1.Role of Genetic Testing in Diagnosis and Prognosis Prediction in Hypertrophic Cardiomyopathy in Korea
Seo-Yeon GWAK ; Jiwon SEO ; Go Hun SEO ; Jiyoung OH ; Hyun-Jung LEE ; Kyu KIM ; Iksung CHO ; Chi Young SHIM ; Jong-Won HA ; Geu-Ru HONG
Journal of Korean Medical Science 2024;39(50):e313-
Background:
Hypertrophic cardiomyopathy (HCM) needs careful differentiation from other cardiomyopathies. Current guidelines recommend genetic testing, but genetic data on differential diagnoses and their relation with clinical outcomes in HCM are still lacking.This study aimed to investigate the prevalence of genetic variants and the proportion of other cardiomyopathies in patients with suspected HCM in Korea and compare the outcomes of HCM according to the presence of sarcomere gene mutation.
Methods:
We enrolled 1,554 patients with suspected HCM having left ventricular hypertrophy on transthoracic echocardiography between April 2012 and February 2023. Patients who declined genetic testing or who had pure apical HCM without a familial history were excluded. Genetic testing was performed using a next-generation sequencing panel or wholeexome sequencing for cardiomyopathies. We performed cardiovascular magnetic resonance if the diagnosis was inconclusive. Genotype-positive HCM was defined as sarcomere gene mutations of pathogenic or likely pathogenic variants. Adverse clinical outcomes were defined as a composite of all-cause death, resuscitated cardiac arrest, heart failure-related admission, appropriate implantable cardioverter defibrillator shocks, and stroke.
Results:
Of 492 patients (mean age 49.6 ± 14.7 years, 29.4% women) who underwent genetic testing, 214 (43.5%) had disease-causing gene mutations. After combining gene tests, multi-imaging modality, and clinical information, 447 (90.9%) had HCM, and 27 (5.5%) had Fabry disease. Among the HCM patients, 182 (40.7%) were genotype-positive, and 265 (59.3%) were genotype-negative. Kaplan–Meier curve analysis showed that genotype-positive HCM patients experienced more composite outcomes (log-rank, P < 0.001). In multivariable Cox analysis, non-sustained ventricular tachycardia (NSVT) (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.17–3.12; P = 0.010), left ventricular ejection fraction (LVEF) < 50% (HR, 5.50; 95% CI, 2.68–11.27; P < 0.001), LA reservoir strain (HR, 0.96; 95% CI, 0.93–0.99;P = 0.037), and positive sarcomere gene mutation (HR, 1.70; 95% CI, 1.04–2.78; P = 0.034) were significantly association with composite outcomes. Sarcomere gene mutation had incremental value for predicting adverse outcomes added on NSVT and LVEF < 50%.
Conclusion
Genetic testing is helpful in diagnosing HCM, and sarcomere gene mutations in HCM are significantly associated with clinical outcomes.
2.Role of Genetic Testing in Diagnosis and Prognosis Prediction in Hypertrophic Cardiomyopathy in Korea
Seo-Yeon GWAK ; Jiwon SEO ; Go Hun SEO ; Jiyoung OH ; Hyun-Jung LEE ; Kyu KIM ; Iksung CHO ; Chi Young SHIM ; Jong-Won HA ; Geu-Ru HONG
Journal of Korean Medical Science 2024;39(50):e313-
Background:
Hypertrophic cardiomyopathy (HCM) needs careful differentiation from other cardiomyopathies. Current guidelines recommend genetic testing, but genetic data on differential diagnoses and their relation with clinical outcomes in HCM are still lacking.This study aimed to investigate the prevalence of genetic variants and the proportion of other cardiomyopathies in patients with suspected HCM in Korea and compare the outcomes of HCM according to the presence of sarcomere gene mutation.
Methods:
We enrolled 1,554 patients with suspected HCM having left ventricular hypertrophy on transthoracic echocardiography between April 2012 and February 2023. Patients who declined genetic testing or who had pure apical HCM without a familial history were excluded. Genetic testing was performed using a next-generation sequencing panel or wholeexome sequencing for cardiomyopathies. We performed cardiovascular magnetic resonance if the diagnosis was inconclusive. Genotype-positive HCM was defined as sarcomere gene mutations of pathogenic or likely pathogenic variants. Adverse clinical outcomes were defined as a composite of all-cause death, resuscitated cardiac arrest, heart failure-related admission, appropriate implantable cardioverter defibrillator shocks, and stroke.
Results:
Of 492 patients (mean age 49.6 ± 14.7 years, 29.4% women) who underwent genetic testing, 214 (43.5%) had disease-causing gene mutations. After combining gene tests, multi-imaging modality, and clinical information, 447 (90.9%) had HCM, and 27 (5.5%) had Fabry disease. Among the HCM patients, 182 (40.7%) were genotype-positive, and 265 (59.3%) were genotype-negative. Kaplan–Meier curve analysis showed that genotype-positive HCM patients experienced more composite outcomes (log-rank, P < 0.001). In multivariable Cox analysis, non-sustained ventricular tachycardia (NSVT) (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.17–3.12; P = 0.010), left ventricular ejection fraction (LVEF) < 50% (HR, 5.50; 95% CI, 2.68–11.27; P < 0.001), LA reservoir strain (HR, 0.96; 95% CI, 0.93–0.99;P = 0.037), and positive sarcomere gene mutation (HR, 1.70; 95% CI, 1.04–2.78; P = 0.034) were significantly association with composite outcomes. Sarcomere gene mutation had incremental value for predicting adverse outcomes added on NSVT and LVEF < 50%.
Conclusion
Genetic testing is helpful in diagnosing HCM, and sarcomere gene mutations in HCM are significantly associated with clinical outcomes.
3.Role of Genetic Testing in Diagnosis and Prognosis Prediction in Hypertrophic Cardiomyopathy in Korea
Seo-Yeon GWAK ; Jiwon SEO ; Go Hun SEO ; Jiyoung OH ; Hyun-Jung LEE ; Kyu KIM ; Iksung CHO ; Chi Young SHIM ; Jong-Won HA ; Geu-Ru HONG
Journal of Korean Medical Science 2024;39(50):e313-
Background:
Hypertrophic cardiomyopathy (HCM) needs careful differentiation from other cardiomyopathies. Current guidelines recommend genetic testing, but genetic data on differential diagnoses and their relation with clinical outcomes in HCM are still lacking.This study aimed to investigate the prevalence of genetic variants and the proportion of other cardiomyopathies in patients with suspected HCM in Korea and compare the outcomes of HCM according to the presence of sarcomere gene mutation.
Methods:
We enrolled 1,554 patients with suspected HCM having left ventricular hypertrophy on transthoracic echocardiography between April 2012 and February 2023. Patients who declined genetic testing or who had pure apical HCM without a familial history were excluded. Genetic testing was performed using a next-generation sequencing panel or wholeexome sequencing for cardiomyopathies. We performed cardiovascular magnetic resonance if the diagnosis was inconclusive. Genotype-positive HCM was defined as sarcomere gene mutations of pathogenic or likely pathogenic variants. Adverse clinical outcomes were defined as a composite of all-cause death, resuscitated cardiac arrest, heart failure-related admission, appropriate implantable cardioverter defibrillator shocks, and stroke.
Results:
Of 492 patients (mean age 49.6 ± 14.7 years, 29.4% women) who underwent genetic testing, 214 (43.5%) had disease-causing gene mutations. After combining gene tests, multi-imaging modality, and clinical information, 447 (90.9%) had HCM, and 27 (5.5%) had Fabry disease. Among the HCM patients, 182 (40.7%) were genotype-positive, and 265 (59.3%) were genotype-negative. Kaplan–Meier curve analysis showed that genotype-positive HCM patients experienced more composite outcomes (log-rank, P < 0.001). In multivariable Cox analysis, non-sustained ventricular tachycardia (NSVT) (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.17–3.12; P = 0.010), left ventricular ejection fraction (LVEF) < 50% (HR, 5.50; 95% CI, 2.68–11.27; P < 0.001), LA reservoir strain (HR, 0.96; 95% CI, 0.93–0.99;P = 0.037), and positive sarcomere gene mutation (HR, 1.70; 95% CI, 1.04–2.78; P = 0.034) were significantly association with composite outcomes. Sarcomere gene mutation had incremental value for predicting adverse outcomes added on NSVT and LVEF < 50%.
Conclusion
Genetic testing is helpful in diagnosing HCM, and sarcomere gene mutations in HCM are significantly associated with clinical outcomes.
4.Role of Genetic Testing in Diagnosis and Prognosis Prediction in Hypertrophic Cardiomyopathy in Korea
Seo-Yeon GWAK ; Jiwon SEO ; Go Hun SEO ; Jiyoung OH ; Hyun-Jung LEE ; Kyu KIM ; Iksung CHO ; Chi Young SHIM ; Jong-Won HA ; Geu-Ru HONG
Journal of Korean Medical Science 2024;39(50):e313-
Background:
Hypertrophic cardiomyopathy (HCM) needs careful differentiation from other cardiomyopathies. Current guidelines recommend genetic testing, but genetic data on differential diagnoses and their relation with clinical outcomes in HCM are still lacking.This study aimed to investigate the prevalence of genetic variants and the proportion of other cardiomyopathies in patients with suspected HCM in Korea and compare the outcomes of HCM according to the presence of sarcomere gene mutation.
Methods:
We enrolled 1,554 patients with suspected HCM having left ventricular hypertrophy on transthoracic echocardiography between April 2012 and February 2023. Patients who declined genetic testing or who had pure apical HCM without a familial history were excluded. Genetic testing was performed using a next-generation sequencing panel or wholeexome sequencing for cardiomyopathies. We performed cardiovascular magnetic resonance if the diagnosis was inconclusive. Genotype-positive HCM was defined as sarcomere gene mutations of pathogenic or likely pathogenic variants. Adverse clinical outcomes were defined as a composite of all-cause death, resuscitated cardiac arrest, heart failure-related admission, appropriate implantable cardioverter defibrillator shocks, and stroke.
Results:
Of 492 patients (mean age 49.6 ± 14.7 years, 29.4% women) who underwent genetic testing, 214 (43.5%) had disease-causing gene mutations. After combining gene tests, multi-imaging modality, and clinical information, 447 (90.9%) had HCM, and 27 (5.5%) had Fabry disease. Among the HCM patients, 182 (40.7%) were genotype-positive, and 265 (59.3%) were genotype-negative. Kaplan–Meier curve analysis showed that genotype-positive HCM patients experienced more composite outcomes (log-rank, P < 0.001). In multivariable Cox analysis, non-sustained ventricular tachycardia (NSVT) (hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.17–3.12; P = 0.010), left ventricular ejection fraction (LVEF) < 50% (HR, 5.50; 95% CI, 2.68–11.27; P < 0.001), LA reservoir strain (HR, 0.96; 95% CI, 0.93–0.99;P = 0.037), and positive sarcomere gene mutation (HR, 1.70; 95% CI, 1.04–2.78; P = 0.034) were significantly association with composite outcomes. Sarcomere gene mutation had incremental value for predicting adverse outcomes added on NSVT and LVEF < 50%.
Conclusion
Genetic testing is helpful in diagnosing HCM, and sarcomere gene mutations in HCM are significantly associated with clinical outcomes.
5.Clinical Indications for RHD Genotyping in Koreans
Jong Hyeon LEE ; Jiyoung SEO ; Min-Young PARK ; Jong Kwon LEE ; Duck CHO
Korean Journal of Blood Transfusion 2024;35(1):27-32
RHD genotyping is used primarily when serological tests alone are insufficient to accurately determine the RhD blood type, especially in RhD-negative or RhD variant (D variant) cases. The frequency of RhD-negative and D variants varies significantly according to ethnicity, influencing clinical utilization differently in Korea and Europe.RHD genotyping has multiple applications, including non-invasive prenatal testing, assessment of RhIG administration suitability, identification of weak D and Asian-type DEL in patients, confirmation of D variants in donors, and determination of RhD blood type in patients with weak or discrepant D antigen results. Specifically, detecting Asian-type DEL in serologically RhD-negative individuals is crucial for Koreans, while accurately identifying Weak D types 1, 2, 3, 4.0, and 4.1 in serologically RhD weak-positive samples is vital for Europeans.
6.An Opinion on the Cause of Anti-K Found in Koreans
Jong Kwon LEE ; Jiyoung SEO ; Duck CHO
Korean Journal of Blood Transfusion 2024;35(2):121-125
The K antigen, one of the 38 immunogenic antigens in the Kell blood group system, can cause severe hemolytic transfusion reactions (HTR) and hemolytic disease of the fetus and newborn (HDFN). The frequency of incidence of the K antigen varies by race (9.02% of Western populations are K+ compared to 0.0% in Koreans), and the incidence and causes of anti-K vary accordingly. Anti-K have occasionally been detected in antibody screening/identification tests, but no hemolytic transfusion reactions have been reported in Korea so far. We conducted a retrospective review of nine cases of anti-K identified at the Samsung Medical Center over the past five years, most of which involved Koreans. No clear causes, such as the transfusion of K antigen-positive donor blood, pregnancy, or infections known to trigger anti-K, were identified. It has been speculated that the increased immigration of people of different races with the K antigen might be a reason for the anti-K formation. However, given the frequency of K+ reported in recent literature and observed in our study, it is suggested that these “unknown causes” may be more common than previously believed. Hence, prospective studies are warranted to identify these causes more accurately.
7.Erratum: Assessment of Disease Severity and Quality of Life in Patients with Atopic Dermatitis from South Korea
Sang Wook SON ; Ji Hyun LEE ; Jiyoung AHN ; Sung Eun CHANG ; Eung Ho CHOI ; Tae Young HAN ; Yong Hyun JANG ; Hye One KIM ; Moon-Bum KIM ; You Chan KIM ; Hyun Chang KO ; Joo Yeon KO ; Sang Eun LEE ; Yang Won LEE ; Bark-Lynn LEW ; Chan Ho NA ; Chang Ook PARK ; Chun Wook PARK ; Kui Young PARK ; Kun PARK ; Young Lip PARK ; Joo Young ROH ; Young-Joon SEO ; Min Kyung SHIN ; Sujin LEE ; Sang Hyun CHO
Annals of Dermatology 2023;35(1):86-87
8.A Survey on the Perception and Behavior Regarding Tinea Pedis among Korean Adults
Minkyung CHO ; Yang Won LEE ; Dong Hun LEE ; Ki-Heon JEONG ; Soon Hyo KWON ; Jung Eun KIM ; Hyojin KIM ; Chan Ho NA ; Hyun-Min SEO ; Min Kyung SHIN ; Jiyoung AHN ; Yu Ri WOO ; Ga-Young LEE ; Yong Hyun JANG ; Hye Jung JUNG ; Yu Sung CHOI ; Tae Young HAN ; Ha-Eun LEE ; Chan Yl BANG ; Mi Woo LEE ; Dong Hyun KIM
Korean Journal of Dermatology 2023;61(7):420-428
Background:
Dermatophyte infection is one of the most common skin diseases affecting the skin, hair, and nails. Despite widespread recognition of the disease, missing details and misperceptions are commonplace in the general population.
Objective:
This study aimed to investigate the public perception and behavior regarding dermatophytosis of the hands and feet.
Methods:
This results from an online survey conducted between July 2022 and August 2022. The survey included 1,000 Korean participants aged 20 to 69 years, of whom 60% experienced symptoms of tinea pedis or onychomycosis. The questionnaire focused on the awareness and personal experience of tinea pedis and perception of the treatment of dermatophytosis.
Results:
Of the 1,000 participants, nearly 80% regarded tinea pedis as a common skin condition by which anyone can be affected. Furthermore, 88.4% had heard that the treatment of tinea pedis could be harmful, causing skin rash (60.4%) and worsening liver function (48.5%). Among 896 participants who noticed suspicious symptoms, 81.2% did not visit the clinic because it was not severe (50.1%) and seemed easily manageable (25.7%). Of the respondents, 84.4% preferred to meet dermatologists rather than non-dermatologist doctors regarding skin diseases, mainly because of trust in experts and belief in a faster cure.
Conclusion
Providing accurate and detailed information via online media, educational campaigns, and medical papers can rectify misconceptions and improve patient appliance, contributing to public skin health.
9.Risk factors for severe postpartum hemorrhage requiring blood transfusion after cesarean delivery for twin pregnancy: a nationwide cohort study
Gi Hyeon SEO ; Jong Yeop KIM ; Da yeong LEE ; Changjin LEE ; Jiyoung LEE
Anesthesia and Pain Medicine 2023;18(4):367-375
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality. Twin pregnancy and cesarean delivery are well-known risk factors for PPH. However, few studies have investigated PPH risk factors in mothers who have undergone cesarean delivery for twin pregnancies. Therefore, this study investigated the risk factors associated with severe PPH after cesarean delivery for twin pregnancies. Methods: We searched and reviewed the Korean Health Insurance Review and Assessment Service’s claims data from July 2008 to June 2021 using the code corresponding to cesarean delivery for twin pregnancy. Severe PPH was defined as hemorrhage requiring red blood cell (RBC) transfusion during the peripartum period. The risk factors associated with severe PPH were identified among the procedure and diagnosis code variables and analyzed using univariate and multivariate logistic regressions. Results: We analyzed 31,074 cesarean deliveries for twin pregnancies, and 4,892 patients who underwent cesarean deliveries for twin pregnancies and received RBC transfusions for severe PPH were included. According to the multivariate analysis, placental disorders (odds ratio, 4.50; 95% confidence interval, 4.09– 4.95; P < 0.001), general anesthesia (2.33, 2.18–2.49; P < 0.001), preeclampsia (2.20, 1.99–2.43; P < 0.001), hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome (2.12, 1.22–3.68; P = 0.008), induction failure (1.37, 1.07–1.76; P = 0.014), and hypertension (1.31, 1.18–1.44; P < 0.001) predicted severe PPH. Conclusions: Placental disorders, hypertensive disorders such as preeclampsia and HELLP syndrome, and induction failure increased the risk of severe PPH after cesarean delivery for twin pregnancy
10.Assessment of Disease Severity and Quality of Life in Patients with Atopic Dermatitis from South Korea
Sang Wook SON ; Ji Hyun LEE ; Jiyoung AHN ; Sung Eun CHANG ; Eung Ho CHOI ; Tae Young HAN ; Yong Hyun JANG ; Hye One KIM ; Moon-Bum KIM ; You Chan KIM ; Hyun Chang KO ; Joo Yeon KO ; Sang Eun LEE ; Yang Won LEE ; Bark-Lynn LEW ; Chan Ho NA ; Chang Ook PARK ; Chun Wook PARK ; Kui Young PARK ; Kun PARK ; Young Lip PARK ; Joo Young ROH ; Young-Joon SEO ; Min Kyung SHIN ; Sujin LEE ; Sang Hyun CHO
Annals of Dermatology 2022;34(6):419-430
Background:
Data illustrating the impact of atopic dermatitis (AD) on lives of adults with AD in South Korea are limited.
Objective:
To assess the AD disease severity and its impact on quality of life (QoL) in patients with AD from South Korea.
Methods:
Patients with AD utilizing the specialist dermatology services of major hospitals in South Korea were assessed for disease severity using Eczema Area and Severity Index (EASI) score, for QoL using Dermatology Life Quality Index (DLQI) (for QoL), and for comorbidities and treatment experience via retrospective review of 12-month medical records. Clinical and sociodemographic characteristics were also measured.
Results:
Of the 1,163 patients, 695 (59.8%) were men (mean age [years]±standard deviation: 31.6±12.1). Overall, 52.9% (n=615) patients had moderate-to-severe disease (EASI>7).The QoL of 72.3% (n=840) patients was affected moderately-to-severely (DLQI score: 6~30).Systemic immunosuppressants were used ≥1 over past 12 months in 51.9% (n=603) patients, and the most commonly used were cyclosporines (45.7%, n=531) and systemic corticosteroids (40.5%, n=471). Approximately, 10.8% (n=126) patients consulted or received treatment for AD-related eye problem. Of these, 40% (n=50) patients reported poor, very poor, or completely blind status; approximately, 16.7% patients (n=192) reported having depression or anxiety; and 35.5% (n=410) reported suicidal ideation or suicidal attempt.
Conclusion
A large proportion of patients had moderate-to-severe AD, a compromised QoL, and ocular or mental health comorbidities, indicating a high disease burden despite systemic treatment. These findings highlight the importance of a holistic approach for the evaluation and treatment of patients with AD.

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