BACKGROUND AND OBJECTIVES: Heart rate variability has been known to be a prognostic factor of heart disease. However, determinants of heart rate variability in general korean population without clinical heart disease have not been studied. Objectives of this study were to measure heart rate variability in general population and to investigate clinical determinants of heart rate variability. METHODS:Heart rate variability measures were obtained by LRR-03TM and MemCalcTM software (GMS, Tokyo, Japan) from public officials in a district of Seoul and their families(n=69). Predictors of heart rate variability included age, gender, heart rate, smoking status, systolic blood pressure, diastolic blood pressure, serum total cholesterol, HDL-cholesterol. Univariate analysis and analysis of variance of low frequency power(0.04-0.15 Hz), high frequency power(0.15-0.30 Hz), and total power spectrum in relation to explanatory variables were done. In order to select determinants of heart rate variability, multiple linear regression model of each heart rate variability measure was created and stepwise selection method was applied. RESULTS: Analysis of variance showed that older age, higher heart rate, body mass index > or =27, systolic blood pressure > or =140 mmHg, diastolic blood pressure > or =90 mmHg, and serum total cholesterol > or =240 mg/dl were negatively associated with one or more heart rate variability measures. Serum HDL-cholesterol > or =35 mg/dl was positively associated with low and high frequency power. Multiple linear regression analyses showed that age and heart rate were the major determinants, gender and cardiovascular risk factors such as diastolic blood pressure, HDL-cholesterol, and smoking contributed to one or more heart rate variability measures. CONCLUSIONS: Age, heart rate, gender, and cardiovascular risk factors must be considered when evaluating heart rate variability.
Blood Pressure ; Body Mass Index ; Cholesterol ; Heart Diseases ; Heart Rate* ; Heart* ; Linear Models ; Risk Factors ; Seoul ; Smoke ; Smoking

BACKGROUND: Left ventricular (LV) remodeling manifests as an increase in LV end-diastolic and end-systolic volumes, an increase in myocardial mass, and a change in chamber geometry to a more spherical shape, and has been considered to be a consequence of heart failure, myocardial infarction or mitral regurgitation. However, less is known about change of LV geometry, especially LV sphericity, in asymptomatic population according to aging. METHODS:We investigated 261 asymptomatic subjects who volunteered for health screening and underwent transthoracic echocardiography. Those with poor echo image, significant coronary artery disease, LV dysfunction, hypertension, and diabetes mellitus were excluded. LV sphericity index is defined as the ratio of the long-axis length divided by LV short-axis length, both during systole and diastole. LV mass was calculated from septal and posterior wall thickness and LV internal dimension at end-diastole and then divided by body surface area to calculate LV mass index RESULTS: The mean age of subjects was 49.6+/-6.7 years and the percentage of male was 81%. LV sphericity index at diastole showed significant correlation with age (r=-0.17, p value<0.01), but LV sphericity index at systole did not. Both indices did not showed significant association with aerobic fitness, blood pressure, glucose, insulin resistance and LV function. LV mass index showed significant correlation with age (r=0.14, p value<0.05). CONCLUSION: Among the parameters of LV geometry, sphericity index showed decrease with aging in healthy population, meaning LV becoming more spherical with aging. Longitudinal follow-up study is needed to determine its usefulness as a predictor of future LV dysfunction in asymptomatic population.
Aging ; Blood Pressure ; Body Surface Area ; Coronary Artery Disease ; Diabetes Mellitus ; Diastole ; Echocardiography ; Glucose ; Heart Failure ; Humans ; Hypertension ; Insulin Resistance ; Male ; Mass Screening ; Mitral Valve Insufficiency ; Myocardial Infarction ; Systole

This study explored the differences in academic achievement and psychological/emotional well-being between criterion-referenced evaluation (CRE) and norm-referenced evaluation (NRE) at a medical school. The objective was to address concerns about declining academic performance and to propose evaluation methods that promote a more supportive learning environment for students. In total, 90 first-year medical students who completed the basic medical curriculum in 2022 and 2023 were surveyed and analyzed. The sample consisted of 45 students assessed by NRE in 2022 and 45 students assessed by CRE in 2023. Academic performance was measured using school grades in basic medical subjects and scores from the Basic Medical Education Evaluation. Psychological and emotional well-being were assessed through scales measuring academic burnout, academic motivation, coping efficacy, anxiety, depression, and quality of life. The results indicated that students assessed by CRE achieved significantly higher academic scores in certain subjects than those assessed by NRE. Additionally, the CRE group exhibited more positive psychological and emotional states, including lower levels of academic burnout, anxiety, and depression. These findings suggest that CRE may have a beneficial impact on students’ emotional well-being and overall academic experience. The study concludes that CRE plays a critical role in improving both academic performance and emotional health among medical students, and that transitioning to CRE may alleviate concerns about declining grades while promoting a more supportive learning environment.

This study explored the differences in academic achievement and psychological/emotional well-being between criterion-referenced evaluation (CRE) and norm-referenced evaluation (NRE) at a medical school. The objective was to address concerns about declining academic performance and to propose evaluation methods that promote a more supportive learning environment for students. In total, 90 first-year medical students who completed the basic medical curriculum in 2022 and 2023 were surveyed and analyzed. The sample consisted of 45 students assessed by NRE in 2022 and 45 students assessed by CRE in 2023. Academic performance was measured using school grades in basic medical subjects and scores from the Basic Medical Education Evaluation. Psychological and emotional well-being were assessed through scales measuring academic burnout, academic motivation, coping efficacy, anxiety, depression, and quality of life. The results indicated that students assessed by CRE achieved significantly higher academic scores in certain subjects than those assessed by NRE. Additionally, the CRE group exhibited more positive psychological and emotional states, including lower levels of academic burnout, anxiety, and depression. These findings suggest that CRE may have a beneficial impact on students’ emotional well-being and overall academic experience. The study concludes that CRE plays a critical role in improving both academic performance and emotional health among medical students, and that transitioning to CRE may alleviate concerns about declining grades while promoting a more supportive learning environment.

This study explored the differences in academic achievement and psychological/emotional well-being between criterion-referenced evaluation (CRE) and norm-referenced evaluation (NRE) at a medical school. The objective was to address concerns about declining academic performance and to propose evaluation methods that promote a more supportive learning environment for students. In total, 90 first-year medical students who completed the basic medical curriculum in 2022 and 2023 were surveyed and analyzed. The sample consisted of 45 students assessed by NRE in 2022 and 45 students assessed by CRE in 2023. Academic performance was measured using school grades in basic medical subjects and scores from the Basic Medical Education Evaluation. Psychological and emotional well-being were assessed through scales measuring academic burnout, academic motivation, coping efficacy, anxiety, depression, and quality of life. The results indicated that students assessed by CRE achieved significantly higher academic scores in certain subjects than those assessed by NRE. Additionally, the CRE group exhibited more positive psychological and emotional states, including lower levels of academic burnout, anxiety, and depression. These findings suggest that CRE may have a beneficial impact on students’ emotional well-being and overall academic experience. The study concludes that CRE plays a critical role in improving both academic performance and emotional health among medical students, and that transitioning to CRE may alleviate concerns about declining grades while promoting a more supportive learning environment.

This study explored the differences in academic achievement and psychological/emotional well-being between criterion-referenced evaluation (CRE) and norm-referenced evaluation (NRE) at a medical school. The objective was to address concerns about declining academic performance and to propose evaluation methods that promote a more supportive learning environment for students. In total, 90 first-year medical students who completed the basic medical curriculum in 2022 and 2023 were surveyed and analyzed. The sample consisted of 45 students assessed by NRE in 2022 and 45 students assessed by CRE in 2023. Academic performance was measured using school grades in basic medical subjects and scores from the Basic Medical Education Evaluation. Psychological and emotional well-being were assessed through scales measuring academic burnout, academic motivation, coping efficacy, anxiety, depression, and quality of life. The results indicated that students assessed by CRE achieved significantly higher academic scores in certain subjects than those assessed by NRE. Additionally, the CRE group exhibited more positive psychological and emotional states, including lower levels of academic burnout, anxiety, and depression. These findings suggest that CRE may have a beneficial impact on students’ emotional well-being and overall academic experience. The study concludes that CRE plays a critical role in improving both academic performance and emotional health among medical students, and that transitioning to CRE may alleviate concerns about declining grades while promoting a more supportive learning environment.

This study explored the differences in academic achievement and psychological/emotional well-being between criterion-referenced evaluation (CRE) and norm-referenced evaluation (NRE) at a medical school. The objective was to address concerns about declining academic performance and to propose evaluation methods that promote a more supportive learning environment for students. In total, 90 first-year medical students who completed the basic medical curriculum in 2022 and 2023 were surveyed and analyzed. The sample consisted of 45 students assessed by NRE in 2022 and 45 students assessed by CRE in 2023. Academic performance was measured using school grades in basic medical subjects and scores from the Basic Medical Education Evaluation. Psychological and emotional well-being were assessed through scales measuring academic burnout, academic motivation, coping efficacy, anxiety, depression, and quality of life. The results indicated that students assessed by CRE achieved significantly higher academic scores in certain subjects than those assessed by NRE. Additionally, the CRE group exhibited more positive psychological and emotional states, including lower levels of academic burnout, anxiety, and depression. These findings suggest that CRE may have a beneficial impact on students’ emotional well-being and overall academic experience. The study concludes that CRE plays a critical role in improving both academic performance and emotional health among medical students, and that transitioning to CRE may alleviate concerns about declining grades while promoting a more supportive learning environment.

Cardiovascular diseases including ischemic heart disease have been emerging as one of the most important public health problems in Korea. Although secondary prevention and rehabilitation are essential components in the management of patients with ischemic heart disease, its program has not been provided to all the patients. There are several barriers, such as availability and accessibility, low awareness of both patients and physicians in implementing cardiac rehabilitation program. Home-based and community-based programs under the direction of medical supervision are needed to further widen its availability and accessibility, as well as hospital-based programs. Cardiac rehabilitation programs emphasize risk factor control and life style change, besides exercise training. Health education, diet, counseling, psychosocial support, and exercise are all important in restoring the patient's quality of life. For this purpose, cardiac rehabilitation should be well integrated with preventive cardiology, and a multidisciplinary approach is mandatory. Since Korean society is very rapidly aging, a big impact on future trend of ischemic heart disease, preventive cardiology and cardiac rehabilitation will play a very important role to overcome the approaching wave of cardiovascular epidemic.
Aging ; Cardiology ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels* ; Counseling ; Diet ; Health Education ; Humans ; Korea ; Life Style ; Myocardial Ischemia ; Organization and Administration ; Public Health ; Quality of Life ; Rehabilitation* ; Risk Factors ; Secondary Prevention

Cardiovascular diseases including ischemic heart disease have been emerging as one of the most important public health problems in Korea. Although secondary prevention and rehabilitation are essential components in the management of patients with ischemic heart disease, its program has not been provided to all the patients. There are several barriers, such as availability and accessibility, low awareness of both patients and physicians in implementing cardiac rehabilitation program. Home-based and community-based programs under the direction of medical supervision are needed to further widen its availability and accessibility, as well as hospital-based programs. Cardiac rehabilitation programs emphasize risk factor control and life style change, besides exercise training. Health education, diet, counseling, psychosocial support, and exercise are all important in restoring the patient's quality of life. For this purpose, cardiac rehabilitation should be well integrated with preventive cardiology, and a multidisciplinary approach is mandatory. Since Korean society is very rapidly aging, a big impact on future trend of ischemic heart disease, preventive cardiology and cardiac rehabilitation will play a very important role to overcome the approaching wave of cardiovascular epidemic.
Aging ; Cardiology ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels* ; Counseling ; Diet ; Health Education ; Humans ; Korea ; Life Style ; Myocardial Ischemia ; Organization and Administration ; Public Health ; Quality of Life ; Rehabilitation* ; Risk Factors ; Secondary Prevention

Heart rate (HR) recovery after exercise is a function of vagal reactivation, and its impairment is a predictor of overall mortality and adverse cardiovascular events. While metabolic syndrome is associated with sympathetic overactivity, little is known about the relationship between metabolic syndrome and HR recovery. A symptom-limited exercise stress test in healthy subjects (n=1, 434) was used to evaluate HR recovery. Metabolic syndrome was defined according to the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP-III) criteria. Seventeen percent of subjects had > or =3 criteria for metabolic syndrome. HR recovery was lower in men than women and in smokers than nonsmokers. The subject with metabolic syndrome (vs. without) showed lower HR recovery (10.3+/-11.6 vs. 13.6+/-9.7 per minute) and higher resting HR (64.3+/-10.3 vs. 61.6+/-9.1 per minute). HR recovery correlated inversely to age (r=-0.25, p<0.0001), but not to resting HR or maximal oxygen uptake. Delayed HR recovery was associated with metabolic syndrome after an adjustment for age, sex, resting HR and smoking (p<0.01). Metabolic syn-drome is associated with impaired vagal reactivation. Adverse cardiovascular out-comes associated with metabolic syndrome may be mediated by the failure of vagal reactivation in addition to sympathetic overactivity.
Walking/physiology ; Smoking ; Sex Factors ; Oxygen Consumption/physiology ; Middle Aged ; Metabolic Syndrome X/blood/*physiopathology ; Male ; Humans ; Heart Rate/*physiology ; Female ; Fasting/blood ; Exercise/*physiology ; Cholesterol, HDL/blood ; Body Mass Index ; Blood Pressure/physiology ; Blood Glucose/metabolism ; Analysis of Variance ; Age Factors ; Adult