1.Pharmacological Strategies beyond Statins: Ezetimibe and PCSK9 Inhibitors
Journal of Lipid and Atherosclerosis 2019;8(2):183-191
Dyslipidemia, highly elevated, low-density lipoprotein (LDL) cholesterol, is a major cardiovascular risk factor. Statins have been proven to effectively reduce the risk of atherosclerotic cardiovascular disease (ASCVD) and are recommended as a first-line therapy for the primary and secondary prevention of ASCVD. However, statins may not be sufficient in decreasing LDL cholesterol levels and pose a significant on-treatment residual risk of major cardiovascular events (i.e., residual cholesterol risk) according to meta-analyses of statin trials. Current guidelines for cholesterol management to achieve additional LDL cholesterol reduction and reduce ASCVD risk recommend two hyperlipidemic agents besides statins. Use of ezetimibe, a cholesterol absorption inhibitor, leads to additional LCL cholesterol reduction and decreased ASCVD risk, when added to statin therapy, without raising significant safety concerns. Furthermore, in combination with a mild-to-moderate statin intensity, ezetimibe is used in situations of statin-associated adverse effects such as myalgia and the combination therapy is relatively safer. Monoclonal antibody of proprotein convertase subtilisin/kexin type 9 (PCSK9), alirocumab, and evolocumab, have been approved to lower LDL cholesterol level. While there are drawbacks to the use of PCSK9 inhibitors, including high cost and adverse events such as injection site reaction, they significantly decreased serum LDL cholesterol levels and thereby ASCVD risks when added to maximally tolerated statin therapy.
Absorption
;
Cardiovascular Diseases
;
Cholesterol
;
Cholesterol, LDL
;
Dyslipidemias
;
Ezetimibe
;
Hydroxymethylglutaryl-CoA Reductase Inhibitors
;
Lipoproteins
;
Myalgia
;
Proprotein Convertases
;
Risk Factors
;
Secondary Prevention
2.Transcatheter Mitral Valve Repair: Growing Evidence Regarding It's Efficacy and Optimal Indication
Korean Circulation Journal 2019;49(6):542-544
No abstract available.
Mitral Valve
6.Congenital Left Atrial Bands with Atrial Fibrillation.
Won Young JANG ; Woohyeun KIM ; Eun Jin PARK ; Jah Yeon CHOI ; Cheol Ung CHOI ; Hong Euy LIM ; Jin Won KIM ; Eung Ju KIM ; Seung Woon RHA ; Jin Oh NA
Journal of Cardiovascular Ultrasound 2017;25(4):140-141
No abstract available.
Atrial Fibrillation*
7.Prevalence, Characteristics, and Clinical Significance of Concomitant Cardiomyopathies in Subjects with Bicuspid Aortic Valves
Hyeonju JEONG ; Chi Young SHIM ; Darae KIM ; Jah Yeon CHOI ; Kang Un CHOI ; Soo Youn LEE ; Geu Ru HONG ; Jong Won HA
Yonsei Medical Journal 2019;60(9):816-823
PURPOSE: The present study aimed to investigate the prevalence, characteristics, and clinical significance of concomitant specific cardiomyopathies in subjects with bicuspid aortic valves (BAVs). MATERIALS AND METHODS: A total of 1186 adults with BAV (850 males, mean age 56±14 years) at a single tertiary center were comprehensively reviewed. Left ventricular non-compaction, hypertrophic cardiomyopathy, and idiopathic dilated cardiomyopathy were confirmed when patients fulfilled current clinical and echocardiographic criteria. Clinical and echocardiographic characteristics, including comorbidities, heart failure presentation, BAV morphology, function, and aorta phenotypes, in BAV subjects with or without specific cardiomyopathies were compared. RESULTS: Overall, 67 subjects (5.6%) had concomitant cardiomyopathies: 40 (3.4%) patients with left ventricular non-compaction, 17 (1.4%) with hypertrophic cardiomyopathy, and 10 (0.8%) with dilated cardiomyopathy. BAV subjects with hypertrophic cardiomyopathy had higher prevalences of diabetes mellitus and heart failure with preserved ejection fraction, and tended to have type 0 phenotype, while BAV subjects with dilated cardiomyopathy showed higher prevalences of chronic kidney disease and heart failure with reduced ejection fraction. BAV subjects with left ventricular non-compaction were significantly younger and predominantly male, and had greater BAV dysfunction and a higher prevalence of normal aorta shape. In multiple regression analysis, cardiomyopathy was independently associated with heart failure (odds ratio 2.795, 95% confidential interval 1.603–4.873, p<0.001) after controlling for confounding factors. CONCLUSION: Concomitant cardiomyopathies were observed in 5.6% of subjects with BAV. A few different clinical and echocardiographic characteristics were found. The presence of cardiomyopathy was independently associated with heart failure.
Adult
;
Aorta
;
Aortic Valve
;
Bicuspid
;
Cardiomyopathies
;
Cardiomyopathy, Dilated
;
Cardiomyopathy, Hypertrophic
;
Comorbidity
;
Diabetes Mellitus
;
Echocardiography
;
Heart Failure
;
Humans
;
Male
;
Phenotype
;
Prevalence
;
Renal Insufficiency, Chronic
8.Surgical Removal of a Left Ventricular Thrombus Which Showed Morphologic Changes Over Time in a Patient with Stress-Induced Cardiomyopathy.
Jah Yeon CHOI ; Eun Jin PARK ; Sung Hun PARK ; Hee Dong KIM ; Ji Young SONG ; Ji Bak KIM ; Sun Ki LEE ; Yang Gi RYU ; Man Jong BAEK ; Jin Oh NA
Journal of Cardiovascular Ultrasound 2015;23(2):103-106
Although stress-induced cardiomyopathy (SCMP) is a reversible disease and the prognosis is usually excellent, several complications can occur and can result in fatal adverse events. The formation of left ventricular (LV) thrombus is one of these critical complications of SCMP. This report describes a case of SCMP complicated by formation of a LV thrombus that became increasingly mobile as LV contractility recovered, and for which surgical removal was performed. Here, we report a case of SCMP complicated by LV thrombus and review the literature regarding this topic.
Cardiomyopathies*
;
Echocardiography
;
Humans
;
Prognosis
;
Takotsubo Cardiomyopathy
;
Thrombosis*
9.Ethanol Infusion in the Vein of Marshall in a Patient with Persistent Atrial Fibrillation.
Jah Yeon CHOI ; Eun Jin PARK ; Hee Dong KIM ; Sung Hun PARK ; Ji Young SONG ; Dae In LEE ; Jaemin SHIM ; Young Hoon KIM
Korean Circulation Journal 2015;45(5):424-427
We report the case of a 64-year-old male with persistent atrial fibrillation (AF) terminated by ethanol infusion into vein of Marshall as add-on therapy. Three-dimensional automated complex fractionated atrial electrogram (CFAE) during AF revealed clustering of CFAE at perimitral isthmus (PMI) and its unipolar mapping showed rotor-like activation, which was suggested to be critical in the perpetuation of AF. AF was organized to atrial tachycardia (AT) by 100% ethanol infusion in the vein of Marshall. Adjunctive radiofrequency ablation at PMI successfully terminated AT and led to bidirectional block of PMI.
Atrial Fibrillation*
;
Catheter Ablation
;
Electrophysiologic Techniques, Cardiac
;
Ethanol*
;
Humans
;
Male
;
Middle Aged
;
Tachycardia
;
Veins*
10.Iliac Artery Rupture and Retroperitoneal Migration of a Stent Graft during Transcatheter Aortic Valve Replacement
Jah Yeon CHOI ; Chi Young SHIM ; Geu Ru HONG ; Chul Min AHN ; Young Guk KO ; Myeong Ki HONG
Korean Circulation Journal 2019;49(3):280-281
No abstract available.
Blood Vessel Prosthesis
;
Iliac Artery
;
Rupture
;
Stents
;
Transcatheter Aortic Valve Replacement