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최시완,정진옥,강승식,성인환,박종훈 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1
Background : Noninvasive attemps to identify left ventricular relaxation have been hampered because relaxation rate, left atrial filling pressure, and chamber compliance are the major determinants of peak early velocity and filling rate. This study was perfomed to evaluate the relation between the velocity of flow propagation and left ventricular relaxation by using pulsed doppler echocardiography to analize flow propagation in the left ventricle. Method : By using pulsed Doppler echocardiography, the velocity of left ventricular flow propagation was measured from the distance and time difference of flow wave along the long axis propagation of left ventricular inflow during early filling in normal subjects (n=30), and M-mode echocardiographic data were obtained to evaluate mitral annulus long axis movement (mitral annulus relaxation rate) which represents left ventricular relaxation. Results : the peak early velocity was not related to mitral annulus relaxation rate, but, the velocity of flow propagation was related to mitral annulus relaxarate (P<0.005) in normal subjects. Conclusion : the velocity of flow propagation during early filling seems to be highly dependent on the mitral annulus relaxation rate and could be an important noninvasive tool in studying diastolic function.
고혈압 환자에서 도플러 심초음파를 이용한 좌심실내 혈류 전파 속도 측정
최시완,김준경,정준용,류정곤,정진옥,강승식,성인환,전은석,김영건 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.1
Background : Early detection and prevention of cardiac dysfunction is an important goal in the management of hypertensive patients. Doppler echocardiography was used to evaluate the pattern of left ventricular diastolic filling, however, filling indices from mitral sampling are not always nfluenced by factors related to left ventricular relaxation properties. Present study was performed to evaluate the relevance of propagation velocity to patients with hypertension by using pulsed Doppler echocardiography. Method : By using pulsed Doppler echocardiography, the velocity of left ventricular flow propagation velocity was measured from the distance and time difference of flow wave alcng the long axis propagation of left ventricular inflow during early filling in hypertensive patients (n=30 ), and M-mode echocardiographic data were obtained to evaluate mitral annulus long axis movement. Results : The values of E/A ratio, deceleration time, and left ventricular mass index were 0.82 + 0.18, 211 ± 55 msec,152 ±23 gr/m^2 respectively, and those of mitral ann ulus relaxation rate and left ventricular flow propagation velocity were 6.0 ±1.1 cm/sec and 62 ±17 cm/sec respectively. Flow propagation velocity was correlated to Doppler profiles such as E/A ratio ,r=0.47), deceleration time (r= -0.63) and mitral annulus relaxation rate (r=0.87) and also to left ventricular mass index (r= -0.69). Conclusion : left ventricular propagation velocity measurement by using pulsed Doppler echocardiography could be an important noninvasive tool in studying left ventricular diastolic function in patients with hypertension.
Acute Pulmonary Embolism Caused by Subacute Infective Endocarditis of the Tricuspid Valve
박재형,강신광,최시완,정진옥,성인환,이재환,유수진 한국심초음파학회 2009 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.17 No.1
Acute pulmonary embolism is usually caused by deep vein thrombosis of the lower extremities. However, vegetations of the tricuspid valve (TV) can cause embolic occlusion of the pulmonary vasculature and hence pulmonary embolism. We experienced a case of acute pulmonary embolism caused by subacute infective endocarditis of the TV. The computerized tomographic scans showed huge vegetations on the patient’s TV and obstruction of the bilateral pulmonary arteries. He was successfully treated with intravenous antibiotics and TV replacement.
한국인에서 Prostacyclin Synthase 유전자의C1117A 다형성과 급성 관동맥 증후군과의 연관성
김정희,정진옥,최시완,성인환 대한심장학회 2004 Korean Circulation Journal Vol.34 No.8
Background and Objectives:Platelets play an important role in the pathogenesis of acute coronary syndrome. Prostacyclin inhibits platelet aggregation, smooth muscle cell proliferation and vasoconstriction, and it counteracts thromboxane A2 activity. The purpose of this study is to evaluate the association between a single nucleotide polymorphism in the prostacyclin synthase gene and myocardial infarction in Koreans. Subjects and Methods:We studied total 119 patients (M:F=72:47, mean ages=57.9). We compared 60 acute coronary syndrome patients who underwent coronary angiography with the diagnosis of acute myocardial infarction (MI), with 59 normal control group patients who had normal coronary angiograms. With the use of polymerase chain reaction-restriction fragment length polymorphism analysis, we identified a single nucleotide polymorphism, C1117A, in exon 8. Results:The genotype distribution and allele frequencies were significantly different between the control group and MI group. Frequency of the genotype C1117A was:AA:AC:CC=3.4%:30.5%:66.1% in control group, respectively, and AA:AC:CC=1.7%:10.0%:88.3% in MI group, respectively. Prostacyclin synthase polymorphism was observed in the MI group and the control group, but the frequency of the CC genotype was high in MI group (odds ratio, 3.88;95% CI 1.49-10.88, p=0.003). Compared to control group, being male, having diabetes, hypertension or obesity, and the smoking rate were high in MI group. There were not significantly differences between genotypes for clinical characteristics. Conclusion:We conclude that the C1117A polymorphism in exon 8 of the prostacyclin synthase gene is associated with MI, and it may be a genetic marker of MI in Koreans. 배경 및 목적:혈소판 응집을 저해하는 prostacylin을 생성하는 prostacylin synthase C1117A의 변이가 급성 관동맥 증후군과 관련성이 있는지를 알아보고자 하였다.방 법:1998년 1월 1일부터 2000년 12월 31일까지 충남대학교병원 순환기내과에서 관상 동맥조영술을 받은 환자중 급성 심근경색 환자군(60예)과 협착이 없는 정상 대조군(59예)을 대상으로 관동맥 조영술 시행 직전 채취한 혈액에서 연층을 분리한후 genomic DNA를 추출하여 중합효소 연쇄반응법 및 restriction fragment length polymorphism(RFLP)을 이용하여 prostacyclin synthase 변이여부를 확인하였다. 결 론: Prostacyclin synthase C1117A는 심근경색 환자군에서 대조군에 비해 C/C형 homozygote의 빈도가 높아서 심근경색의 위험 인자 중 하나로 생각된다.