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Oh PC, Eom YS, Moon J, Jang HJ, Kim TH, Suh J, Kong MG, Park SD, Kwon SW, Suh SY, Lee K, Han SH, Ahn T, Kang WC. Addition of routine blood biomarkers to TIMI risk score improves predictive performance of 1-year mortality in patients with ST-segment elevation myocardial infarction. BMC Cardiovasc Disord 2020; 20:486. [PMID: 33208092 PMCID: PMC7672980 DOI: 10.1186/s12872-020-01777-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/09/2020] [Indexed: 01/03/2023] Open
Abstract
Background Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase > twice the normal upper limit and glucose < 90 or > 250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR 2.019; 95% CI 1.104–3.695), dysglycemia (HR 2.535; 95% CI 1.324–3.923), anemia (HR 2.071; 95% CI 1.093–3.923), and high NLR (HR 3.651; 95% CI 1.927–6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p < 0.001), and the NRI and IDI were estimated at 0.203 (95% CI 0.130–0.275; p < 0.001) and 0.089 (95% CI 0.060–0.119; p < 0.001), respectively. Conclusions The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.
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Affiliation(s)
- Pyung Chun Oh
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760
| | - Young Sil Eom
- Department of Endocrinology and Metabolism, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jeonggeun Moon
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760
| | - Ho-Jun Jang
- Department of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
| | - Tae-Hoon Kim
- Department of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
| | - Jon Suh
- Department of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Min Gyu Kong
- Department of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Sang-Don Park
- Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Sung Woo Kwon
- Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Soon Yong Suh
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760
| | - Kyounghoon Lee
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760
| | - Seung Hwan Han
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760
| | - Taehoon Ahn
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760
| | - Woong Chol Kang
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon, Republic of Korea, 405-760.
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202
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Yoon JH, Kim HJ, Kim JH, Kim TH, Seo CH, Sung YK, Kim KH. Corrigendum: BMP4-Induced Differentiation of Human Hair Follicle Neural Crest Stem Cells into Precursor Melanocytes from Hair Follicle Bulge. Ann Dermatol 2020; 32:539. [PMID: 33911805 PMCID: PMC7875242 DOI: 10.5021/ad.2020.32.6.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jung-Ho Yoon
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Ho-Jin Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Jung-Hwan Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Tae-Hoon Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Chang-Hoon Seo
- Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Young Kwan Sung
- Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ki-Ho Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
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203
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Sposob M, Moon HS, Lee D, Kim TH, Yun YM. Comprehensive analysis of the microbial communities and operational parameters of two full-scale anaerobic digestion plants treating food waste in South Korea: Seasonal variation and effect of ammonia. J Hazard Mater 2020; 398:122975. [PMID: 32512456 DOI: 10.1016/j.jhazmat.2020.122975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/11/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
There are about ninety full-scale anaerobic digestion (AD) plants in South Korea that treat food waste (FW); however, the key diff ;erences in the microbial communities in different seasons and the effects of ammonia in AD remain poorly understood. In this study, the seasonal changes in microbial communities associated with operational parameters of two full-scale ADs (C and W plants) treating FW were analyzed. The organic loading rate (OLR) variability had an influence on the seasonal CH4 yield; the W plant had a lower CH4 yield with an unstable AD performance while the C plant had a higher CH4 yield with a stable AD performance. It was mainly due to the substantially different NH4+ concentration; the W plant had a NH4+ concentration nearly 1.6 times higher compared to the C plant. The high NH4+ presence in the W plant led to the dominance of class Clostridia, and methanogenesis was mostly done by hydrogenotrophs (Methanomassiliicoccus luminyensis). Additionally, the members belonging to Clostridia and Bacteroidia were found at both plants in each season (share ≥0.5%) implying their indispensable role during the anaerobic digestion of FW.
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Affiliation(s)
- Michal Sposob
- Department of Environmental Engineering, Chungbuk National University, 1 Chungdae-ro, Seowon-Gu, Cheongju, 28644, Republic of Korea
| | - Hee-Sung Moon
- Waste-Energy Research Division, Environmental Resources Research Department, National Institute of Environmental Research, Environmental Research Complex, Incheon, 22689, Republic of Korea
| | - Dongjin Lee
- Waste-Energy Research Division, Environmental Resources Research Department, National Institute of Environmental Research, Environmental Research Complex, Incheon, 22689, Republic of Korea
| | - Tae-Hoon Kim
- Department of Environmental Engineering, Chungbuk National University, 1 Chungdae-ro, Seowon-Gu, Cheongju, 28644, Republic of Korea
| | - Yeo-Myeong Yun
- Department of Environmental Engineering, Chungbuk National University, 1 Chungdae-ro, Seowon-Gu, Cheongju, 28644, Republic of Korea.
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204
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Toslak D, Son T, Erol MK, Kim H, Kim TH, Chan RVP, Yao X. Portable ultra-widefield fundus camera for multispectral imaging of the retina and choroid. Biomed Opt Express 2020; 11:6281-6292. [PMID: 33282490 PMCID: PMC7687931 DOI: 10.1364/boe.406299] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 05/02/2023]
Abstract
Multispectral imaging (MSI) of the retina and choroid has increasing interest for better diagnosis and treatment evaluation of eye diseases. However, currently available MSI systems have a limited field of view (FOV) to evaluate the peripheral retina. This study is to validate trans-pars-planar illumination for a contact-mode ultra-widefield MSI system. By freeing the available pupil for collecting imaging light only, the trans-pars-planar illumination enables a portable, non-mydriatic fundus camera, with 200° FOV in a single fundus image. The trans-pars-planar illumination, delivering illumination light from one side of the eye, naturally enables oblique illumination ophthalmoscopy to enhance the contrast of fundus imaging. A broadband (104 nm) 565 nm light-emitting diode (LED) is used for validating color fundus imaging first. Four narrowband (17-60 nm) 530 nm, 625 nm, 780 nm, and 970 nm LEDs are tested for MSI. With 530 nm illumination, the fundus image reveals retinal vasculature predominantly. 625 nm and 780 nm illuminations enhance the visibility of choroidal vasculature. With further increased wavelength of 970 nm, the fundus image is predominated by large veins in the choroid, with multiple vortex ampullas observed simultaneously in a single fundus image.
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Affiliation(s)
- Devrim Toslak
- Department of Bioengineering, University of
Illinois at Chicago, Chicago, IL 60607, USA
- Antalya Training and Research Hospital,
Department of Ophthalmology, Antalya, 07100, Turkey
| | - Taeyoon Son
- Department of Bioengineering, University of
Illinois at Chicago, Chicago, IL 60607, USA
| | - Muhammet Kazim Erol
- Antalya Training and Research Hospital,
Department of Ophthalmology, Antalya, 07100, Turkey
| | - Hoonsup Kim
- Department of Bioengineering, University of
Illinois at Chicago, Chicago, IL 60607, USA
| | - Tae-Hoon Kim
- Department of Bioengineering, University of
Illinois at Chicago, Chicago, IL 60607, USA
| | - R. V. Paul Chan
- Department of Ophthalmology and Visual
Sciences, University of Illinois at Chicago, Chicago, IL 60612,
USA
| | - Xincheng Yao
- Department of Bioengineering, University of
Illinois at Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual
Sciences, University of Illinois at Chicago, Chicago, IL 60612,
USA
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205
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Hong M, Park JW, Yang PS, Hwang I, Kim TH, Yu HT, Uhm JS, Joung B, Lee MH, Jee SH, Pak HN. A mendelian randomization analysis: The causal association between serum uric acid and atrial fibrillation. Eur J Clin Invest 2020; 50:e13300. [PMID: 32474920 DOI: 10.1111/eci.13300] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 04/07/2020] [Accepted: 05/20/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Observational studies have shown that high levels of serum uric acid (UA) were associated with atrial fibrillation (AF). However, the causal effect of urate on the risk of AF is still unknown. To clarify the potential causal association between UA and AF, we performed a Mendelian randomization (MR) analysis using genetic instrumental variables (IVs). MATERIALS AND METHODS From the Korean GWAS dataset of 633 patients with AF (mean age 50.6 ± 7.8 years, 80.9% male, Yonsei AF Ablation cohort) who underwent radiofrequency catheter ablation and the data from 3533 controls (from the Korea Genome Epidemiology Study), we selected 9 SNPs, with a P value less than .05, associated with an increased UA serum level. Additionally, we calculated the weighted genetic risk score (wGRS) using the selected 9 SNPs, to use it as an instrumental variable. A Mendelian randomization analysis was calculated by a 2-stage estimator method. RESULTS The conventional association between the serum UA and AF was significant (P = .001) after adjusting for potential confounding factors. The SNP rs1165196 on SLC17A1 (F-statistics = 208.34, 0.18 mg/mL per allele change, P < .001) and wGRS (F-statistics = 222.26, 0.20 mg/mL per 1SD change, P < .001) were significantly associated with an increase in the UA level. The MR analysis was causally associated with rs1165196 (estimated odds ratio (OR), 0.21, 95% confidence interval (CI), 0.06-0.75, P = .017), but not wGRS (estimated OR, 1.07, 95% CI, 0.57-2.01, P = .832). CONCLUSION The serum UA level was independently associated with the AF risk.
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Affiliation(s)
- Myunghee Hong
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Je-Wook Park
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Inseok Hwang
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Yonsei University, Seoul, Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Yonsei University Health System, Seoul, Korea
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206
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Kim IS, Yang PS, Jang E, Jung H, You SC, Yu HT, Kim TH, Uhm JS, Pak HN, Lee MH, Kim JY, Joung B. Long-term PM 2.5 exposure and the clinical application of machine learning for predicting incident atrial fibrillation. Sci Rep 2020; 10:16324. [PMID: 33004983 PMCID: PMC7530980 DOI: 10.1038/s41598-020-73537-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/15/2020] [Indexed: 11/09/2022] Open
Abstract
Clinical impact of fine particulate matter (PM2.5) air pollution on incident atrial fibrillation (AF) had not been well studied. We used integrated machine learning (ML) to build several incident AF prediction models that include average hourly measurements of PM2.5 for the 432,587 subjects of Korean general population. We compared these incident AF prediction models using c-index, net reclassification improvement index (NRI), and integrated discrimination improvement index (IDI). ML using the boosted ensemble method exhibited a higher c-index (0.845 [0.837-0.853]) than existing traditional regression models using CHA2DS2-VASc (0.654 [0.646-0.661]), CHADS2 (0.652 [0.646-0.657]), or HATCH (0.669 [0.661-0.676]) scores (each p < 0.001) for predicting incident AF. As feature selection algorithms identified PM2.5 as a highly important variable, we applied PM2.5 for predicting incident AF and constructed scoring systems. The prediction performances significantly increased compared with models without PM2.5 (c-indices: boosted ensemble ML, 0.954 [0.949-0.959]; PM-CHA2DS2-VASc, 0.859 [0.848-0.870]; PM-CHADS2, 0.823 [0.810-0.836]; or PM-HATCH score, 0.849 [0.837-0.860]; each interaction, p < 0.001; NRI and IDI were also positive). ML combining readily available clinical variables and PM2.5 data was found to predict incident AF better than models without PM2.5 or even established risk prediction approaches in the general population exposed to high air pollution levels.
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Affiliation(s)
- In-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Eunsun Jang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hyunjean Jung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Seng Chan You
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jong-Youn Kim
- Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Choi DS, Kim TH, Lee SH, Pang C, Bae JW, Kim SY. Beyond Human Hand: Shape-Adaptive and Reversible Magnetorheological Elastomer-Based Robot Gripper Skin. ACS Appl Mater Interfaces 2020; 12:44147-44155. [PMID: 32870646 DOI: 10.1021/acsami.0c11783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Developing a simple and universal solution for gripping fragile, multiscaled, and arbitrary-shaped objects using a robot gripper is challenging. Herein, we propose a universal, shape-adaptive/-retaining and reversible, hardness-variable gripper skin that serves as a resourceful solution for grasping such objects without damaging them. The proposed universal gripper skin based on a magnetorheological elastomer is attached to a robot gripper. The proposed skin takes the shape of a target object as soon as the gripper grasps the object. At this time, we solidify the gripper skin by applying a magnetic field, thereby allowing the gripper to grasp the target object easily. After releasing the objects, the magnetic field is removed and the deformed proposed gripper skin rapidly restores its original shape. The proposed adaptive gripper skin is made to grasp various target objects, such as cylinders, cuboids, and triangular prisms, based on which its grasping performance is evaluated.
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Affiliation(s)
- Dong-Soo Choi
- School of Computer Science, College of Engineering and Information Technology, Semyung University, Jecheon, Chungcheongbuk-do 27136, Republic of Korea
| | - Tae-Hoon Kim
- Interaction Laboratory of Advanced Technology Research Center, Korea University of Technology and Education, Cheonan, Chungcheongnam-do 31253, Republic of Korea
| | - Seok-Han Lee
- Interaction Laboratory of Advanced Technology Research Center, Korea University of Technology and Education, Cheonan, Chungcheongnam-do 31253, Republic of Korea
| | - Changhyun Pang
- School of Chemical Engineering, Sungkyunkwan University (SKKU), Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Jin Woo Bae
- School of Energy, Materials and Chemical Engineering, Korea University of Technology and Education, Cheonan, Chungcheongnam-do 31253, Republic of Korea
| | - Sang-Youn Kim
- Interaction Laboratory of Advanced Technology Research Center, Korea University of Technology and Education, Cheonan, Chungcheongnam-do 31253, Republic of Korea
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208
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Yoon JH, Kim HJ, Kim JH, Kim TH, Seo CH, Sung YK, Kim KH. BMP4-Induced Differentiation of Human Hair Follicle Neural Crest Stem Cells into Precursor Melanocytes from Hair Follicle Bulge. Ann Dermatol 2020; 32:409-416. [PMID: 33911776 PMCID: PMC7992575 DOI: 10.5021/ad.2020.32.5.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 11/08/2022] Open
Abstract
Background Vitiligo is a skin depigmentation disorder, for which, repigmentation treatment with combined follicular unit extraction (FUE) graft and narrowband ultraviolet B (NBUVB) is considered superior to micro-punch graft therapy. BMP4 can induce MITF expression in Neural crest stem cells (NCSCs), and α-MSH subsequently promotes the differentiation of MITF-expressing cells along the melanocyte lineage. Objective To investigate why FUE grafting is superior to epidermal mini grafting in promoting hair follicles (HF) melanocyte cell survival and longevity, we planned the in vitro experiments HF bulge NCSCs differentiate into melanocyte precursors under the co-treatment of BMP4 and α-MSH. Methods Cells that migrated from the HF bulge of scalp were cultured and assessed using immunofluorescence. Transcriptome analysis was performed on RNA sequencing results. Results Basic fibroblast growth factor promotes the proliferation and survival of NCSCs, with spontaneous differentiation into SOX10+/SOX2+ glial progenitors, but not into SOX10+/MITF+ precursor melanocytes. Both BMP4 and α-MSH promoted the differentiation into MITF-expressing cells. RNA sequencing revealed a downregulation in neuregulin-1 (NRG1) and sermaphorin 3C (SEMA3C), and upregulation in WNT10A. Furthermore, FUE grafting had a source of reservoir melanocytes superior to mini- grafting in treatment for vitiligo. Conclusion We obtained SOX10+/MITF+ precursor melanocytes through an induction of differentiation along the melanocyte lineage by BMP4 and α-MSH. According to the RNA sequencing results that NRG1 and SEMA3C were downregulated and WNT10A was upregulated, we postulated that HF NCSCs differentiated into melanocyte by co-treatment of BMP4 and α-MSH. Overall, FUE grafting is a more robust and substitutive treatment option for vitiligo.
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Affiliation(s)
- Jung-Ho Yoon
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Ho-Jin Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Jung-Hwan Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Tae-Hoon Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | - Chang-Hoon Seo
- Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yeong-Kwan Sung
- Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ki-Ho Kim
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
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209
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Park YJ, Yang PS, Yu HT, Kim TH, Jang E, Uhm JS, Pak HN, Lee MH, Lip GY, Joung B. What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population? J Clin Med 2020; 9:jcm9092988. [PMID: 32947828 PMCID: PMC7563734 DOI: 10.3390/jcm9092988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/11/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022] Open
Abstract
Intensive blood pressure (BP) lowering in patients with hypertension at increased risk of cardiovascular disease has been associated with a lowered risk of incident atrial fibrillation (AF). It is uncertain whether maintaining the optimal BP levels can prevent AF in the general elderly population. We included 115,866 participants without AF in the Korea National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013. We compared the influence of BP on the occurrence of new-onset AF between octogenarians (≥80 years) and non-octogenarians (<80 years) subjects. With up to 6.7 ± 1.7 years of follow-up, 4393 incident AF cases occurred. After multivariable adjustment for potentially confounding clinical covariates, the risk of AF in non-octogenarians was significantly higher in subjects with BP levels of <120/<80 and ≥140/90 mm Hg, with hazard ratios of 1.15 (95% confidence interval (CI), 1.03-1.28; p < 0.001) and 1.14 (95% CI, 1.04-1.26; p < 0.001), compared to the optimal BP levels (120-129/<80 mm Hg). In octogenarians, the optimal BP range was 130-139/80-89 mm Hg, higher than in non-octogenarians. A U-shaped relationship for the development of incident AF was evident in non-octogenarians, and BP levels of 120-129/<80 mm Hg were associated the lowest risk of incident AF. Compared to non-octogenarians, the lowest risk of AF was associated with higher BP levels of 130-139/80-89 mm Hg amongst octogenarians.
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Affiliation(s)
- Yoon Jung Park
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Centre, CHA University, Seongnam 13496, Korea;
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Eunsun Jang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
| | - Gregory Y.H. Lip
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK
- Correspondence: (G.Y.H.L.); (B.J.); Tel.: +82-2-2228-846 (B.J.)
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (Y.J.P.); (H.T.Y.); (T.-H.K.); (E.J.); (J.-S.U.); (H.-N.P.); (M.-H.L.)
- Correspondence: (G.Y.H.L.); (B.J.); Tel.: +82-2-2228-846 (B.J.)
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Park JS, Kim TH, Oh YJ, Park EJ, Kim JW, Jeong H. Investigation of photodarkening in tandem-pumped Yb-doped fibers. Opt Express 2020; 28:27316-27323. [PMID: 32988028 DOI: 10.1364/oe.400094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
Investigation of photodarkening (PD) in Yb-doped fibers tandem-pumped at 1018 nm is reported. For a homemade Yb-doped aluminosilicate double-clad fiber (YADF), the transmitted power of a 633 nm probe beam is reduced by 2.4% over 2 hours for the tandem pumping configuration at 1018 nm, which is significantly smaller than 33.3% for a laser diode (LD) pumping at 976 nm. A tandem-pumped Yb fiber amplifier also shows a much smaller decrease in the amplified output power over time than a LD-pumped Yb fiber amplifier. Based on fluorescence spectra of the YADF, we can not only associate PD of the YADF to intrinsic oxygen deficiency centers or Tm3+ impurities but also confirm the impact of the excited Yb3+ ion density on PD. The benefits of the tandem pumping in a high-power Yb fiber laser system will be discussed.
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Chun KH, Oh J, Yu HT, Lee CJ, Kim TH, Uhm JS, Pak HN, Lee MH, Joung B, Kang SM. The role of sacubitril/valsartan in the management of cardiac resynchronization therapy non-responders: a retrospective analysis. ESC Heart Fail 2020; 7:4404-4407. [PMID: 32918402 PMCID: PMC7755012 DOI: 10.1002/ehf2.12988] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/04/2020] [Accepted: 08/13/2020] [Indexed: 12/11/2022] Open
Abstract
Aims Optimal medical therapy after cardiac resynchronization therapy (CRT) implantation is important in heart failure (HF) with reduced ejection fraction (HFrEF) patients. Although sacubitril/valsartan (SV) is a mainstay in the treatment of HFrEF, its efficacy in the management of CRT non‐responders has not been emphasized. We aimed to investigate the efficacy of SV in CRT non‐responders. Methods and results We analysed 175 HFrEF patients who received CRT implantation between January 2010 and January 2019. CRT responder was defined as a decrease in left ventricular (LV) end‐systolic volume > 15% on echocardiography 6 months after implantation. Medical records were retrospectively reviewed. Patients underwent follow‐up for HF rehospitalization, heart transplantation (HT), implantation of a LV assistant device (LVAD), cardiac death, and all‐cause death. Among the study population, 164 patients were evaluated for CRT response; 54 (33%) were CRT non‐responders. Four patients (6%) who received SV before CRT implantation were excluded, leaving 50 patients for analysis. Twenty‐two non‐responders (44%) received SV. There was no significant difference in baseline characteristics between SV users and non‐users (n = 28). During follow‐up, SV users had significantly lower incidence of all‐cause death [1 (5%) vs. 10 (36%), P = 0.022] and tended to have lower HF rehospitalization [6 (27%) vs. 16 (57%), P = 0.068] and cardiac death (including HT and LVAD implant) [2 (9%) vs. 10 (36%), P = 0.064]. Kaplan–Meier survival analysis revealed that SV use was associated with a lower risk of cardiac death (including HT and LVAD implant) (log‐rank P = 0.029). Conclusions SV treatment was related to a lower incidence of cardiac death including HT and LVAD implant in CRT non‐responders. The optimization of HF management, including SV, should be considered in CRT non‐responders.
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Affiliation(s)
- Kyeong-Hyeon Chun
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jaewon Oh
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Tae Yu
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Joo Lee
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Hoon Kim
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Sun Uhm
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hui-Nam Pak
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Moon-Hyoung Lee
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Boyoung Joung
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seok-Min Kang
- Cardiology Division, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Kim TH, Yang PS, Yu HT, Jang E, Shin H, Kim HY, Uhm JS, Kim JY, Sung JH, Pak HN, Lee MH, Joung B, Lip GYH. Effect of hypertension duration and blood pressure level on ischaemic stroke risk in atrial fibrillation: nationwide data covering the entire Korean population. Eur Heart J 2020; 40:809-819. [PMID: 30608537 DOI: 10.1093/eurheartj/ehy877] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/18/2018] [Accepted: 12/06/2018] [Indexed: 12/22/2022] Open
Abstract
AIMS There are a paucity of data on the association of duration of hypertension and blood pressure (BP) level with risk of ischaemic stroke in patients with atrial fibrillation (AF). Our objective was to investigate the association between duration of hypertension and secondly, BP levels with risk of ischaemic stroke among patients with AF. METHODS AND RESULTS A total of 246 459 oral anticoagulant-naïve non-valvular AF patients were enrolled from Korea National Health Insurance Service (NHIS) database (2005-2015). The risk of ischaemic stroke according to the duration of hypertension and systolic BP (SBP) levels were assessed. One-year increase of hypertension duration continuously increased the adjusted risk of ischaemic stroke (95% confidence interval 1.07-1.09) until 7 years, and reached a plateau with adjusted hazard ratio of 1.6. Risk of ischaemic stroke increased linearly with the increase of hypertension duration in patients younger than 65 years of age, whereas the risk reached a plateau in patients aged 65 years or older. In all baseline and pre-AF average SBP subgroups, longer duration of hypertension before AF was associated with higher ischaemic stroke risk than shorter duration of hypertension (all P-values for trends <0.01). However, the effect of long-term hypertension was not observed in patients with strictly well-controlled pre-AF average SBP of less than 120 mmHg. CONCLUSION The increase of hypertension duration was associated with the increased risk of ischaemic stroke. However, this long-term effect of hypertension duration can be attenuated by long-term strict SBP control throughout the entire duration of hypertension.
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Affiliation(s)
- Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Eunsun Jang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Hyejung Shin
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Ha Yan Kim
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jong-Youn Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jung-Hoon Sung
- Department of Cardiology, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam, Gyeonggi-do, Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Gregory Y H Lip
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, Republic of Korea.,Institute of Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham, UK.,Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
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Kim SW, Kim YR, Choi KH, Cho EY, Song JS, Kim JE, Kim TH, Lee YH, Yoon KH. Staging of Liver Fibrosis by Means of Semiautomatic Measurement of Liver Surface Nodularity in MRI. AJR Am J Roentgenol 2020; 215:624-630. [PMID: 32755157 DOI: 10.2214/ajr.19.22041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE. The purposes of this study were to evaluate the accuracy of a semiautomatic method of measuring liver surface nodularity (LSN) on contrast-enhanced MR images and to compare the LSN score with pathologic fibrosis stage. MATERIALS AND METHODS. This retrospective study included patients who had undergone gadoxetate disodium-enhanced liver MRI 6 months before or after histopathologic investigation including percutaneous parenchymal biopsy and surgical biopsy for staging of chronic liver disease between January 2010 and December 2018. Semiautomated LSN quantification software was developed to measure LSN at MRI. Aspartate aminotransferase to platelet ratio index and fibrosis-4 index were derived from serum laboratory test results. The reference standard for staging of liver fibrosis was Metavir score. The accuracy of LSN score for staging of liver fibrosis was evaluated with AUC, and the optimal cutoff value was calculated by Youden index. Spearman correlation coefficient was used for correlation analysis. RESULTS. The study included 132 patients (93 men, 39 women). LSN score was evaluated without technical failure. There was high correlation between LSN score and Metavir score (Spearman ρ = 0.713, p < 0.001). The AUCs of LSN score for distinguishing Metavir score were 0.93 for F0-F1 versus F2-F4 (95% CI, 0.88-0.97; p < 0.001), 0.98 for F0-F2 vs F3-F4 (95% CI, 0.95-1.00; p < 0.001), and 0.83 for F0-F3 versus F4 (95% CI, 0.76-0.90; p < 0.001). The optimal cutoff value for differentiating F0-F2 from F3-F4 was 0.850 with 100% sensitivity and 85.4% specificity. CONCLUSION. LSN score calculated semiautomatically from MR images of the liver has high accuracy and correlates directly with the pathologic fibrosis stage.
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Affiliation(s)
- Seong Woo Kim
- Department of Radiology, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Youe Ree Kim
- Department of Radiology, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Keum Ha Choi
- Department of Pathology, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Eun Young Cho
- Department of Gastroenterology, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Ji Soo Song
- Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea
| | - Ji-Eon Kim
- Medical Convergence Research Center, Wonkwang University, Iksan, Republic of Korea
| | - Tae-Hoon Kim
- Medical Convergence Research Center, Wonkwang University, Iksan, Republic of Korea
| | - Young Hwan Lee
- Department of Radiology, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Kwon-Ha Yoon
- Department of Radiology, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan, Jeollabuk-do 54538, Republic of Korea
- Medical Convergence Research Center, Wonkwang University, Iksan, Republic of Korea
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Kim TH, Wang B, Lu Y, Son T, Yao X. Functional optical coherence tomography enables in vivo optoretinography of photoreceptor dysfunction due to retinal degeneration. Biomed Opt Express 2020; 11:5306-5320. [PMID: 33014616 PMCID: PMC7510876 DOI: 10.1364/boe.399334] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 05/16/2023]
Abstract
Stimulus-evoked intrinsic optical signal (IOS), which occurs almost immediately after the onset of retinal stimulus has been observed in retinal photoreceptors, promises to be a unique biomarker for objective optoretinography (ORG) of photoreceptor function. We report here the first-time in vivo ORG detection of photoreceptor dysfunction due to retinal degeneration. A custom-designed optical coherence tomography (OCT) was employed for longitudinal ORG monitoring of photoreceptor-IOS distortions in retinal degeneration mice. Depth-resolved OCT analysis confirmed the outer segment (OS) as the physical source of the photoreceptor-IOS. Comparative ERG measurement verified the phototransduction activation as the physiological correlator of the photoreceptor-IOS. Histological examination revealed disorganized OS discs, i.e. the pathological origin of the photoreceptor-IOS distortion.
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Affiliation(s)
- Tae-Hoon Kim
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Benquan Wang
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA
| | - Yiming Lu
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Taeyoon Son
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Xincheng Yao
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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Ha T, Kang DK, Kim TH. Percentage volume of delayed kinetics in computer-aided diagnosis of MRI of the breast to reduce false-positive results and unnecessary biopsies. Clin Radiol 2020; 75:962.e1-962.e8. [PMID: 32888654 DOI: 10.1016/j.crad.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Abstract
AIM To investigate the best cut-off percentage volume of delayed kinetics using magnetic resonance imaging (MRI) with computer-aided diagnosis (CAD) to reduce unnecessary biopsies in patients with newly diagnosed breast cancer. MATERIALS AND METHODS Between January 2017 and December 2018, 94 malignant and 56 benign masses were analysed using MRI CAD. All malignant and benign masses measured <2 cm and were confirmed histopathologically. The optimal cut-off values for washout, plateau, and persistent components were determined using the maximum Youden Index. The positive predictive value (PPV) was analysed using morphological descriptors and combining the percentage volume of delayed kinetics. RESULTS The area under the curve (AUC) was highest at ≤73% persistent component (AUC=0.759). In the subgroup analyses of masses <1 cm, the AUC was highest a plateau of >26% (AUC=0.697). When the persistent ≤73% criterion was applied to the lesions of C4a, the positive predictive value (PPV) increased from 61.9% to 72.44% with reduced false-negative cases and when applied to the lesions of C4a and C4b, the PPV increased from 61.9% to 78.1% with slightly increased false-negative cases. For subcentimetre lesions, the PPV increased from 46.77% to 54.72% with the same number of false-negative cases, when a plateau of >26% was applied to C4a, and the PPV increased from 46.77% to 61.36% with five false-negative cases when applied to C4a and C4b. CONCLUSION The percentage volume of delayed kinetics has the potential to improve the PPV of breast MRI. When suspicious masses <2 cm do not show ≤73% persistence, follow-up rather than biopsy could be considered; however, to avoid increasing false-negative cases, delayed kinetic information should be used with caution and accurate margin assessment is essential.
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Affiliation(s)
- T Ha
- Department of Radiology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon, Gyeonggi-do, 16499, South Korea
| | - D K Kang
- Department of Radiology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon, Gyeonggi-do, 16499, South Korea
| | - T H Kim
- Department of Radiology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon, Gyeonggi-do, 16499, South Korea.
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Kwon OS, Lee J, Lim S, Park JW, Han HJ, Yang SH, Hwang I, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Accuracy and clinical feasibility of 3D-myocardial thickness map measured by cardiac computed tomogram. Int J Arrhythm 2020. [DOI: 10.1186/s42444-020-00020-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Although myocardial thickness is an important variable for therapeutic catheter ablation of cardiac arrhythmias, quantification of wall thickness has been overlooked. We developed a software (AMBER) that measures 3D-myocardial thickness using a cardiac computed tomogram (CT) image, verified its accuracy, and tested its clinical feasibility.
Methods
We generated 3D-thickness maps by calculating wall thickness (WT) from the CT images of 120 patients’ hearts and a 3D-phantom model (PhM). The initial vector field of the Laplace equation was oriented to calculate WT with the field lines derived from the 3D mesh. We demonstrate the robustness of the Laplace WT algorithm by comparing with the real thickness of 3D-PhM, echocardiographically measured left ventricular (LV) WT, and regional left atrial (LA) WT reported from previous studies. We conducted a pilot case of catheter ablation for atrial fibrillation (AF) utilizing real-time LAWT map-guided radiofrequency (RF) energy titration.
Results
AMBER 3D-WT had excellent correlations with the real thickness of the PhM (R = 0.968, p < 0.001) and echocardiographically measured LVWT in 10 patients (R = 0.656, p = 0.007). AMBER 3D-LAWT (n = 120) showed a relatively good match with 12 previously reported regional LAWT. We successfully conducted pilot AF ablation utilizing AMBER 3D-LAWT map-guided real-time RF energy titration.
Conclusion
We developed and verified an AMBER 3D-cardiac thickness map measured by cardiac CT images for LAWT and LVWT, and tested its feasibility for RF energy titration during clinical catheter ablation.
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Kim TH, Kim JY, Bae J, Kim YM, Won MH, Ha KS, Kwon YG, Kim YM. Korean Red ginseng prevents endothelial senescence by downregulating the HO-1/NF-κB/miRNA-155-5p/eNOS pathway. J Ginseng Res 2020; 45:344-353. [PMID: 33841015 PMCID: PMC8020293 DOI: 10.1016/j.jgr.2020.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/05/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background Korean Red ginseng extract (KRGE) has beneficial effects on the cardiovascular system by improving endothelial cell function. However, its pharmacological effect on endothelial cell senescence has not been clearly elucidated. Therefore, we examined the effect and molecular mechanism of KRGE on the senescence of human umbilical vein endothelial cells (HUVECs). Methods HUVECs were grown in normal or KRGE-supplemented medium. Furthermore, they were transfected with heme oxygenase-1 (HO-1) gene or treated with its inhibitor, a NF-κB inhibitor, and a miR-155-5p mimic or inhibitor. Senescence-associated characteristics of endothelial cells were determined by biochemical and immunohistochemical analyses. Results Treatment of HUVECs with KRGE resulted in delayed onset and progression of senescence-associated characteristics, such as increased lysosomal acidic β-galactosidase and decreased telomerase activity, angiogenic dysfunction, and abnormal cell morphology. KRGE preserved the levels of anti-senescent factors, such as eNOS-derived NO, MnSOD, and cyclins D and A: however, it decreased the levels of senescence-promoting factors, such as ROS, activated NF-κB, endothelial cell inflammation, and p21 expression. The beneficial effects of KRGE were due to the induction of HO-1 and the inhibition of NF-κB-dependent biogenesis of miR-155-5p that led to the downregulation of eNOS. Moreover, treatment with inhibitors of HO-1, NF-κB, and miR-155-5p abolished the anti-senescence effects of KRGE. Conclusion KRGE delayed or prevented HUVEC senescence through a signaling cascade involving the induction of HO-1, the inhibition of NF-κB-dependent miR-155-5p biogenesis, and the maintenance of the eNOS/NO axis activity, suggesting that it may protect against vascular diseases associated with endothelial senescence.
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Affiliation(s)
- Tae-Hoon Kim
- Department of Molecular and Cellular Biochemistry, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Ji-Yoon Kim
- Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, 04763, South Korea
| | - Jieun Bae
- Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, 04763, South Korea
| | - Young-Mi Kim
- Department of Molecular and Cellular Biochemistry, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Moo-Ho Won
- Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Kwon-Soo Ha
- Department of Molecular and Cellular Biochemistry, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
| | - Young-Guen Kwon
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, South Korea
| | - Young-Myeong Kim
- Department of Molecular and Cellular Biochemistry, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do 24341, South Korea
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Pak HN, Park J, Park JW, Yang SY, Yu HT, Kim TH, Uhm JS, Choi JI, Joung B, Lee MH, Kim YH, Shim J. Electrical Posterior Box Isolation in Persistent Atrial Fibrillation Changed to Paroxysmal Atrial Fibrillation: A Multicenter, Prospective, Randomized Study. Circ Arrhythm Electrophysiol 2020; 13:e008531. [PMID: 32755396 DOI: 10.1161/circep.120.008531] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Persistent atrial fibrillation (AF) can change to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether electrical posterior box isolation (POBI) may improve rhythm outcome of catheter ablation in those patient groups. METHODS We prospectively randomized 114 patients with persistent AF to paroxysmal AF (men, 75%; 59.8±9.9 years old) to circumferential pulmonary vein isolation (CPVI) alone group (n=57) and additional POBI group (n=57). Primary end point was AF recurrence after a single procedure, and secondary end points were recurrence pattern, cardioversion rate, and response to antiarrhythmic drugs. RESULTS After a mean follow-up of 23.8±10.2 months, the clinical recurrence rate did not significantly differ between the CPVI alone and additional POBI group (31.6% versus 28.1%; P=0.682; log-rank P=0.729). The recurrences as atrial tachycardias (5.3% versus 12.3%; P=0.134) and cardioversion rates (5.3% versus 10.5%; P=0.250) were not significantly different between the CPVI and POBI groups. At the final follow-up, sinus rhythm was maintained without antiarrhythmic drug in 52.6% of CPVI group and 59.6% of POBI group (P=0.450). No significant difference was found in major complication rates between the two groups (5.3% versus 1.8%; P=0.618), but the total ablation time was significantly longer in the POBI group (4187±952 versus 5337±1517 s; P<0.001). CONCLUSIONS In patients with persistent AF converted to paroxysmal AF by antiarrhythmic drug, the addition of POBI to CPVI did not improve the rhythm outcome of catheter ablation or influence overall safety, while leading to longer ablation time. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02176616.
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Affiliation(s)
- Hui-Nam Pak
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Junbeom Park
- Department of Cardiology, Ewha Womans University Medical Center, Seoul, Republic of Korea (J.P.)
| | - Je-Wook Park
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Song-Yi Yang
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Hee Tae Yu
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Tae-Hoon Kim
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Jae-Sun Uhm
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Jong-Il Choi
- Department of Cardiology, Korea University Medical Center, Seoul, Republic of Korea (J.I.C., Y.-H.K., J.S.)
| | - Boyoung Joung
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Moon-Hyoung Lee
- Department of Cardiology, Yonsei University Health System, Seoul, Republic of Korea (H.-N.P., J.-W.P., S.-Y.Y., H.T.Y., T.-H.K., J.-S.U., B.J., M.-H.L.)
| | - Young-Hoon Kim
- Department of Cardiology, Korea University Medical Center, Seoul, Republic of Korea (J.I.C., Y.-H.K., J.S.)
| | - Jaemin Shim
- Department of Cardiology, Korea University Medical Center, Seoul, Republic of Korea (J.I.C., Y.-H.K., J.S.)
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Kim TH, Song SW, Heo W, Lee KH, Yoo KJ, Lee HS, Cho BK. Temporal pattern of aortic remodelling after endovascular treatment for chronic DeBakey IIIb dissection. Interact Cardiovasc Thorac Surg 2020; 31:232-238. [PMID: 32442253 DOI: 10.1093/icvts/ivaa070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/13/2020] [Accepted: 03/18/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Endovascular treatment has emerged as a safe procedure for treating chronic DeBakey IIIb dissection. The objective of this study was to investigate the mid-term outcome and temporal pattern of aortic remodelling after endovascular treatment for DeBakey IIIb dissection. METHODS From 2012 to 2017, 85 patients who underwent endovascular aortic repair for DeBakey IIIb dissection were enrolled. The temporal pattern of aortic remodelling in terms of false lumen (FL) thrombosis [level 1 (∼T7), level 2 (T7 ∼ coeliac axis) and level 3 (coeliac trunk ∼ aortic bifurcation)] and aortic diameter [mid-thoracic level (T7), coeliac axis and the largest infrarenal abdominal aorta] was investigated on serial follow-up computed tomography scan. RESULTS Eighty-five patients underwent endovascular treatment during the study period. Male sex was a significant risk factor for repetitive reintervention and segments 2 and 3 FL thrombosis. The preoperative FL diameter at T7 was significantly associated with FL diameter regression. The number of visceral vessels from the FL and residual DeBakey IIIb dissection after type A repair were significant factors for FL growth at the coeliac trunk and at the largest infrarenal abdominal aorta. The overall mortality was 3 (3.6%). CONCLUSIONS Endovascular treatment is a safe strategy in the management of DeBakey IIIb dissection. However, unfavourable aortic remodelling and repetitive reintervention were expected in male patients with a large number of visceral vessels from the FL and residual DeBakey IIIb dissection after type A repair. Endovascular treatment should be cautiously considered, and close follow-up is required for these patients.
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Affiliation(s)
- Tae-Hoon Kim
- Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Suk-Won Song
- Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woon Heo
- Department of Thoracic and Cardiovascular Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kwang-Hun Lee
- Department of Interventional Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Jong Yoo
- Department of Cardiovascular Surgery, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
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Kim TH, Zhao H, Xu B, Jensen BA, King AH, Kramer MJ, Nan C, Ke L, Zhou L. Mechanisms of Skyrmion and Skyrmion Crystal Formation from the Conical Phase. Nano Lett 2020; 20:4731-4738. [PMID: 32202799 DOI: 10.1021/acs.nanolett.0c00080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Real-space topological magnetic structures such as skyrmions and merons are promising candidates for information storage and transport. However, the microscopic mechanisms that control their formation and evolution are still unclear. Here, using in situ Lorentz transmission electron microscopy, we demonstrate that skyrmion crystals (SkXs) can nucleate, grow, and evolve from the conical phase in the same ways that real nanocrystals form from vapors or solutions. More intriguingly, individual skyrmions can also "reproduce" by division in a mitosis-like process that allows them to annihilate SkX lattice imperfections, which is not available to crystals made of mass-conserving particles. Combined string method and micromagnetic calculations show that competition between repulsive and attractive interactions between skyrmions governs particle-like SkX growth, but nonconservative SkX growth appears to be defect mediated. Our results provide insights toward manipulating magnetic topological states by applying established crystal growth theory, adapted to account for the new process of skyrmion mitosis.
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Affiliation(s)
- Tae-Hoon Kim
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
| | - Haijun Zhao
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
- School of Physics, Southeast University, Nanjing 211189, China
| | - Ben Xu
- School of Materials Science and Engineering, State Key Laboratory of New Ceramics and Fine Processing, Tsinghua University, Beijing 100084, China
| | - Brandt A Jensen
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
| | - Alexander H King
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
- Department of Materials Science and Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Matthew J Kramer
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
| | - Cewen Nan
- School of Materials Science and Engineering, State Key Laboratory of New Ceramics and Fine Processing, Tsinghua University, Beijing 100084, China
| | - Liqin Ke
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
| | - Lin Zhou
- Ames Laboratory, United States Department of Energy, Ames, Iowa 50011, United States
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Kang JH, Yang HW, Park JH, Shin JM, Kim TH, Lee SH, Lee HM, Park IH. Lipopolysaccharide regulates thymic stromal lymphopoietin expression via TLR4/MAPK/Akt/NF-κB-signaling pathways in nasal fibroblasts: differential inhibitory effects of macrolide and corticosteroid. Int Forum Allergy Rhinol 2020; 11:144-152. [PMID: 32623837 DOI: 10.1002/alr.22641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is an inflammatory disease of the sinonasal mucosa. Thymic stromal lymphopoietin (TSLP) is associated with T-helper 2 (Th2) response and induced by pathogen, allergen, toll-like receptor (TLR) ligands, and cytokines. Fibroblasts are known to be modulators of wound-healing, from inflammation to tissue remodeling. We examined effect of lipopolysaccharide (LPS) on TSLP production and the underlying mechanisms. We aimed to determine whether the effects of commonly used medications in CRS, namely corticosteroids, and macrolides, are related to LPS-induced TSLP in nasal fibroblasts. METHODS Fibroblasts were isolated from inferior turbinate tissues of CRS patients. TSLP and TLR4 expressions were determined by reverse transcript-polymerase chain reaction (RT-PCR), Western blot, enzyme-linked immunoassay, and immunofluorescence staining. Mitogen-activated protein kinase (MAPK), protein kinase B (Akt), and nuclear factor-kappaB (NF-κB) phosphorylation was determined by Western blot and/or luciferase assay. RESULTS LPS increased TSLP expression in a dose- and time-dependent manner. LPS antagonist and corticosteroids inhibited TLR4 expression in LPS-stimulated fibroblasts. LPS-RS, macrolides, corticosteroids, and specific inhibitors suppressed LPS-induced alterations. Ex vivo culture showed similar results. CONCLUSION LPS induces TSLP production via the TLR4, MAPK, Akt, and NF-κB pathways. The effects of corticosteroids and macrolides are related to LPS-induced TSLP expression. We explored new treatment modalities targeting LPS-induced TSLP production that could replace the currently used corticosteroid and macrolides for treatment of CRS.
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Affiliation(s)
- Ju-Hyung Kang
- Upper Airway Chronic Inflammatory Diseases Laboratory, Korea University College of Medicine, Seoul, South Korea
| | - Hyun-Woo Yang
- Upper Airway Chronic Inflammatory Diseases Laboratory, Korea University College of Medicine, Seoul, South Korea.,Medical Devices Clinical Trials Laboratory, Korea University College of Medicine, Seoul, South Korea
| | - Joo-Hoo Park
- Upper Airway Chronic Inflammatory Diseases Laboratory, Korea University College of Medicine, Seoul, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea.,Medical Devices Clinical Trials Laboratory, Korea University College of Medicine, Seoul, South Korea
| | - Jae-Min Shin
- Upper Airway Chronic Inflammatory Diseases Laboratory, Korea University College of Medicine, Seoul, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea.,Medical Devices Clinical Trials Laboratory, Korea University College of Medicine, Seoul, South Korea.,IVD Support Center, Korea University Guro Hospital, Seoul, South Korea
| | - Tae-Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Seung Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea
| | - Heung-Man Lee
- Upper Airway Chronic Inflammatory Diseases Laboratory, Korea University College of Medicine, Seoul, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea.,Medical Devices Clinical Trials Laboratory, Korea University College of Medicine, Seoul, South Korea
| | - Il-Ho Park
- Upper Airway Chronic Inflammatory Diseases Laboratory, Korea University College of Medicine, Seoul, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea.,Medical Devices Clinical Trials Laboratory, Korea University College of Medicine, Seoul, South Korea.,IVD Support Center, Korea University Guro Hospital, Seoul, South Korea
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Kim BG, Uhm JS, Yang PS, Yu HT, Kim TH, Joung B, Pak HN, Kim SY, Park MS, Lee JG, Paik HC, Lee MH. Clinical significance of postoperative atrial arrhythmias in patients who underwent lung transplantation. Korean J Intern Med 2020; 35:897-905. [PMID: 31752476 PMCID: PMC7373957 DOI: 10.3904/kjim.2018.326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/18/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Atrial arrhythmia (AA) occasionally occurs after lung transplantation (LT); however, risk factors for AA and their impact on clinical outcomes are inconsistent. We aimed to investigate the incidence, predisposing factors, and clinical outcomes of AA after LT. METHODS We retrospectively evaluated 153 consecutive patients who underwent LT between January 2010 and August 2016. An AA episode was defined as a documented atrial fibrillation (AF), atrial flutter, or atrial tachycardia on 12-lead electrocardiography or episodes lasting ≥ 30 seconds on telemetry monitoring. RESULTS The mean follow-up time was 22.0 ± 19.1 months. Postoperative AA occurred in 46 patients (30.1%) after LT. Patients with postoperative AA were older, had larger body surface area, and had an increased incidence of paroxysmal AF prior to transplantation, idiopathic pulmonary fibrosis, and postoperative tracheostomy than patients without AA. Preoperative right atrial pressure (RAP) (odds ratio [OR], 1.19; p = 0.005) and longer periods of mechanical ventilation (OR, 1.03; p = 0.008) were found to be independent risk factors for AA after surgery. Development of AA was a significant predictor of long-term overall mortality (hazard ratio, 2.75; p = 0.017). CONCLUSION Patients with elevated preoperative RAP and long-term ventilator care had a higher risk of AA after LT. Further, AA after LT was associated with poor long-term survival.
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Affiliation(s)
- Byung Gyu Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Pil-Sung Yang
- Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Song Yee Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Moo Suk Park
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Gu Lee
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Chae Paik
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Correspondence to Moon-Hyoung Lee, M.D. Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2228-8443 Fax: +82-2-2227-7732 E-mail:
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Yao X, Kim TH. Fast intrinsic optical signal correlates with activation phase of phototransduction in retinal photoreceptors. Exp Biol Med (Maywood) 2020; 245:1087-1095. [PMID: 32558598 DOI: 10.1177/1535370220935406] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPACT STATEMENT As the center of phototransduction, retinal photoreceptors are responsible for capturing and converting photon energy to bioelectric signals for following visual information processing in the retina. This article summarizes experimental observation and discusses biophysical mechanism of fast photoreceptor-intrinsic optical signal (IOS) correlated with early phase of phototransduction. Quantitative imaging of fast photoreceptor-IOS may provide objective optoretinography to advance the study and diagnosis of age-related macular degeneration, retinitis pigmentosa, diabetic retinopathy, and other eye diseases that can cause photoreceptor dysfunctions.
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Affiliation(s)
- Xincheng Yao
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA.,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Tae-Hoon Kim
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
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Hong M, Chun KH, Hwang I, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Clinical and genetic relationships between the QTc interval and risk of a stroke among atrial fibrillation patients undergoing catheter ablation. Int J Arrhythm 2020. [DOI: 10.1186/s42444-020-00017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yu HT, Yang PS, Jang E, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Lip GYH, Joung B. Label Adherence of Direct Oral Anticoagulants Dosing and Clinical Outcomes in Patients With Atrial Fibrillation. J Am Heart Assoc 2020; 9:e014177. [PMID: 32495677 PMCID: PMC7429045 DOI: 10.1161/jaha.119.014177] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Dose adjustment of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in some patients with atrial fibrillation (AF), based on selected patient factors or concomitant medications. We assessed the frequency of label adherence of NOAC dosing among AF patients and the associations between off-label NOAC dosing and clinical outcomes. Methods and Results We evaluated 53 649 AF patients treated with an NOAC using Korean National Health Insurance Service database during the period from 2013 to 2016. NOAC doses were classified as either underdosed or overdosed, consistent with Korea Food and Drug Administration labeling. Cox proportional hazards regression was performed to investigate the effectiveness and safety outcomes including stroke or systemic embolism, major bleeding, and all-cause mortality. Overall, 16 757 NOAC-treated patients (31.2%) were underdosed, 4492 were overdosed (8.4%), and 32 400 (60.4%) were dosed appropriately according to drug labeling. Compared with patients with label adherence, those who were underdosed or overdosed were older (aged 71±8 and 75±7 years versus 70±9 years, respectively; P<0.001) and had higher CHA2DS2-VASc scores (4.6±1.7 and 5.3±1.7 versus 4.5±1.8, respectively; P<0.001). NOAC overdosing was associated with increased risk for stroke or systemic embolism (5.76 versus 4.03 events/100 patient-years, P<0.001), major bleeding (4.77 versus 2.94 events/100 patient-years, P<0.001), and all-cause mortality (5.43 versus 3.05 events/100 patient-years, P<0.001) compared with label-adherent use. Conclusions In real-world practice, a significant proportion (almost 2 in 5) of AF patients received NOAC doses inconsistent with drug labeling. NOAC overdosing is associated with worse clinical outcomes in Asian AF patients.
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Affiliation(s)
- Hee Tae Yu
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Pil-Sung Yang
- Department of Cardiology CHA Bundang Medical Center CHA University Seongnam Republic of Korea
| | - Eunsun Jang
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Jong-Youn Kim
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science University of Liverpool United Kingdom
| | - Boyoung Joung
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
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Ock HS, Hwang SW, Lee HJ, Kim CH, Kim SH, Kim TH, Lee JH, Lee JS. The effects of hidden female smokers on the association between smoking and chronic obstructive pulmonary disease in Korean adults. Pulmonology 2020; 27:286-295. [PMID: 32474057 DOI: 10.1016/j.pulmoe.2020.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Smoking is an important causative factor of chronic obstructive pulmonary disease (COPD), and females are considered more susceptible to the effects of smoking than males. However, in previous Korean studies, the effects of sex differences on the association between smoking and COPD have been controversial. In this study, the effects of sex differences on the association between smoking and COPD and the effects of female hidden smokers on that association in Korean adults were investigated. METHODS Data were acquired from the Korea National Health and Nutrition Examination Surveys (KNHANES). RESULTS The multivariate logistic regression analysis showed that self-reported smoking status for ex-smoker and current smoker correlated with COPD (odds ratio, OR: 1.67 and OR: 2.41, respectively). Self-reported smoking status for ex-smoker and current smoker correlated with COPD in men (OR: 1.61, OR: 2.43, respectively). Female self-reported current smoking status correlated with COPD (OR: 2.52), but female ex-smoker status was not significantly correlated with COPD. The ratios of cotinine-verified to self-reported smoking rates were 1.95 for women and 1.07 for men. CONCLUSION The results of this study were that sex differences might affect the association between COPD and smoking and that female hidden smoking might affect the association between smoking and COPD in Korean adults.
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Affiliation(s)
- H S Ock
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - S W Hwang
- Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - H J Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - C H Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - S H Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - T H Kim
- Department of Pediatrics, Pusan National University, Pusan, Republic of Korea
| | - J H Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - J S Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
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Kim TH, Han E. Impact of overweight or obesity trajectory on health expenditure in Korea. J Public Health (Oxf) 2020; 42:e165-e173. [PMID: 31219159 DOI: 10.1093/pubmed/fdz068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/07/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study aimed to identify the effect of the overweight or obesity (OWOB) trajectory on current health care expenditure in South Korea. METHODS Ten years of publicly released data (2002-12) were obtained in 2016 from a retrospective cohort of National Health Insurance System claims. This study included 51,844 adults (aged 30-59 years in 2002) and 21,196 elderly adults (aged ≥ 60 years in 2002). RESULTS Compared with adults who maintained normal weight (NW), higher yearly total health expenditures were estimated for adults who lost weight over the 10-year period: by 11.5% (95% confidence interval (CI): 0.18-22.96%) when changing from NW to underweight (UW) and 6.2% (95% CI: 0.47-12.01%) from OWOB to UW/NW. Elderly adults had higher health expenditures when they lost weight by 14.0% (95% CI: 0.37-27.70%) from NW to UW and 6.8% (95% CI: 0.13-13.51%) from OWOB to UW/NW compared with when they maintained NW. CONCLUSIONS These findings indicate the importance of early intervention to control OWOB, particularly because people in late adulthood have greater health care needs for reasons other than OWOB.
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Affiliation(s)
- T H Kim
- Graduate School of Public Health and Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - E Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
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Oh PC, Eom YS, Moon J, Jang HJ, Kim TH, Suh J, Kong MG, Park SD, Kwon SW, Choe JY, Suh SY, Lee K, Han SH, Ahn T, Kang WC. Prognostic impact of the combination of serum transaminase and alkaline phosphatase determined in the emergency room in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. PLoS One 2020; 15:e0233286. [PMID: 32442225 PMCID: PMC7244093 DOI: 10.1371/journal.pone.0233286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/01/2020] [Indexed: 02/07/2023] Open
Abstract
Background Elevated serum transaminase or alkaline phosphatase (ALP) has been proposed as a novel prognosticator for ST-segment elevation myocardial infarction (STEMI). We evaluated the combined prognostic impact of elevated serum transaminases and ALP on admission in STEMI patients who underwent primary percutaneous coronary intervention (PCI). Methods A total of 1176 patients with STEMI undergoing primary PCI were retrospectively enrolled from the INTERSTELLAR registry. Hypoxic liver injury (HLI) was defined as serum transaminase > twice the upper limit of normal. The cut-off value of high ALP was set at the median level (73 IU/L). Patients were divided into four groups according to their serum transaminase and ALP levels. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven revascularization. Results Median follow-up duration was 25 months (interquartile range, 10–39 months). The rate of MACCE was highest in patients with HLI (+) and high ALP (25.9%), compared to those in the other groups (8.2% in HLI [-] and low ALP, 11.8% in HLI [-] and high ALP, and 15.0% in HLI [+] and low ALP). Each of HLI or high ALP was an independent predictor for MACCE (HR 1.807, 95% CI 1.191–2.741; HR 1.721, 95% CI 1.179–2.512, respectively). Combined HLI and high ALP was associated with the worst prognosis (HR 3.145, 95% CI 1.794–5.514). Conclusions Combined HLI and high ALP on admission is associated with poor clinical outcomes in patients with STEMI who have undergone primary PCI.
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Affiliation(s)
- Pyung Chun Oh
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Young Sil Eom
- Endocrinology and Metabolism, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jeonggeun Moon
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Ho-Jun Jang
- Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
| | - Tae-Hoon Kim
- Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
| | - Jon Suh
- Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Min Gyu Kong
- Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Sang-Don Park
- Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Sung Woo Kwon
- Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Jae Yeol Choe
- Department of Medicine, Gachon University School of Medicine, Incheon, Republic of Korea
| | - Soon Yong Suh
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Kyounghoon Lee
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seung Hwan Han
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Taehoon Ahn
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Woong Chol Kang
- Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- * E-mail:
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Yang PS, Sung JH, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B. Catheter Ablation Improves Mortality and Other Outcomes in Real-World Patients With Atrial Fibrillation. J Am Heart Assoc 2020; 9:e015740. [PMID: 32427022 PMCID: PMC7429005 DOI: 10.1161/jaha.119.015740] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background It is still controversial whether catheter ablation for atrial fibrillation (AF) improves survival and other outcomes in patients with AF. This study evaluated whether ablation reduces death and other events in nationwide real‐world Asian patients with AF. Methods and Results From the Korean National Health Insurance Service database, 194 928 adult patients (aged ≥18 years) with newly diagnosed AF were treated with ablation or medical therapy (antiarrhythmic or rate control drugs) between January 1, 2005, and December 1, 2015. Among these patients, this study included 9185 with ablation and 18 770 with medical therapy. The time at risk was counted from the first medical therapy, and ablation was analyzed as a time‐varying covariate. Inverse probability of treatment weighting was used to correct for differences between the groups. After weighting, the 2 cohorts had similar background characteristics. During a median (25th, 75th percentiles) follow‐up of 43 (19, 81) months, ablation of AF was associated with lower incidence and risk of composite outcome, including death, heart failure admission, and stroke/systemic embolism (2.5 and 6.4 per 100 person‐years, respectively; hazard ratio [HR], 0.47; 95% CI, 0.43–0.52; P<0.001), all‐cause death (1.0 and 3.6 per 100 person‐years; HR, 0.41; 95% CI, 0.36–0.47; P<0.001), heart failure admission (0.7 and 1.9 per 100 person‐years; HR, 0.43; 95% CI, 0.37–0.50), and ischemic stroke/systemic embolism (1.1 and 2.8 per 100 person‐years; HR, 0.39; 95% CI, 0.34–0.44) than medical therapy. Conclusions Ablation may be associated with lower risk of death, heart failure admission, and ischemic stroke/systemic embolism in real‐world Asian patients with AF.
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Affiliation(s)
- Pil-Sung Yang
- Department of Cardiology CHA Bundang Medical Center CHA University Seongnam Republic of Korea
| | - Jung-Hoon Sung
- Department of Cardiology CHA Bundang Medical Center CHA University Seongnam Republic of Korea
| | - Eunsun Jang
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Jong-Youn Kim
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
| | - Boyoung Joung
- Division of Cardiology Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of Korea
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Jang HJ, Suh J, Kwon SW, Park SD, Oh PC, Moon J, Lee K, Kang WC, Jung IH, An H, Kim TH. The selection of β-blocker after successful reperfusion in patients with ST-elevation myocardial infarction. Perfusion 2020; 35:338-347. [DOI: 10.1177/0267659119878396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The selection of β-blocker for survivors after primary intervention due to acute ST-elevation myocardial infarction seems crucial to improve the outcomes. However, rare comparison data existed for these patients. We aimed to compare the effectiveness of selective β-blockers to that of carvedilol in patients treated with primary intervention. Methods and results: Among the 1,485 patients in the “INTERSTELLAR” registry between 2007 and 2015, 238 patients with selective β-blockers (bisoprolol, nebivolol, atenolol, bevantolol, and betaxolol) and 988 with carvedilol were included and their clinical outcomes were compared for a 2-year observation period. In the clinical baseline characteristics, the unfavorable trends in the carvedilol group were high Killip presentation, lower ejection fractions, smaller diameters, and longer lengths of deployed stents. Although mortality (2.5% vs. 1.7%; p = 0.414) and the rate of stroke (0.8% vs. 0.6%; p = 0.693) were not different between groups, the rate of recurrent myocardial infarction (4.6% vs. 1.2%; p = 0.001) and of target vessel revascularization (4.2% vs. 0.9%; p < 0.001) were lower in the carvedilol group. After eliminating the difference by propensity matching, the similar outcome result was shown (all-cause death, 0.6% vs. 1.0%, p = 0.678; stroke, 0.6% vs. 1.2%, p = 0.479; myocardial infarction, 5.0% vs. 1.2%, p = 0.003; target vessel revascularization, 4.5% vs. 0.7%, p < 0.006) for 595 matched populations. The use of carvedilol was also determined to be an independent predictor for recurrent myocardial infarctions (hazard ratio = 0.305; p = 0.005; 95% confidence interval = 0.13-0.69). Conclusion: Use of a carvedilol in ST-segment myocardial infarction survivor is associated with lower recurrent myocardial infarction events. Thus, it might be the better choice of β-blocker for secondary prevention in ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention.
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Affiliation(s)
- Ho-Jun Jang
- Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon-si, Republic of Korea
| | - Jon Suh
- Division of Cardiology, Soon Chun Hyang University Bucheon Hospital, Bucheon-si, Republic of Korea
| | - Sung Woo Kwon
- Division of Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Sang-Don Park
- Division of Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Pyung Chun Oh
- Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeonggeun Moon
- Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kyounghoon Lee
- Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Woong Chol Kang
- Division of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - In Hyun Jung
- Division of Cardiology, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Hyonggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon-si, Republic of Korea
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Kim IS, Yang PS, Lee J, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B. Long-term fine particulate matter exposure and cardiovascular mortality in the general population: a nationwide cohort study. J Cardiol 2020; 75:549-558. [DOI: 10.1016/j.jjcc.2019.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
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Pak HN, Park JW, Yang SY, Yu HT, Uhm JS, Joung B, Lee MH, Kim TH. A mesh-type flexible tip catheter vs a contact force catheter for catheter ablation of atrial fibrillation: A prospective nonrandomized 1:1 matched study. J Cardiovasc Electrophysiol 2020; 31:1279-1288. [PMID: 32270578 DOI: 10.1111/jce.14484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Mesh-type flexible tip (MFT) catheters allow clinicians to safely generate large radiofrequency lesions during catheter ablation of atrial fibrillation (AF), while contact force (CF) catheters provide better catheter-tissue contact. We compared the clinical outcomes of catheter ablation of AF using MFT and CF catheters in a prospective, nonrandomized manner. METHODS We prospectively assigned 217 patients with AF (paroxysmal AF 73.5%; male 69.1%; 59.9 ± 10.7 years old) at a 1:1 ratio to ablation with MFT catheters (FlexAbility) or CF catheters (TactiCath). The primary endpoint was AF recurrence after a single procedure; the secondary endpoint was a response to antiarrhythmic drugs. RESULTS After a mean follow-up of 22.3 ± 4.4 months, the clinical recurrence rate did not significantly differ between the two study groups (29.7% vs 30.2%; P = .941) (log-rank P = .838). The recurrence rate for atrial tachycardias (30.3% vs 9.7%; P = .035) and cardioversion rates (8.1% vs 1.9%; P = .024) were higher in the MFT group than CF group. At the final follow-up, sinus rhythm was maintained without antiarrhythmic drugs in 57.7% of the MFT group and 40.6% of the CF group (P = .010). No significant difference was found in the major complication rates between the two groups (0.9% vs 5.7%), although the ablation time was significantly longer in the MFT group (4192.1 ± 1080.2 vs 3583.8 ± 977.2 seconds; P < .001). CONCLUSION MFT and CF catheters had similar effectiveness in achieving AF rhythm control during catheter ablation, and there was no significant difference between the two catheters with regard to overall safety.
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Affiliation(s)
- Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Je-Wook Park
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Song-Yi Yang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kim M, Hong M, Kim JY, Kim IS, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Clinical relationship between anemia and atrial fibrillation recurrence after catheter ablation without genetic background. Int J Cardiol Heart Vasc 2020; 27:100507. [PMID: 32258364 PMCID: PMC7125353 DOI: 10.1016/j.ijcha.2020.100507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/01/2022]
Abstract
Background Anemia is a known adverse prognostic factor among patients with cardiovascular diseases. We investigated whether the hemoglobin level was associated with the rhythm outcome after atrial fibrillation (AF) catheter ablation (AFCA). Methods We included 2627 patients who underwent AFCA and a guidelines-based rhythm follow-up (age 58 ± 10.9 years, 73% men, 30.6% with persistent AF), and evaluated the association of pre-AFCA anemia (haemoglobin <13 g/dL in men and <12 g/dL in women) and rhythm outcomes. We studied the mechanistic relationship between anemia and AF recurrence using a Mendelian randomization analysis (1775 subjects with genome-wide association study) after reviewing already proven 12 hemoglobin-associated genetic polymorphisms. Results The body mass index, paroxysmal AF, warfarin use, and baseline red cell distribution width were independently associated with anemia in patients with AF. During a 23-month follow-up (interval OR 9–48 months), the clinical AF recurrence rate was significantly higher in patients with than without anemia (log-rank p = 0.001; propensity score-matched log-rank p = 0.004). This pattern was more significant in male patients (Log-rank p < 0.001) or patients with paroxysmal AF (Log-rank p < 0.001). Anemia (hazard ratio [HR] 1.45 [1.17–1.80], p = 0.001), left atrial diameter (HR 1.03 [1.01–1.04], p < 0.001), a female sex (HR 1.17 [1.00–1.36], p = 0.047), and persistent AF (HR 1.58 [1.36–1.84], p < 0.001) were independently associated with post-AFCA clinical recurrence. In the Mendelian randomization, we could not find a significant direct causal relationship between anemia and AF recurrence at the genetic level. Conclusions Pre-AFCA anemia is an independent predictor of post-AFCA clinical recurrence, especially in male patients, without a genetically direct causal relationship.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hui-Nam Pak
- Corresponding author at: 50 Yonseiro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
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Kim D, Yang PS, Jang E, Tae Yu H, Kim TH, Uhm JS, Kim JY, Sung JH, Pak HN, Lee MH, Lip GYH, Joung B. Blood Pressure Control and Dementia Risk in Midlife Patients With Atrial Fibrillation. Hypertension 2020; 75:1296-1304. [PMID: 32172620 DOI: 10.1161/hypertensionaha.119.14388] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Atrial fibrillation (AF) is associated with increased risk of cognitive impairment and dementia, even with no overt stroke. Hypertension has been a potentially modifiable risk factor for dementia, especially in midlife (<70 years) individuals. We aimed to investigate the associations of blood pressure (BP) and hypertension burden with dementia risk among midlife AF patients. From the Korean National Health Insurance Service database, we enrolled 171 228 incident AF patients aged 50 to 69 years with no prior dementia from 2005 to 2016. During a mean of 6.6 years of follow-up, 9909 patients received a first-time diagnosis of dementia. U-shaped relationships were noted between systolic or diastolic BP and dementia risk: A 10 mm Hg increase or decrease in systolic BP starting from 120 mm Hg was associated with 4.4% (95% CI, 2.7%-6.0%) and 4.6% (95% CI, 0.1%-8.2%) higher dementia risk, respectively. An increase or decrease in diastolic BP starting from 80 mm Hg also increased dementia risk. In subtype analyses, Alzheimer disease increases with BP decrease whereas vascular dementia increases according to BP increase. When BP changes over time were accounted for in time-updated models, BP of 120 to 129/80 to 84 mm Hg was associated with the lowest dementia risk. Increasing hypertension burden (the proportion of days with increased BP during follow-up) was associated with higher dementia risk (hazard ratio, 1.10 per 10% increase [95% CI, 1.08-1.12]). Among midlife AF patients, there were a U-shaped association of BP and a log-linear association of hypertension burden with dementia risk. Minimizing the burden of hypertension in AF patients might help to prevent dementia.
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Affiliation(s)
- Daehoon Kim
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (P.-S.Y., J.-H.S.)
| | - Eunsun Jang
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Hee Tae Yu
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Tae-Hoon Kim
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Jae-Sun Uhm
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Jong-Youn Kim
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Jung-Hoon Sung
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (P.-S.Y., J.-H.S.)
| | - Hui-Nam Pak
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Moon-Hyoung Lee
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
| | - Gregory Y H Lip
- Cardiovascular Medicine, Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, United Kingdom (G.Y.H.L.)
| | - Boyoung Joung
- From the Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (D.K., E.J., H.T.Y., T.-H.K., J.-S.U., J.-Y.K., H.-N.P., M.-H.L., B.J.)
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Kim YB, Kim DH, Jeong SB, Lee JW, Kim TH, Lee HG, Lee KW. Black soldier fly larvae oil as an alternative fat source in broiler nutrition. Poult Sci 2020; 99:3133-3143. [PMID: 32475450 PMCID: PMC7597637 DOI: 10.1016/j.psj.2020.01.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/09/2020] [Accepted: 01/12/2020] [Indexed: 11/24/2022] Open
Abstract
The present study was conducted to investigate growth performance, carcass characteristics, short-chain fatty acids, fatty acid composition in abdominal fat, and serum parameters in broiler chickens fed diets containing corn oil, coconut oil, or black soldier fly larvae (BSFL) oil at the level of 50 g per kg of diet during the 30-day-feeding period. A total 450 one-day-old male broiler chicks (Ross 308) were randomly allocated to one of 3 dietary groups. Each treatment had 10 replicates with 15 chicks per replicate. Feed conversion ratio was decreased in the coconut and BSFL oil group compared with the corn oil group. Dietary BSFL oil increased ileal weight-to-length ratio at day 30 after hatch. Dietary BSFL oil increased significantly ileal branched-chain fatty acid (P < 0.05) and moderately total short-chain fatty acid in 15-day-old broilers (P = 0.074). At day 30, ileal propionate was highest in the coconut oil group but cecal propionate was highest (P < 0.05) in the BSFL oil group. Fatty acid composition of abdominal fat was affected by dietary fat sources. Especially, chickens fed diets containing coconut oil or BSFL oil had higher contents (P < 0.05) of saturated fatty acid being dominant in lauric and myristic acids compared with those fed on corn oil. On the other hand, the reverse trend was noted (P < 0.05) as to polyunsaturated fatty acids being dominant in corn oil compared with coconut oil and BSFL oil. Coconut oil vs. corn oil significantly increased total and high-density lipoprotein cholesterol. Finally, BSFL oil vs. corn oil significantly increased total antioxidant capacity in chickens. It is concluded that dietary BSFL oil improves feed conversion ratio and increases the incorporation of medium-chain fatty acids into abdominal fat pad and serum antioxidant capacity in broiler chickens.
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Affiliation(s)
- Yoo Bhin Kim
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, South Korea
| | - Da-Hye Kim
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, South Korea
| | - Su-Been Jeong
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, South Korea
| | - Jeong-Woo Lee
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, South Korea
| | - Tae-Hoon Kim
- FoodyWorm Inc., Cheongju-si, Chungcheongbuk-do 28162, South Korea
| | - Hong-Gu Lee
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, South Korea
| | - Kyung-Woo Lee
- Department of Animal Science and Technology, Sanghuh College of Life Sciences, Konkuk University, Seoul 05029, South Korea.
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Choi YJ, Uhm JS, Kim TH, Cha MJ, Lee JM, Park J, Park JK, Kang KW, Shim J, Kim J, Park HW, Choi EK, Kim JB, Kim C, Lee YS, Joung B. Differences in anticoagulation strategy and outcome in atrial fibrillation patients with chronic kidney disease: a CODE-AF registry study. Int J Arrhythm 2020. [DOI: 10.1186/s42444-020-0011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
Dose reduction of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in patients with atrial fibrillation (AF) with renal impairment. This study investigated anticoagulation patterns and outcomes in patients with chronic kidney disease (CKD).
Materials and methods
In a prospective observational registry (CODE-AF), 3445 patients with non-valvular AF including 1129 with CKD (estimated glomerular filtration rate ≤ 60 mL min−1 1.73 m−2) were identified between June 1, 2016, and July 3, 2017.
Results
Compared with patients with no-CKD, patients with CKD more frequently had a high stroke risk (94.9% vs. 67.0%, p < 0.001) and higher NOAC usage rate (61.1% vs. 47.8%, p < 0.001). Among 718 patients with renal indication for dose reduction (RIDR), 7.5% were potentially overdosed. Among 2587 patients with no-RIDR, 79% were potentially underdosed. Compared with patients with no-RIDR, the underdose rates of dabigatran (0% vs. 88.6%, p = 0.001) and rivaroxaban (0% vs. 79.5%, p = 0.001) were lower in patients with RIDR. However, the underdose rate of apixaban was not different (62.5% vs. 53.9%, p = 0.089). The overdose rate of dabigatran (7.5% vs. 0%) and rivaroxaban (13.7% vs. 0%) was higher in RIDR than in no-RIDR patients. Stroke/transient ischemic attack was significantly higher in CKD patients (1.4 vs. 0.6 per 100 person-years, p = 0.045). Aspirin significantly increased minor bleeding in CKD patients compared with controls (p = 0.037).
Conclusion
CKD patients might have a high stroke risk and NOAC usage rate. The underdose rate of NOACs decreased in CKD patients, except for apixaban. Aspirin significantly increased minor bleeding in CKD patients.
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Lim B, Kim J, Hwang M, Song JS, Lee JK, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology. Sci Rep 2020; 10:2417. [PMID: 32051487 PMCID: PMC7016008 DOI: 10.1038/s41598-020-59372-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 11/06/2019] [Indexed: 12/22/2022] Open
Abstract
We previously reported the feasibility and efficacy of a simulation-guided clinical catheter ablation of atrial fibrillation (AF) in an in-silico AF model. We developed a highly efficient realistic AF model reflecting the patient endocardial voltage and local conduction and tested its clinical feasibility. We acquired > 500 endocardial bipolar electrograms during right atrial pacing at the beginning of the AF ablation procedures. Based on the clinical bipolar electrograms, we generated simulated voltage maps by applying fibrosis and local activation maps adjusted for the fiber orientation. The software's accuracy (CUVIA2.5) was retrospectively tested in 17 patients and feasibility prospectively in 10 during clinical AF ablation. Results: We found excellent correlations between the clinical and simulated voltage maps (R = 0.933, p < 0.001) and clinical and virtual local conduction (R = 0.958, p < 0.001). The proportion of virtual local fibrosis was 15.4, 22.2, and 36.9% in the paroxysmal AF, persistent AF, and post-pulmonary vein isolation (PVI) states, respectively. The reconstructed virtual bipolar electrogram exhibited a relatively good similarities of morphology to the local clinical bipolar electrogram (R = 0.60 ± 0.08, p < 0.001). Feasibility testing revealed an in situ procedural computing time from the clinical data acquisition to wave-dynamics analyses of 48.2 ± 4.9 min. All virtual analyses were successfully achieved during clinical PVI procedures. We developed a highly efficient, realistic, in situ procedural simulation model reflective of individual anatomy, fiber orientation, fibrosis, and electrophysiology that can be applied during AF ablation.
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Affiliation(s)
- Byounghyun Lim
- Yonsei University Health System, Seoul, Republic of Korea
| | - Jaehyeok Kim
- Yonsei University Health System, Seoul, Republic of Korea
| | - Minki Hwang
- Yonsei University Health System, Seoul, Republic of Korea
| | - Jun-Seop Song
- Yonsei University Health System, Seoul, Republic of Korea
| | - Jung Ki Lee
- Yonsei University Health System, Seoul, Republic of Korea
| | - Hee-Tae Yu
- Yonsei University Health System, Seoul, Republic of Korea
| | - Tae-Hoon Kim
- Yonsei University Health System, Seoul, Republic of Korea
| | - Jae-Sun Uhm
- Yonsei University Health System, Seoul, Republic of Korea
| | - Boyoung Joung
- Yonsei University Health System, Seoul, Republic of Korea
| | - Moon-Hyung Lee
- Yonsei University Health System, Seoul, Republic of Korea
| | - Hui-Nam Pak
- Yonsei University Health System, Seoul, Republic of Korea.
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Uhm JS, Lee Y, Roh YH, Lee J, Kang D, Jin MN, Kim IS, Yu HT, Kim TH, Kim JY, Joung B, Pak HN, Lee MH. Nonspecific intraventricular conduction delay is associated with future occurrence of atrial fibrillation in patients with structurally normal heart. Eur J Intern Med 2020; 72:67-72. [PMID: 31735548 DOI: 10.1016/j.ejim.2019.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 11/03/2019] [Accepted: 11/07/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND We aimed to elucidate the long-term prognosis of nonspecific intraventricular conduction delay (NIVCD) in patients with structurally normal heart. METHODS We included 107,838 patients (age, 52.1 ± 15.5 years; men, 46.8%) who underwent electrocardiography in outpatient clinics or medical checkup (unmatched cohort). NIVCD was defined as QRS duration ≥110 ms without meeting the criteria for bundle branch block. Patients with structurally normal heart and sinus rhythm were assigned to the NIVCD and normal QRS groups according to propensity score with matching variables of age, sex, hypertension, and diabetes (matched cohort 1), and additional PR interval (matched cohort 2). Baseline characteristics, electrocardiographic parameters, and clinical outcomes were compared in the unmatched cohort and the matched cohort. RESULTS In the unmatched cohort, the frequencies of male sex and preexisting atrial fibrillation were significantly higher in the NIVCD group than in the normal QRS group. In matched cohort 1 (n = 690), the NIVCD group exhibited significant slower sinus rate and longer PR interval than the normal QRS group. In matched cohort 2 (n = 598), the cumulative incidence of atrial fibrillation was significantly higher in the NIVCD group than in the normal QRS group during a follow-up period of 8.8 ± 2.9 years. NIVCD significantly increased the risk for AF (hazard ratio, 2.571; 95% confidence interval, 1.074-6.156; p = 0.034). CONCLUSIONS It is suggested that NIVCD may be associated with future occurrence of atrial fibrillation in patients with structurally normal heart and sinus rhythm.
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Affiliation(s)
- Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Youngchae Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinae Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dongseon Kang
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moo-Nyun Jin
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - In-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Jong-Youn Kim
- Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul 03722, Republic of Korea.
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Van TT, Kim TH, Butler-Wu SM. Evaluation of the Biofire FilmArray meningitis/encephalitis assay for the detection of Cryptococcus neoformans/gattii. Clin Microbiol Infect 2020; 26:1375-1379. [PMID: 31972318 DOI: 10.1016/j.cmi.2020.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Cryptococcal meningitis (CM) remains an important cause of morbidity and mortality among immunocompromised patients. Laboratory diagnostics for CM includes antigen detection, staining and culture. Data on the performance of the Biofire® FilmArray® meningitis/encephalitis (ME) panel for detecting Cryptococcus neoformans/gattii is limited, with several reports describing false negativity for this target. METHODS A retrospective analysis of 1384 physician-ordered ME panel tests ordered between January 2017 to October 2018 was performed. ME panel results were compared to cerebrospinal fluid (CSF) cryptococcal antigen (CrAg) and CSF culture testing and clinical significance of cryptococcal detection was determined. RESULTS There were 34 patients positive for cryptococcal detection by either ME panel, CSF CrAg or CSF culture in 2.7% of CSF specimens tested (38/1384). Of the 34 patients positive for cryptococcal detection, 85.3% were human immunodeficiency virus positive (29/34). The ME panel detected 32/38 (84.2%) cryptococcal-positive specimens, culture detected 28/38 (73.7%) and CSF CrAg was positive in 37/38 specimens (97.4%). The ME panel had a sensitivity and specificity of 96.4% (95% CI 81.7-99.9%) and 99.6% (95% CI 99.2-99.9%) compared with culture, and 83.8% (95% CI 68.0-93.8%) and 99.9% (95% CI 99.6-100.0%) compared to CSF CrAg testing, respectively. CrAg titres were lower among ME panel-negative, culture-negative specimens compared with ME panel-positive, culture-negative specimens (reciprocal median end-point titres of 128 ± 60 vs. 1920 ± 1730, p 0.04). All five CrAg-positive, ME panel- and culture-negative specimens were obtained from previously treated CM patients. DISCUSSION The ME panel had high correlation with CSF culture and a somewhat lower correlation with CSF CrAg testing. The potential utility of using negative ME panel test results to predict culture sterility among patients undergoing treatment for CM warrants further study.
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Affiliation(s)
- T T Van
- Department of Pathology, Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - T H Kim
- Department of Pathology and Laboratory Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - S M Butler-Wu
- Department of Pathology and Laboratory Medicine, Keck School of Medicine of USC, Los Angeles, CA, USA.
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Yu HT, Kim IS, Kim TH, Uhm JS, Kim JY, Joung B, Lee MH, Pak HN. Persistent atrial fibrillation over 3 years is associated with higher recurrence after catheter ablation. J Cardiovasc Electrophysiol 2020; 31:457-464. [PMID: 31919909 PMCID: PMC7027787 DOI: 10.1111/jce.14345] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/07/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023]
Abstract
Instruction Longer atrial fibrillation (AF) durations have higher recurrence rates after rhythm control. However, there is limited data on the effect of the AF duration on recurrence after atrial fibrillation catheter ablation (AFCA). In the present study, we investigated the rhythm outcome of AFCA according to the AF duration based on the first electrocardiogram (ECG) diagnosis. Methods and Results We included 1005 patients with AF (75% male, 59 ± 11 years old) who underwent AFCA and whose first ECG diagnosis time point was evident. The clinical characteristics and rhythm outcomes were compared based on the AF duration (≤3 years, n = 537; >3 years, n = 468) and AF burden (paroxysmal atrial fibrillation [PAF], n = 387; persistent atrial fibrillation [PeAF], n = 618). Longer AF durations were associated with older age (P = .020), larger left atrial size (P = .009) and a higher number of patients with hypertension (P < .001) or PeAF (P < .001). During 24 ± 22 months of follow‐up, the postablation clinical recurrence rate was higher in patients with a longer AF duration (logrank P = .002). The AF recurrence rate was significantly higher in PeAF patients with an AF duration >3 years (logrank P = 0.009), but not in subjects with PAF (logrank P = .939). In a multivariate Cox regression analysis, a longer AF duration was significantly associated with a higher clinical recurrence rate after AFCA in PeAF patients (adjusted hazard ratio, 1.06; range, 1.03‐0.10; P = 0.001), but not PAF. Conclusion Although longer AF duration was associated with higher clinical recurrence rates after AFCA, the rate was significant in patients with PeAF lasting >3 years, but not in PAF patients.
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Affiliation(s)
- Hee Tae Yu
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - In-Soo Kim
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - Jong-Youn Kim
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - Boyoung Joung
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
| | - Hui-Nam Pak
- Division of Cardiology, Yonsei University Health System, Seoul, Republic of Korea
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Heo R, Cha MJ, Kim TH, Lee JM, Park J, Park HW, Kang KW, Shim J, Uhm JS, Kim J, Kim JB, Kim C, Lee YS, Choi EK, Joung B, Park JK. Characteristics of symptom burden in atrial fibrillation with concomitant heart failure. Int J Arrhythm 2020. [DOI: 10.1186/s42444-019-0009-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Symptom burden is an important factor in determining the treatment of atrial fibrillation (AF). AF is frequently accompanied by heart failure (HF). This study investigated the characteristics of AF symptoms with concomitant HF.
Methods
A total of 4885 patients with AF were consecutively enrolled through a prospective observational registry (the Comparison Study of Drugs for Symptom Control and Complication Prevention of Atrial Fibrillation [CODE-AF] registry). Clinically diagnosed HF was divided into three categories (preserved, mid-range, and reduced ejection fraction [EF]). Symptom severity was assessed using the European Heart Rhythm Association (EHRA) classification.
Results
The presence of AF-related symptoms was comparable irrespective of concomitant HF. Patients with HF with reduced EF demonstrated severe (EHRA classes 3 and 4) and atypical symptoms. HF with preserved EF was also associated with atypical symptoms. Female sex and AF type were associated with the presence of symptoms in AF without HF, and non-maintenance of sinus rhythm and increased left atrial pressure (E/e′ ≥ 15) were factors related to the presence of symptoms in AF with HF.
Conclusion
AF with concomitant HF presented with more severe and atypical symptoms than AF without HF. Maintaining the sinus rhythm and reducing the E/e’ ratio are important factors for reducing symptoms in AF with concomitant HF.
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242
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Zhang B, Zhu C, Wu Z, Stavitski E, Lui YH, Kim TH, Liu H, Huang L, Luan X, Zhou L, Jiang K, Huang W, Hu S, Wang H, Francisco JS. Integrating Rh Species with NiFe-Layered Double Hydroxide for Overall Water Splitting. Nano Lett 2020; 20:136-144. [PMID: 31774999 DOI: 10.1021/acs.nanolett.9b03460] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
NiFe-layered double hydroxide (LDH) is thought of as a promising bifunctional water-splitting catalyst, owing to its excellent performances for alkaline oxygen evolution reactions (OERs). However, it shows extremely poor activity toward hydrogen evolution reactions (HERs) due to the weak hydrogen adsorption. We demonstrated that the integration of Rh species and NiFe-LDH can dramatically improve its HER kinetics without sacrificing the OER performance. The Rh species were initially integrated into NiFe-LDH as oxidized dopants and metallic clusters (< 1 nm). In 1 M KOH electrolyte, an overpotential of 58 mV is needed to catalyze 10 mA cm-2 HER current density. Furthermore, this catalyst only requires 1.46 V to drive an electrolyzer at 10 mA cm-2. A strong interaction between metallic Rh clusters and NiFe hydroxide during the HER process is revealed. The theoretical calculation shows the Rh ions replace Fe ions as the major active sites that are responsible for OERs.
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Affiliation(s)
- Bowei Zhang
- Department of Mechanical Engineering , Iowa State University , Ames , Iowa 50011 , United States
- Department of Chemistry , Yale University , New Haven , Connecticut 06511 , United States
- Energy Sciences Institute , Yale University , West Haven , Connecticut 06516 , United States
| | - Chongqin Zhu
- Department of Earth & Environmental Science , University of Pennsylvania , Philadelphia , Pennsylvania 19104 , United States
| | - Zishan Wu
- Department of Chemistry , Yale University , New Haven , Connecticut 06511 , United States
- Energy Sciences Institute , Yale University , West Haven , Connecticut 06516 , United States
| | - Eli Stavitski
- National Synchrotron Light Source II , Brookhaven National Laboratory , Upton , New York 11973 , United States
| | - Yu Hui Lui
- Department of Mechanical Engineering , Iowa State University , Ames , Iowa 50011 , United States
| | - Tae-Hoon Kim
- Ames National Laboratory, U.S. Department of Energy , Ames , Iowa 50011 , United States
| | - Huan Liu
- Department of Chemistry , Yale University , New Haven , Connecticut 06511 , United States
- Energy Sciences Institute , Yale University , West Haven , Connecticut 06516 , United States
| | - Ling Huang
- Department of Chemistry , Yale University , New Haven , Connecticut 06511 , United States
- Energy Sciences Institute , Yale University , West Haven , Connecticut 06516 , United States
| | - Xuechen Luan
- Department of Chemistry , Iowa State University , Ames , Iowa 50011 , United States
| | - Lin Zhou
- Ames National Laboratory, U.S. Department of Energy , Ames , Iowa 50011 , United States
| | - Kun Jiang
- Joint Center for Artificial Photosynthesis , Lawrence Berkeley National Laboratory , Berkeley , California 94720 , United States
- Department of Chemical and Biomolecular Engineering , University of California , Berkeley , California 94720 , United States
| | - Wenyu Huang
- Department of Chemistry , Iowa State University , Ames , Iowa 50011 , United States
| | - Shan Hu
- Department of Mechanical Engineering , Iowa State University , Ames , Iowa 50011 , United States
| | - Hailiang Wang
- Department of Chemistry , Yale University , New Haven , Connecticut 06511 , United States
- Energy Sciences Institute , Yale University , West Haven , Connecticut 06516 , United States
| | - Joseph S Francisco
- Department of Earth & Environmental Science , University of Pennsylvania , Philadelphia , Pennsylvania 19104 , United States
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Kim M, Kim TH. Finding Cardiac Resynchronization Therapy Responders: Postprocedural QRS-T Morphologies Matter. Korean Circ J 2020; 50:1074-1076. [PMID: 33258316 PMCID: PMC7707977 DOI: 10.4070/kcj.2020.0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/02/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Min Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kim H, Lee YS, Kim TH, Cha MJ, Lee JM, Park J, Park JK, Kang KW, Shim J, Uhm JS, Park HW, Choi EK, Kim JB, Kim C, Kim J, Joung B. A prospective survey of the persistence of warfarin or NOAC in nonvalvular atrial fibrillation: a COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF). Korean J Intern Med 2020; 35:99-108. [PMID: 31014064 PMCID: PMC6960047 DOI: 10.3904/kjim.2017.415] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/10/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/AIMS Efforts to reduce stroke in patients with atrial fibrillation (AF) have focused on increasing physician adherence to oral anticoagulant (OAC) guidelines; however, the high early discontinuation rate of vitamin K antagonists (VKAs) is a limitation. Although non-VKA OACs (NOACs) are more convenient to administer than warfarin, their lack of monitoring may predispose patients to nonpersistence. We compared the persistence of NOAC and VKA treatment for AF in real-world practice. METHODS In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 7,013 patients with nonvalvular AF (mean age 67.2 ± 10.9 years, women 36.4%) were consecutively enrolled between June 2016 and June 2017 from 10 tertiary hospitals in Korea. This study included 3,381 patients who started OAC 30 days before enrollment (maintenance group) and 572 patients who newly started OAC (new-starter group). The persistence rate of OAC was evaluated. RESULTS In the maintenance group, persistence to OAC declined during 6 months, to 88.3% for VKA and 95.5% for NOAC (p < 0.0001). However, the persistence rate was not different among NOACs. In the new-starter group, persistence to OAC declined during 6 months, to 78.9% for VKA and 92.1% for NOAC (p < 0.0001). The persistence rate was lower for rivaroxaban (83.7%) than apixaban (94.6%) and edoxaban (94.1%, p < 0.001). In the new-starter group, diabetes, valve disease, and cancer were related to nonpersistence of OAC. CONCLUSION Nonpersistence was significantly lower with NOAC than VKA in both the maintenance and new-starter groups. In only the new-starter group, apixaban or edoxaban showed higher persistence rates than rivaroxaban.
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Affiliation(s)
- Hyeongsoo Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Soo Lee
- Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myung-Jin Cha
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jung Myung Lee
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Junbeom Park
- Department of Cardiology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jin-Kyu Park
- Department of Cardiology, Hanyang University Seoul Hospital, Seoul, Korea
| | - Ki-Woon Kang
- Division of Cardiology, Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea
| | - Jaemin Shim
- Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Wook Park
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jin-Bae Kim
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Kim
- Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
- Correspondence to Boyoung Joung, M.D. Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2228-8460, Fax: +82-2-393-2041, E-mail:
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Chung S, Kim TH, Uhm JS, Cha MJ, Lee JM, Park J, Park JK, Kang KW, Kim J, Park HW, Choi EK, Kim JB, Kim CS, Lee YS, Shim J, Joung B. Stroke and Systemic Embolism and Other Adverse Outcomes of Heart Failure With Preserved and Reduced Ejection Fraction in Patients With Atrial Fibrillation (from the COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF]). Am J Cardiol 2020; 125:68-75. [PMID: 31699363 DOI: 10.1016/j.amjcard.2019.09.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/19/2022]
Abstract
It is unknown whether heart failure (HF) with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) carry a similar risk of stroke or systemic embolism (SE) and other outcomes in patients with nonvalvular atrial fibrillation (AF). A prospective, multicenter outpatient registry with echocardiographic data which enrolled 10,589 patients from June 2016 to May 2019 was analyzed. In this registry, 935 (8.8%) patients had HF, and the proportions of patients with HFpEF and HFrEF were 43.2% and 56.8%, respectively. During follow-up over 1.33 years, 11 (2.07 per 100 person-years [PYR]) and 5 (0.76 per 100 PYR) patients had stroke/SE in the HFpEF and HFrEF groups, respectively, whereas 102 patients (0.84 per 100 PYR) had these sequelae in the no-HF group. The HFpEF group had a significantly higher cumulative incidence of stroke/SE (p = 0.004) and risk of stroke/SE (adjusted hazard ratio [HR] 2.23, 95% confidence interval [CI] 1.19 to 4.18) than the no-HF group. The risk of stroke/SE in the HFpEF group compared with that in the no-HF group was consistently increased even in patients on oral anticoagulation therapy (adjusted HR 2.55, 95% CI 1.31 to 4.96). There was a correlation between larger left atrial size and risk of stroke/SE (adjusted HR 1.53, 95% CI 1.03 to 2.29), but not between reduced left ventricular ejection fraction and this risk. In conclusion, these results suggest that strict oral anticoagulation therapy helps reduce the risk of stroke/SE in patients with nonvalvular AF and HFpEF, especially in those with a larger left atrial size.
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Lu Y, Kim TH, Yao X. Comparative study of wild-type and rd10 mice reveals transient intrinsic optical signal response before phosphodiesterase activation in retinal photoreceptors. Exp Biol Med (Maywood) 2019; 245:360-367. [PMID: 31852239 DOI: 10.1177/1535370219896284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Transient intrinsic optical signal (IOS) has been observed in stimulus-evoked retinal photoreceptors. This study is to compare IOS changes in wild-type and retinal degeneration 10 (rd10) mouse retinas, to evaluate the effect of cyclic guanosine monophosphate phosphodiesterase on photoreceptor-IOS. Time-lapse near-infrared light microscopy was employed to monitor the spatiotemporal dynamics of the IOS responses in freshly isolated retinas activated by visible light stimulation. Comparative IOS recordings were conducted at postnatal days 14 (P14) and P16. At P14, intrinsic optical signal magnitudes and spatiotemporal dynamics in wild-type and rd10 retinas were similar, indicating that the phosphodiesterase deficiency in rd10 did not affect the formation of photoreceptor-IOS. At P16, IOS magnitude in rd10 significantly decreased compared to that in wild-type, suggesting the IOS sensitivity to the photoreceptor degeneration in rd10. Our experimental results and theoretical analysis indicate that early disc-based stages of the phototransduction cascade before the activation of phosphodiesterase may contribute to the formation of the photoreceptor-IOS responses; and the IOS can be a sensitive biomarker for objective assessment of retinal function. Impact statement Comparative study of wild-type and rd10 mice was implemented to reveal that transient intrinsic optical signal (IOS) was initiated before the phosphodiesterase activation in stimulus-activated photoreceptors and the IOS magnitude was sensitive to photoreceptor degeneration. The photoreceptor-IOS promises a noninvasive biomarker for objective assessment of age-related macular degeneration, retinitis pigmentosa, and other eye diseases that can produce photoreceptor dysfunctions.
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Affiliation(s)
- Yiming Lu
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Tae-Hoon Kim
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Xincheng Yao
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA.,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
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Heo W, Song SW, Kim TH, Lim SH, Yoo KJ, Cho BK, Lee HS. Impact of Supraaortic Intimal Tears on Aortic Diameter Changes After Nontotal Arch Replacement. Ann Thorac Surg 2019; 110:20-26. [PMID: 31846644 DOI: 10.1016/j.athoracsur.2019.10.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study evaluated the impact of the intimal tear location on aortic dilation and reintervention after nontotal arch replacement (non-TAR) for acute type I aortic dissection. METHODS Between 2009 and 2017, 92 patients who underwent non-TAR for acute type I aortic dissection were enrolled. Intimal tears were analyzed at the supraaortic (SA) segment; segment 1, proximal descending thoracic aorta (DTA); segment 2, distal DTA; and segment 3, abdominal aorta. Aortic diameter was measured at the pulmonary artery bifurcation, celiac axis, maximal abdominal aorta, and maximal thoracoabdominal aorta using serial follow-up computed tomographic scans. The Fisher exact or χ2 test, independent t or Mann-Whitney U test, and log-rank test were used in the statistical analyses. RESULTS The significant factors for increasing aortic diameter were the first location of intimal tear in the SA segment and segments 1 and 2. In the adjusted analysis, the first location of intimal tear in the SA segment and segment 1 was statistically significant. In the additional adjusted analysis, a segment 1 tear without SA tear was the only significant factor for increasing aortic diameter. The 5-year freedom from reintervention rate was significantly higher in patients with no intimal tear than in those with a segment 1 intimal tear with/without SA tear. CONCLUSIONS We confirmed that SA and proximal DTA intimal tears are associated with subsequent aortic dilation and reintervention. These proximal aortic intimal tears might warrant aggressive surgical treatment at the initial operation or close postoperative follow-up.
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Affiliation(s)
- Woon Heo
- Department of Cardiovascular Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea; Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Suk-Won Song
- Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Tae-Hoon Kim
- Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sun-Hee Lim
- Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Jong Yoo
- Department of Cardiovascular Surgery, Yonsei Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | | | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
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248
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Kim TH, Kim DH. The effects of head rotation and tilt on oral pressure and muscle activity. Anat Cell Biol 2019; 52:378-384. [PMID: 31949975 PMCID: PMC6952685 DOI: 10.5115/acb.19.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/22/2019] [Accepted: 12/02/2019] [Indexed: 11/27/2022] Open
Abstract
We present basic data on head positions that can serve as compensatory interventions for patients with weak tongue and buccinator muscles. We studied 30 Korean adults (15 males, 15 females; mean age, 23 years; range, 20-30 years). A TPS-100 instrument was used to measure tongue and cheek pressures and suprahyoid and buccinator muscle activities at various head rotations and tilts, as independent variables. The data were subjected to one-way analysis of variance and post-hoc (linear contrast) testing. Tongue elevation pressures differed significantly when the head was flexed or extended compared to the neutral position (P<0.01). Suprahyoid muscle activity varied significantly when the head was rotated left or right compared to neutral, or tilted with the tongue elevated (P<0.01). Cheek pressure varied significantly when the head was rotated left or right compared to neutral, or tilted (P<0.01). Both tongue and cheek pressures increased significantly when the head was extended or rotated contralaterally compared to the neutral position. Suprahyoid muscle activity increased when the head was flexed or extended, or contralaterally or ipsilaterally rotated compared to the neutral position. Therefore, we suggest that head rotation or tilting could be used to vary oral pressure and muscle activity.
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Affiliation(s)
- Tae-Hoon Kim
- Department of Occupational Therapy, Division of Health Science, Dongseo University, Busan, Korea
| | - Da-Hye Kim
- Department of Dental Hygiene, Division of Health Sciences, Dongseo University, Busan, Korea
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249
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Ma T, Fan Z, Xu B, Kim TH, Lu P, Bellaiche L, Kramer MJ, Tan X, Zhou L. Uncompensated Polarization in Incommensurate Modulations of Perovskite Antiferroelectrics. Phys Rev Lett 2019; 123:217602. [PMID: 31809133 DOI: 10.1103/physrevlett.123.217602] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Indexed: 06/10/2023]
Abstract
Complex polar structures of incommensurate modulations (ICMs) are revealed in chemically modified PbZrO_{3} perovskite antiferroelectrics using advanced transmission electron microscopy techniques. The Pb-cation displacements, previously assumed to arrange in a fully compensated antiparallel fashion, are found to be either antiparallel, but with different magnitudes, or in a nearly orthogonal arrangement in adjacent stripes in the ICMs. Ab initio calculations corroborate the low-energy state of these arrangements. Our discovery corrects the atomic understanding of ICMs in PbZrO_{3}-based perovskite antiferroelectrics.
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Affiliation(s)
- Tao Ma
- Ames Laboratory, U.S. Department of Energy, Ames, Iowa 50011, USA
| | - Zhongming Fan
- Department of Materials Science and Engineering, Iowa State University, Ames, Iowa 50011, USA
| | - Bin Xu
- Physics Department and Institute for Nanoscience and Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA
- School of Physical Science and Technology, Soochow University, Suzhou, Jiangsu 215006, China
| | - Tae-Hoon Kim
- Ames Laboratory, U.S. Department of Energy, Ames, Iowa 50011, USA
| | - Ping Lu
- Sandia National Laboratories, P.O. Box 5800, MS 1411, Albuquerque, New Mexico 87185, USA
| | - Laurent Bellaiche
- Physics Department and Institute for Nanoscience and Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA
| | - Matthew J Kramer
- Ames Laboratory, U.S. Department of Energy, Ames, Iowa 50011, USA
- Department of Materials Science and Engineering, Iowa State University, Ames, Iowa 50011, USA
| | - Xiaoli Tan
- Department of Materials Science and Engineering, Iowa State University, Ames, Iowa 50011, USA
| | - Lin Zhou
- Ames Laboratory, U.S. Department of Energy, Ames, Iowa 50011, USA
- Department of Materials Science and Engineering, Iowa State University, Ames, Iowa 50011, USA
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250
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Jin MN, Lim B, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Hwang C, Pak HN. Long-Term Outcome of Additional Superior Vena Cava to Septal Linear Ablation in Catheter Ablation of Atrial Fibrillation. J Am Heart Assoc 2019; 8:e013985. [PMID: 31726961 PMCID: PMC6915280 DOI: 10.1161/jaha.119.013985] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background We previously reported the benefit of linear ablation from the superior vena cava to the right atrial septum (SVC‐L) within a year after circumferential pulmonary vein isolation (CPVI) in patients with paroxysmal atrial fibrillation (AF). We explored the long‐term effects of SVC‐L and its potential related mechanisms. Methods and Results Among 2140 consecutive patients with AF ablation, we included 614 patients (73.3% male, aged 57.8±10.7 years, 13.7% with persistent AF) who did not undergo an extra–pulmonary vein left atrial ablation after propensity score matching; of those, 307 had additional SVC‐L and 307 had CPVI alone. We evaluated the heart rate variability and computational modeling study to explore mechanisms. Although the procedure time was longer in the SVC‐L group than the CPVI group (P<0.001), the complication rates did not differ (P=0.560). During 40.5±24.4 months of follow‐up, the rhythm outcome was significantly better in the SVC‐L group than the CPVI group (log rank, P<0.001). At 2‐year follow‐up of heart rate variability, a significantly higher mean heart rate (P=0.018) and a lower ratio of low/high‐frequency components (P=0.011) were found with SVC‐L than CPVI alone. In realistic in silico biatrial modeling, which reflected the electroanatomies of 10 patients, SVC‐L significantly reduced biatrial dominant frequency compared with CPVI alone (P<0.001) and increased AF termination and defragmentation rates (P=0.033). Conclusions SVC‐L ablation in addition to CPVI significantly improved the long‐term rhythm outcome over 2 years after AF catheter ablation by mechanisms involving autonomic modulation and AF organization.
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Affiliation(s)
- Moo-Nyun Jin
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | - Byounghyun Lim
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | - Hee Tae Yu
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | - Tae-Hoon Kim
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | - Jae-Sun Uhm
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | - Boyoung Joung
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | - Moon-Hyoung Lee
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
| | | | - Hui-Nam Pak
- Division of Cardiology Yonsei University Health System Seoul Republic of Korea
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