Echocardiography provides a broad array of interrelated methods for the study of left ventricular structure and function. Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change could be obtained in patients with dilated cardiomyopathy. Peak dD/dT and peak dD/dT/D were significantly depressed in the patients. Normalized rates of systolic wall movement appear to be useful in detecting left ventricular disease because it reflect an increase in cavity size as much as any abnormality of contraction pattern. Digitized echocardiographic analysis may be one of good objective methods of evaluating the response to treatment in patients with various cardiac diseases.
Cardiomyopathy, Dilated* ; Echocardiography ; Heart Diseases ; Humans ; Ventricular Function, Left*

BACKGROUND: Many reports have shown that hormone replacement therapy(HRT) in postmenopausal women decreases lipoprotein(a)[Lp(a)]. However these had small numbers of subjects, short duration of therapy, or comparisons of only a few regimens. The influences of progesterone on Lp(a) and lipids, administered with estrogen, are controversial. METHODS: Five hundred and fifty-one postmenopausal women were divided into 4 groups : group A ; 0.625mg conjugated equine estrogen(CEE)(m=140), group B ; 0.625mg CEE plus 5mg medroxyprogesterone acetate(MPA)(m=97), group C ; 0.625mg CEE plus 10mg MPA(n=109), and group D ; 2mg estradiol valerate(E2) plus 0.5mg norgestrel(N)(n=134) and group E ; control(n=71). Lp(a) and lipids levels were measured before and 12 months after HRT. RESULTS: Estrogen replacement therapy(ERT) for 12 months lowered Lp(a) level by 37.1%. The addition of progesterone attenuated the Lp(a)-lowering effect of estrogen and decreased by 27.7%, 29.6%, and 30.3% in groups B(p<0.05), C(p<0.05), and D(p<0.0001) respectively. High density lipoprotein cholesterol(HDL-C) was increased markedly in group A(16.5%), increased moderately in groups B(10.8%) and C(11.3%), and not changed in group D. Low density lipoprotein cholesterol was decreased by 10.9%, 13.7%, 11.3%, and 17.6% in groups A, B, C, and D respectively. CONCLUSIONS: Reduction of Lp(a) with estrogen replacement therapy may be one of mechanisms for cardioprotective effect in postmenopausal women. The combined therapy of estrogen and progesterone may reveal different effects on heart due to adverse actions of progesterone on Lp(a) and HDL-C. The variations in the androgenic potency of progesterone may explaine inconsistent results on HDL-C in previous studies.
Cholesterol, LDL ; Estradiol ; Estrogen Replacement Therapy ; Estrogens ; Female ; Heart ; Hormone Replacement Therapy* ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Medroxyprogesterone ; Progesterone*

Diabetes mellitus is known to be associated with a specific cardiomyopathy. This is evident from the clinical-pathological work and the epidemiologic data. An investigation was made in this study to determine whether diabetic cardiomyopathy in rats is associated with an alteration of biochemical characteristics of cardiac contractile proteins. Rats were made diabetic with intravenous injection of streptozotocin and hearts removed 8 weeks later for the isolation of myofibrils. The basal ATPase activity of myofibrils from diabetic hearts was significantly lower than that of the controls, suggesting the presence of some subtle structural and conformational changes in diabetic myofibrils. The activating effect of Mg ions on the myofibrillar actomyosin system of rat heart muscle was also demonstrated. Sodium dodecylsulfate gel electrophoresis showed the presence of myosin heavy chain, light chain 1 and 2, actin and troponin but failed to reveal differences in the patterns of these contractile proteins of light subunits between diabetics and controls. The deficiency in utilization of energy rich phosphates by the myofibrillar protein may be one of of the main mechanisms of cardiodepression observed in diabetic hearts. The cardiac myofibrillar ATPase activity may be one of useful measurements in evaluating pathophysiological states of cardiac contractile proteins.
Actins ; Actomyosin ; Adenosine Triphosphatases* ; Animals ; Cardiomyopathies ; Contractile Proteins ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Electrophoresis ; Heart ; Injections, Intravenous ; Ions ; Myocardium ; Myofibrils ; Myosin Heavy Chains ; Phosphates ; Rats* ; Sodium ; Streptozocin ; Troponin

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis was administered to 34 patients with primary hypertlipidemia, 20 mg once daily with the evening meal. Patients experienced mean total and LDL cholesterol reductions of 30.9% and 34.0% respectively. HDL cholesterol level was significantly increased by 15.4% and plasma triglyceride level was decreased by 11.2%. maximal hypocholesterolemic effects were evident at 8 weeks, after which the effects were stable. Adverse effects were noted in 2 patients who had mild gastrointestinal symptoms, that subsided after discontinuing the drug. We concluded that lovastatin is a well tolerated and effective agent for the treatment of primary hyperlipidemia.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipidemias* ; Lovastatin ; Meals ; Plasma* ; Triglycerides

No abstract available.
Growth Hormone* ; Testosterone*

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

The fundamental alterations in the cardiovascular system that occur consequent to aging are of great pratical importnace to clinicians. Senescent cardic muscle has many features of prolonged tension development, impaired relaxation and diminished response to receptor-mediated inotropic interactions. We estimated left ventricular mass by 2-D echo area-length method using a high quality planimeter. Age-related increments in left ventricular mass demostrated, but left ventricular enddiastolic cavity volumes were unaffected by age. The increase in left ventricular mass observed with aging is typical of pressuer-overload hypertrophy and its stimulus may be increased afterload from senescent changes.
Aging* ; Cardiovascular System ; Hypertrophy ; Relaxation