BACKGROUND: Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. METHODS: A population sample of 240 normotensive (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height(2.7) was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m(2.7) men or 47 g/m(2.7) in women. RESULTS: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height(2.7) (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). CONCLUSION: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy.
Adult* ; Body Mass Index ; Body Size ; Diabetes Mellitus ; Echocardiography ; Female ; Heart Diseases ; Hip ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Mortality ; Obesity* ; Overweight ; Risk Factors ; Thyroid Diseases ; Waist Circumference

BACKGROUND: Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for cardiovascular morbidity and mortality. The combination of hypertension and obesity are well known to act as risk factors of left ventricular hypertrophy in a number of studies, but it is unclear whether obesity itself stimulates LVH independently. Therefore, we investigated the relationship of left ventricular mass to body size in normotensive adults. METHODS: A population sample of 240 normotensive (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) adults (139 men and 101 women) was examined by echocardiography. We excluded adults with history of hypertension, thyroid diseases, diabetes mellitus and other cardiac diseases. Left ventricular mass normalized for height(2.7) was used in the analyses and left ventricular hypertrophy was defined as a value of 50 g/m(2.7) men or 47 g/m(2.7) in women. RESULTS: Left ventricular mass significantly and positively correlated with body mass index. On univariate correlation analysis after adjusting for age, the body mass index was associated with LV mass/height(2.7) (LVMI: Left Ventricular Mass Index) in males and body mass index, waist circumference, hip circumference and waist/hip circumference ratio were associated with LVMI in females. Left ventricular hypertrophy was more frequent in overweight (33.3%) and obese (39.4%) groups than in lean group (15.9%). CONCLUSION: Left ventricular mass was strongly related to obesity in normotensive adults, especially in females. Obesity may be an independent risk factor for left ventricular hypertrophy.
Adult* ; Body Mass Index ; Body Size ; Diabetes Mellitus ; Echocardiography ; Female ; Heart Diseases ; Hip ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Mortality ; Obesity* ; Overweight ; Risk Factors ; Thyroid Diseases ; Waist Circumference

Idiopathic hypereosinophilic syndrome is a rare systemic, leukoproliferative disorder characterized by eosinophil- mediated tissue injury causing multiple organ failure, including the heart. Cardiac involvement occurs in more than 75% of patients with hypereosinophilic syndrome. Cardiac manifestations include subendocardial fibrosis, thrombus leading to peripheral emboli, restrictive cardiomyopathy, and valvular dysfunction. It is more common in men than in women (9:1), and trends to present between the ages of 20 and 50 years. Presentation in childhood is unusual. We report for the first time a case of a 58-year-old man with idiopathic hypereosinophilic syndrome manifested by prosthetic aortic valve dysfunction that was successfully treated by steroid and hydroxyurea therapy after surgical valvular replacement.
Aortic Valve* ; Cardiomyopathy, Restrictive ; Female ; Fibrosis ; Heart ; Humans ; Hydroxyurea ; Hypereosinophilic Syndrome* ; Male ; Middle Aged ; Multiple Organ Failure ; Thrombosis

BACKGROUND AND OBJECTIVES: The overall prognosis of patients with vasospastic angina (VA) is relatively good. However, the long-term prognosis and its influencing factors are not well understood in Korean patients. SUBJECTS AND METHODS: Between August 1996 and January 2007, 256 consecutive patients with VA were reviewed (215 men, 53+/-9 years). Coronary spasm was confirmed via intravenous ergonovine provocation in all study patients during coronary angiography. Major adverse cardiac events (MACEs) were defined as myocardial infarction (MI), resuscitation from cardiac arrest, or repeat hospitalization due to recurrent angina. RESULTS: The 256 patients were followed for an average of 59 months (range, 5 months to 11 years). Thirty-one patients (12.1%) were lost to follow-up. Cardiac deaths occurred in 6 patients (2.3%), non-fatal MIs occurred in 3 patients (1.2%), and MACEs occurred in 52 patients (20.3%). The rates of survival at 1, 3, and 5 years were 99%, 97%, and 97%, respectively, and the rates of MI-free survival at 1, 3, and 5 years were 99%, 96%, and 95%, respectively. Rates of MACE-free survival at 1, 3, and 5 years were 91%, 81%, and 62%, respectively. MI at initial presentation and current smoking were factors significantly associated with MACEs; these factors were also independent predictors of MACE-free survival. CONCLUSION: Despite treatment with calcium channel blockers, recurrent episodes of angina were frequently observed, whereas sudden cardiac death and non-fatal MI were rare. Smoking and myocardial infarction at admission were independent risk factors for cardiac death, non-fatal MI, and repeat hospitalization due to recurrent angina in patients with variant angina.
Angina Pectoris, Variant ; Calcium Channel Blockers ; Coronary Angiography ; Death ; Death, Sudden, Cardiac ; Ergonovine ; Heart Arrest ; Hospitalization ; Humans ; Lost to Follow-Up ; Male ; Myocardial Infarction ; Prognosis ; Resuscitation ; Risk Factors ; Smoke ; Smoking ; Spasm

BACKGROUND AND PURPOSE: There is little information available about the effects of Emergency Medical Service (EMS) hospital notification on transfer and intrahospital processing times in cases of acute ischemic stroke. METHODS: This study retrospectively investigated the real transfer and imaging processing times for cases of suspected acute stroke (AS) with EMS notification of a requirement for intravenous (IV) tissue-type plasminogen activator (t-PA) and for cases without notification. Also we compared the intra-hospital processing times for receiving t-PA between patients with and without EMS prehospital notification. RESULTS: Between December 2008 and August 2009, the EMS transported 102 patients with suspected AS to our stroke center. During the same period, 33 patients received IV t-PA without prehospital notification from the EMS. The mean real transfer time after the EMS call was 56.0+/-32.0 min. Patients with a transfer distance of more than 40 km could not be transported to our center within 60 min. Among the 102 patients, 55 were transferred via the EMS to our emergency room for IV t-PA. The positive predictive value for stroke (90.9% vs. 68.1%, p=0.005) was much higher and the real transfer time was much faster in patients with an EMS t-PA call (47.7+/-23.1 min, p=0.004) than in those without one (56.3+/-32.4 min). The door-to-imaging time (17.8+/-11.0 min vs. 26.9+/-11.5 min, p=0.01) and door-to-needle time (29.7+/-9.6 min vs. 42.1+/-18.1 min, p=0.01) were significantly shorter in the 18 patients for whom there was prehospital notification and who ultimately received t-PA than in those for whom there was no prehospital notification. CONCLUSIONS: Our results indicate that prehospital notification could enable the rapid dispatch of AS patients needing IV t-PA to a stroke centre. In addition, it could reduce intrahospital delays, particularly, imaging processing times.
Emergencies ; Emergency Medical Services ; Humans ; Retrospective Studies ; Stroke ; Tissue Plasminogen Activator