be established. The purpose of this study was to evaluate the relationship between complex ventricular arrhythmias, left ventricular hypertrophy, and sudden cardiac death in Korean patients. Methods: Twenty four hour ambulatory electrocardiographic monitoring, echocardiographic data and medical records were reviewed in 360 subjects from 1991 to 1994. We evaluated the relationship between complex ventricular arrhythmias and left ventricular mass index, and the prognostic values of them. Of the 360 subjects, 187 could be followed up for one to four years. The mean follow-up period was 2.8 years. Results: The incidence of complex ventricular arrhythmias was significantly correlated with left ventricular mass index and ejection fraction in all subjects. During the follow-up periods, seven of 187 subjects died from sudden cardiac death. Six of them had complex ventricular arrhythmias with left ventricular hypertrophy. Conclusion - The incidence of complex ventricular arrhythmias was significantly correlated with echocardiographically determined left ventricular hypertrophy and it is suggested that subjects with complex ventricular arrhythmias combined with left ventricular hypertrophy have higher risk for sudden cardiac death.
확장성심근중 환자에서 Enalapril 치료가 좌심실내경의 순간변화율에 미치는 영향
김철우(Cheol Woo Kim),정유석(Yoo Suk Jung),이광제(Kwang Je Lee),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),김태호(Tae Ho Kim),김치정(Chee Jeong Kim),류왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1997 대한내과학회지 Vol.52 No.5
N/A Objective: Angiotensin-converting enzyme inhibitors have been shown to improve survival in patients with congestive heart failure. To evaluate the efficacy of enalapril in patients with dilated cardiomyopathy during concurrent treatment with digoxin and diuretics, the peak rates of left ventricular movement were assessed after 6 months of follow-up by digitized echocardiography. Methods: Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change (dD/dt) were obtained throughout the cardiac cycle. Normalized rates of wall movement (dD/dt/D) were used for comparison. Results: 1) Compared with control subjects, patients with dilated cardiomyopathy showed much lower Peak(-) dD/dt and Peak(-) dD/dt/D. 2) Peak(+) dD/dt and Peak(+) dD/dt/D were also depressed in patients. 3) Peak dD/dt improved significantly (p<0.05) in the enalapril group (n=16), but did not change in the conventional treatment group (n=20) after 6 months. Peak dD/dt/D improved approximately (p<0.005) in the enalapril group. 5) There were no deaths in 2 treatment groups during initial 6 months, but 3 patients in the conventional treatment group died suddenly during 1 year of follow-up. Conclusion: The present study has shown that left ventrieular Peak dD/dt and Peak dD/dt/D are significantly depressed in patients with dilated cardiomyopathy. Enalapril appears to provide well-tolerated and effective long-term therapy by improving peak rates of left ventricular movement in patients with dilated cardiomyopathy.
폐경후 여성에서 호르몬 대치요법의 투여기간이 지질과 Lipoprotein ( a ) 에 대한 효과에 미치는 영향
김치정(Chee Jeong Kim),곽미향(Mi Hyang Kwak),김경만(Kyung Man Kim),이광제(Kwang Je Lee),정유석(Yoo Suk Chung),민용기(Young Ki Min),유왕성(Wang Seong Ryu),유언호(Un Ho Ryoo) 대한내과학회 1997 대한내과학회지 Vol.52 No.6
N/A Objectievs: Hormone replacement therapy(HRT) in postmenopausal women decreases lipoprotein(a) [Lp(a)]. The influences of progesterone on Lp(a) and lipids, administered with estrogen, are controversial. However, previous studies had variable duration of therapy, and there was no report evaluating the effect of the duration of medication. Methods: A total 246 postmenopausal women were divided into 4 groups: group A; 0.625mg conjugated equine estrogen(CEE)(n=90), group B; 0.625mg CEE plus 5mg medroxyprogesterone acetate(MPA)(n=35), group C; 0.625mg CEE plus 10mg MPA(n=43), and group D; 2mg estradiol valerate(E2) plus 0.5mg norgestrel(N)(n=76). Lp(a) and lipids levels were measured before, 2, 6 and 12 months after HRT. Results: In total subjects, Lp(a) was decreased with medication for 2 months by 20.7%(p<0,0001). Compared with levels at 2 months after medication, levels at 6 and 12 months revealed further reduction(p<0.001) by 5.3% and 9.0% respectively. Medication for 2 months increased HDL-C in group A, not changed in group B and C, and decreased in group D. After 12 months, HDL-C levels were increased in Group A, B, and C, and not changed in group D, In total subjects, low density lipoprotein- cholesterol(LDL-C) was decreased by 12.2% after 2 months(p<0.001). Compared with levels at 2 months after medication, LDL-C level was decreased by 3.4% after 6 months(p<0.001) and there was no further reduction after 12 months. Conclusion: The effect of hormone replacement therapy on Lp(a) and lipids were dependent upon the duration of medication. Inconsistent results in previous studies can be partially explained by the difference in this parameter.
Enalapril 경구 투여가 혈중 Angiotensin 전환효소 활성도에 미치는 영향
유언호,류호준 중앙대학교 의과대학 의과학연구소 1995 中央醫大誌 Vol.20 No.1
Enalapril, a angiotensin converting enzyme(ACE) inhibitor, was given in a single oral dose of 10mg to 13 patients with essential hypertension and to 10 control patients with normal blood pressure. Blood pressure, plasma renin activity, aldosteron, and SCE activity were measured before and after enalapril administration. The results were as follow : 1. At 3 hours. after administration of enalapril, plasma ACE activity decreased in both groups of patients(p<0.05) but more decreased in patients with essential hypertension from 19.4±8.8 to 9.7±5.7 nmole/min/ml(p<0.05). 2. Decresed levels of plasma ACE activity were accompanied by reduction of blood pressure in response to enalapril, especially systolic blood pressure in patients with hypertension. Blood pressure also decreased in both groups of patients including those with normal or low renin levels(p<0.05), but there was not a significant correlation between the magnitude of blood pressure reduction and baseline plasma renin activity. 3. After 10mg of enalapril administration, mean plasma renin activity rose(p<0.05), while plasma aldosterone concentration fell in both groups of patients. It suggest that enalapril is an effective ACE inhibitor and the measurement of plasma ACE activity is useful for monitoring the efficacy of ACE inhibitor and compliance to treatment with enalapril.