Search

Essential thrombocythemia (ET) is a chronic myeloproliferative disorder with a prolonged clinical course. Since this disorder is considered to be at increased risk of thromboembolism, therapy is mainly focused on the decreased risk of thrombohemorrhagic events by use of cytotoxic agents. Anagrelide is a phosphodiesterase III inhibitor which is utilized in the treatment of ET for the reduction of platelets. However, patients treated with anagrelide might experience cardiovascular adverse effects including myocardial infarction (MI), although these events are rare. Herein, we report a case of a 30-year-old female with well controlled ET by anagrelide, who eventually developed an acute non-ST elevation myocardial infarction (MI). There has no found any cardiovascular risk factors in this ET patient, strongly suggesting that anagrelide might be the cause of MI. Therefore, cardiovascular function should be monitored in those patients prescribed with anagrelide.

Background and Objectives The structural significance of the inappropriateness of left ventricular mass (iLVM) is known to be an important prognostic factor for cardiovascular events; however, the functional changes associated with iLVM have not been established. This study was performed to determine if diastolic dysfunction is associated with iLVM using a tissue Doppler technique. Subjects and Methods Three hundred sixty consecutive subjects, including 221 hypertension patients from the echocardiography database, were analyzed. Regarding the appropriateness of left ventricular (LV) mass, an observed/predicted ratio of LV mass (OPR) >130% was defined as inappropriate. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), isovolumetric relaxation time (IVRT), and E/early mitral annulus velocity (E'), were compared between the appropriate LV mass (aLVM) group and the iLVM group. Results Among transmitral flow parameters, only the E velocity was negatively correlated with the OPR when adjusted for age (adjusted r=-0.107, p=0.04). Based on multiple regression analysis, the OPR (β=0.163, p=0.003), as well as age (β=0.286, p=0.0001), systolic blood pressure (β=0.120, p=0.019), fasting blood glucose (β=0.098, p=0.042), and male gender (β=0.157, p=0.002) were independent factors determining E/E'. The cholesterol level was not an independent factor (β=-0.059, p=0.355). In the iLVM group (n=105), the adjusted E/E' was higher than in the aLVM group (n=255; 11.7±3.4 vs. 10.8±3.1, p=0.02), while the peak E flow velocity was significantly lower than in the aLVM group (70.9±15.1 vs. 75.5±17.6, p=0.03). Conclusion Inappropriateness of LV mass is independently associated with increased E/E'. Thus, E/E' may be a useful parameter for the evaluation of diastolic dysfunction.

Background and Objectives:The aim of the study was to evaluate the difference of temporal lability in my- ocardial repolarization between acute non-Q (NQMI and Q-wave myocardial infarction (QMI, and to discern whether the locations of myocardial infarction influence such temporal lability. Subjects and Methods:Tw- elve patients with NQMI and 28 with QMI, including 16 anterior (AMI and 12 inferior MI (IMI patients were enrolled. Twenty four-hour ambulatory ECG recordings of each patient were analyzed, and the digitized data was partitioned into 30-min sections. The QT intervals were measured using a template matching strategy. We then calculated the low (LF:0.03-0.15 Hz and high frequency (HF:0.15-0.4 Hz power of the QT interval variability using an algorithm capable of removing the influence of the RR-interval on QT interval va- riability (Normalized Idioventricular QT variability Index:IV-QT. Results:For patients with QMI, the low frequency IV QT (LF IV-QT was higher than that of NQMI (1.941±0.101 and 1.556±0.114 respectively, p

Background and Objectives:Our purpose was to assess the characteristics of ST segment deviation in the lateral leads (aVL, I, V5, V6) of patients with acute inferior myocardial infarction (AIMI) and elucidate any relationship with the culprit arteries. Materials and Method:The subjects were comprised 51 patients diagnosed as AIMI by standard electrocardiogram, cardiac enzymes and typical chest pain. The subjects were divided into two groups by angiographically proven culprit arteries:a left circumflex artery (LCx) group and a right coronary artery (RCA) group. We compared the frequencies of a ST segment depression more than 1 mm and less than 1 mm in aVL and I, and a ST segment elevation more than 0.5 mm and less than 0.5 mm in V5 and V6 in each culprit artery group. Results:Among the 51 patients with AIMI, 42 were in the RCA group and 9 were in the LCx group. The frequency of a ST segment depression more than 1 mm in aVL was 44% in the LCx group and 71% in the RCA group (p=0.140). 11% of the LCx group and 43% of the RCA group showed more than 1 mm ST segment depression in lead I (p=0.128). 56% of the LCx group showed more than 0.5 mm ST segment elevation in V5 and V6 and 81% of the RCA group showed less than 0.5 mm ST segment elevation in V5 and V6 (p=0.036). Conclusion:Culprit arteries in patients with AIMI and ST segment deviation in V5 and V6 are significantly related. ST segment elevation more than 0.5 mm in V5 and V6 was predominantly found in the LCx group, rather than the RCA group. Observation for ST segment deviation in the lateral precordial lead V5 and V6 would be important in predicting the culprit artery in AIMI. (Korean Circulation J 2001;31(10):982-987)

Background:A recent case-control study from Finland reported a strong relationship between high antibody titers to Chlamydia pneumoniae, strain TWAR, and both chronic heart disease and acute myocardial infarction. Other studies also suggested an association between C. pneumoniae infection and coronary atherosclerosis, based on the demonstration of increased serologic titers and the detection of bacteria within atherosclerotic tissue, but this association has not been yet regarded as an established theory. The objective of this study was to investigate the relationship between C. pneumoniae immnoglobulin G antibody titers and angiographically diagnosed coronary artery disease. Method:Coronary angiography was performed. Controls (n=89 were co- ronary angiographically normal cases and coronary artery disease (n=115 was diagnosed if coronary artery luminal diameter is obstructed more than 50% in more than one coronary artery. Micro-IF assay was used to measure C. pneumoniae TWAR antibodies. The sera were titrated in two-fold dilutions starting from 1 in 8, and a titre of 1 in 8 or more was judjed positive. Results:The estimated risk of coronary artery disease, adjusted for age and gender, was greater among subjects with high (≥1:128 antibody titers than with low (≤1:8 antibody titers (relative risk, 7.9:95% confidence interval, 1.3-47.9. Conclusion:These results support an association between infection with C. pneumoniae and coronary artery disease only in high (≥1:128 antibody titers. (Korean Circulation J 1999;29(10 :1076-1081

Background:Early diagnosis and treatment of hypertension is imperative to prevent the complications associated with this condition. The development of accurate and convenient methods of blood pressure measurement, therefore, is indispensible. At present, the JNC V has acknowledged the use of automatic sphygmomanometer that can be used without the help of someone else. We compared automatic oscillometric sphygmomanometers manufactured by Sein Electronics, korea (SE-7000 and SE-5000 with the standard Korotkoff auscultatory mercury sphygmomanometer meter. The correlation between these two methods were calulated to determine whether these prod- ucts could actually be used in clinical practice. This study was undertaken to ensure the clinical evaluation of these two products and standardization of an automatic sphygmomanometer in korea before it is actually used. Methods:The study included eighty-three patients, ranging in age from 14 to 81 years, who were admitted to Hanyang University Hospital in October, 1995. The blood pressure measured by the automatic oscillometric sphygmomanometer(SE-7000 in the right arm and was compared with that measured by the standard mercury sphygmomanometer(baumanometer in the left arm. Also the blood pressure measured by the automatic oscillometric sphygmoma-nometer(SE-5000 at the wrist was compared by the baumanometer in the same side arm. The correlation between these methods were determined by the paired Student' s t-test and by the simple liner regression method. Results:The p value of systolic blood pressure between two methods(SE-7000 and bauma- nomter in the both arms was 0.896 and correlation coefficient was 0.8286. The p value of diastolic

Nowadays left vocal cord paralysis is a rare presenting sign of cardiovascular diseases, associated with pulmonary hypertension. This condition is known as Cardiovocal syndrome. The mechanism of this condition is thought to be due to compression of the recurrent laryngeal nerve by a dilated, tense pulmonary artery against its adjacent structure. Two patients complaining hoarseness were proven to have cardiovascular diseases. The one had patent ductus arteriosus and the other had primary pulmonary hypertension. A causal relation between cardiovascular problem and the vocal cord paralysis is proposed. We describe two cases of Cardiovocal syndrome with a review of the literature.