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1.
Int J Tuberc Lung Dis ; 8(9): 1120-6, 2004 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15455598

RESUMEN

SETTING: University-affiliated general hospital. OBJECTIVE: To evaluate the pump performance of right heart before and after exercise in post-tuberculosis emphysema. DESIGN: In patients with post-tuberculosis or primary emphysema (similar lung volumes), body plethysmography, arterial blood gas analysis and echocardiography were performed at rest and after exercise. Right heart pump performance was evaluated with the ejection fraction. RESULTS: At rest, in post-tuberculosis emphysema, diffusing capacity (mean +/- SE 72.7 +/- 3.9 vs. 91.0 +/- 7.1% of reference) and right ventricular ejection fraction (57.5 + 1.4 vs. 61.3 +/- 1.2%) were lower and PaCO2 (42.7 +/- 1.1 vs. 38.6 +/- 0.7 mmHg) was higher, while lung compliance, airway resistance, PaO2, and alveolar-arterial oxygen difference were not different. After exercise, PaO2 (65.6 +/- 2.8 vs. 80.5 +/- 3.5 mmHg) and right ventricular ejection fraction (51.2 +/- 2.4 vs. 59.6 +/- 1.7%) were lower and PaCO2 (47.0 +/- 1.5 vs. 40.9 +/- 1.5 mmHg) was higher in post-tuberculosis emphysema, whereas alveolar-arterial oxygen difference was not different. PaCO2 and alveolar-arterial oxygen difference increased, and PaO2 and right ventricular ejection fraction decreased in post-tuberculosis emphysema, while they did not significantly change in primary emphysema. CONCLUSION: In post-tuberculosis emphysema, the impairment of gas exchange was more serious. Global assessment should be focused on right heart dysfunction which might be more affected than in primary emphysema.


Asunto(s)
Enfisema/complicaciones , Enfisema/etiología , Tuberculosis Pulmonar/complicaciones , Disfunción Ventricular Derecha/etiología , Análisis de los Gases de la Sangre , Dióxido de Carbono/sangre , Ecocardiografía , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Pruebas de Función Respiratoria , Disfunción Ventricular Derecha/diagnóstico por imagen , Disfunción Ventricular Derecha/patología
2.
J Am Soc Echocardiogr ; 14(1): 57-9, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11174435

RESUMEN

When patent ductus arteriosus (PDA) is complicated by pulmonary hypertension resulting in a right-to-left shunt, an erroneous diagnosis of primary pulmonary hypertension may be made, even after echocardiographic examination. Among the 8 patients referred to our echocardiography laboratory with the diagnosis of primary pulmonary hypertension between June 1994 and November 1999, 2 patients were found to have PDA with Eisenmenger's syndrome. Patent ductus arteriosus with Eisenmenger's syndrome can be diagnosed by the opacification of the abdominal aorta without opacification of the left-sided chambers during contrast echocardiography.


Asunto(s)
Medios de Contraste , Conducto Arterioso Permeable/diagnóstico por imagen , Ecocardiografía , Complejo de Eisenmenger/diagnóstico por imagen , Adolescente , Adulto , Aorta Abdominal/diagnóstico por imagen , Diagnóstico Diferencial , Conducto Arterioso Permeable/complicaciones , Complejo de Eisenmenger/complicaciones , Femenino , Humanos , Hipertensión Pulmonar/complicaciones , Masculino , Persona de Mediana Edad
3.
J Am Soc Echocardiogr ; 12(11): 927-31, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10552353

RESUMEN

This study assessed the clinical utility of mitral annulus velocity in the evaluation of left ventricular diastolic function in patients with atrial fibrillation. Atrial fibrillation is the most common sustained arrhythmia encountered in clinical practice. The clinical usefulness of conventional Doppler indexes is limited in atrial fibrillation because of the altered left atrial pressure and loss of synchronized atrial contraction. Mitral inflow and mitral annulus velocities were measured simultaneously with tau in 27 patients with nonrheumatic atrial fibrillation at the cardiac catheterization laboratory. Among deceleration time of mitral inflow, peak mitral inflow velocity (E), and peak diastolic mitral annulus velocity (E), only E correlated with tau (r = 0.51, P =.007). Prolonged tau (>/=50 ms) could be predicted by E <8 cm/s with a sensitivity of 73% (16 of 22) and a specificity of 100% (5 of 5). The E/E ratio correlated with left ventricular filling pressure (r = 0.79, P <.001). The E/E ratio of >/=11 could predict elevated left ventricular filling pressure (>/=15 mm Hg) with a sensitivity of 75% (9 of 12) and a specificity of 93% (14 of 15). Mitral annulus velocity is useful in the detection of impaired left ventricular relaxation and estimation of filling pressure even in patients with atrial fibrillation.


Asunto(s)
Fibrilación Atrial/diagnóstico por imagen , Fibrilación Atrial/fisiopatología , Ecocardiografía Doppler de Pulso , Válvula Mitral/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Velocidad del Flujo Sanguíneo , Diástole/fisiología , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Curva ROC , Sensibilidad y Especificidad , Estadísticas no Paramétricas , Presión Ventricular
4.
Am J Chin Med ; 28(2): 205-16, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10999439

RESUMEN

This study is to estimate the effect of Korean red ginseng on vascular endothelial cell dysfunction in patients with hypertension. Seventeen patients with hypertension who were divided into ginseng-treated (7) and non-treated (10) groups and 10 normotensive subjects were included. To assess the function of the vascular endothelial cell, changes of forearm blood flow to infusion of acetylcholine, sodium nitroprusside and bradykinin in incremental doses were measured by venous occlusion plethysmography. In the ginseng-treated hypertensive group, forearm blood flows at the highest dose of acetylcholine and bradykinin were significantly higher than those of the non-treated hypertensive group and were not different from those of the control group. In the case of sodium nitroprusside infusion, no significant differences were observed between the control, non-treated and treated groups. In conclusion, Korean red ginseng can improve the vascular endothelial dysfunction in patients with hypertension possibly through increasing synthesis of nitric oxide.


Asunto(s)
Medicamentos Herbarios Chinos/farmacología , Endotelio Vascular/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Panax/uso terapéutico , Fitoterapia , Plantas Medicinales , Vasodilatadores/farmacología , Acetilcolina/farmacología , Adulto , Anciano , Bradiquinina/farmacología , Medicamentos Herbarios Chinos/uso terapéutico , Endotelio Vascular/fisiología , Femenino , Antebrazo/irrigación sanguínea , Humanos , Masculino , Persona de Mediana Edad , Nitroprusiato/farmacología , Pletismografía , Flujo Sanguíneo Regional/efectos de los fármacos , Vasodilatadores/uso terapéutico
6.
Korean J Intern Med ; 10(2): 143-5, 1995 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-7495773

RESUMEN

OBJECTIVES: Atrial fibrillation is an important risk factor for systemic embolism. A number of clinical studies demonstrated the beneficial effect of anticoagulant therapy for the prevention of embolism. But there has been no study on the fate of left atrial thrombus demonstrated by transesophageal echocardiography in the course of anticoagulation therapy. METHODS: Thirteen patients, demonstrated to have left atrial thrombus by transesophageal echocardiography were followed with anticoagulation therapy. Repeated transesophageal echocardiography was done 15 months after 1st study. RESULTS: Among 9 patients with adequate anticoagulation effect (INR > 2.0), left atrial thrombus disappeared in 3 patients. The size of thrombus decreased from 2.2 +/- 0.8cm to 0.9 +/- 1.0cm (p < 0.05 by paired Student's t-test). CONCLUSIONS: Left atrial thrombus could dissolve or decrease in size with adequate anticoagulation.


Asunto(s)
Trombosis Coronaria/tratamiento farmacológico , Ecocardiografía Transesofágica , Warfarina/uso terapéutico , Trombosis Coronaria/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Masculino
7.
Korean J Intern Med ; 16(2): 56-61, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11590902

RESUMEN

BACKGROUND: Hepatopulmonary syndrome (HPS) refers to the association of hypoxemia, intrapulmonary shunting and chronic liver disease. But there is no clear data about the prevalence of HPS in postnecrotic liver cirrhosis by hepatitis B virus (HBV), the most common cause of liver disease in Korea. The aim of this study was to investigate the prevalence of HPS in poorly compensated postnecrotic liver cirrhosis by HBV, and the correlation of the hepatopulmonary syndrome with clinical aspects of postnecrotic liver cirrhosis by HBV. METHODS: Thirty-five patients underwent pulmonary function test, arterial blood gas analysis and contrast-enhanced echocardiography. All patients were diagnosed as HBV-induced Child class C liver cirrhosis and had no evidence of intrinsic cardiopulmonary disease. RESULTS: Intrapulmonary shunt was detected in 6/35 (17.1%) by contrast-enhanced echocardiography. Two of six patients with intrahepatic shunts had significant hypoxemia (PaO2 < 70 mmHg) and four showed increased alveolar-arterial oxygen gradient over 20 mmHg. Only cyanosis could reliably distinguish between shunt positive and negative patients. CONCLUSIONS: The prevalence of intrapulmonary shunt in poorly compensated postnecrotic liver cirrhosis by HBV was 17.1% and the frequency of hepatopulmonary syndrome was relatively low (5.7%). 'Subclinical' hepatopulmonary syndrome (echocardiographically positive intrapulmonary shunt but without profound hypoxemia) exists in 11.4% of cases with poorly compensated postnecrotic liver cirrhosis by HBV. Cyanosis is the only reliable clinical indicator of HPS of HBV-induced poorly compensated liver cirrhosis. Further studies are required to determine if the prevalence and clinical manifestations of HPS varies with etiology or with geographical and racial differences.


Asunto(s)
Hepatitis B/epidemiología , Síndrome Hepatopulmonar/epidemiología , Cirrosis Hepática/epidemiología , Adulto , Anciano , Análisis de Varianza , Comorbilidad , Femenino , Hepatitis B/diagnóstico , Síndrome Hepatopulmonar/diagnóstico , Humanos , Corea (Geográfico)/epidemiología , Cirrosis Hepática/clasificación , Masculino , Persona de Mediana Edad , Necrosis , Prevalencia , Probabilidad , Pruebas de Función Respiratoria , Medición de Riesgo
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