To assess the role of multiple factors in influencing occurrence of ventricular premature complexes after acute myocardial infarction twenty-four hour Holter electrocardiographic tape recording were made in 40 survivors of an acute myocardial infarction 10 to 20days after attack. Ventricular premature complexes in the early post infarction period were not correlated with left ventricular function, age, sex, smoking, diabetes mellitus, previous angina, and previous myocardial infarction. The occurrence of ventricular premature complexes showed a positive correlation with the occurrence of ST-T change. The occurrence of ventricular premature complexes during sleep hours was compared to the awake state. In 22 patients, the incidence of ventricular premature complexes are excluded from analysis, the 22 of patients, or in 76 percent, sleep was associated with a lowered occurrence of ventricular extrasystoles.
Diabetes Mellitus ; Electrocardiography ; Humans ; Incidence ; Infarction ; Myocardial Infarction ; Smoke ; Smoking ; Survivors ; Tape Recording ; Ventricular Function, Left ; Ventricular Premature Complexes*

Atrial fibrillation in mitral stenosis(MS) may be cause of error in calculation of mitral valve area(MVA) by Doppler derived pressure half-time(PHT) method. This is due to changes of peak velocity and diastolic slope in mitral inflow Doppler spectrum in cases of assoociated with atrial fibrillation. However, few data exist regarding the effect of atrial fibrillation on the validity of this method. Two hundreds and three patients with mitral stenosis were studied by Doppler echocardiography and two-dimensional echocardiography(2DE) to assess whether atrial fibrillation affected the calcullation of MVA. Total patients was divided into four groups according to the accompanied mitral or aortic regurgitation. Ninety patients had mitral stenosis only(group 1), 45 patients had mitral stenosis only(group 2), 54 patients were combined with aortic regurgitation(group 3) and 14 patients were combined with both mitral and aortic regurgitation(group 4). And then, each group was divided into sinus rhythm subgroup and atrial fibrillation subgroup respectively. In total patients, Doppler echocardiographic indices(pressure half-time, mean pressure gradient, peak pressure gradient and peak velocity) were correlated significantly with 2DE-MVA in both patients with sinus rhythm and patients, with atrial fibrillation(P<0.005). In group 1 patients, Doppler echocardiographic indices were significantly correlated with 2DE-MVA in both patients with sinus rhythm and patients with atrial fibrillation(P<0.005). In group 2 patients, these Doppler derived indices were significantly correlated with 2DE-MVA in both patients with sinuns rhythm and patients with atrial fibrillation(P<0.005). In group 3 patients, only pressure half-time was significantly correlated with 2DE-MVA in both patients with sinus rhythm and patients with atrial fibrillation(P>0.005). In group 4 patients, pressure half-time was significantly correlated in patients with atrial fibrillation(P<0.005). Therefore, Doppler echocardiography can estimates mitral valve area in patients with mitral stenosis associated with mitral and aortic regurgitation regardless of presence of the atrial fibrillation.
Aortic Valve Insufficiency ; Atrial Fibrillation* ; Echocardiography ; Echocardiography, Doppler* ; Humans ; Mitral Valve ; Mitral Valve Stenosis*

Mitral pressure half-time(PHT) is widely used as an independent measure of mitral valve area(MVA) in patients with mitral stenosis. However, few data exist regarding the effect of mitral regurgitation and aortic regurgitation on the validity of this method. Two hundreds and three patients with mitral stenosis were studied by Doppler echocardiography and 2 dimensional echocardiography(2 DE) to assess whether mitral regurgitation and aortic regurgitation affected the calculation. Ninety patients had mitral stenosis only, 45 patients were combined with mitral regurgtation, 54 patients were combined with aortic regurgitation and 14 patients were combined with both mitral and aortic regurgitation group. Doppler PHT and 2DE estimates of MVA correlated well in total patients(r=0.903) and mitral stenosis only group(r=0.924). Good correlations were maintained in patient subgroups combined with mitral or aortic regurgitation(r=0.867 and 0.911, respectively) and both mitral and aortic regurgitation(r=0.843). Thus, measurement by Doppler PHT may reflect accurately the MVA as determined by 2DE regardless of presence of mitral and/or aortic regurgitation.
Aortic Valve Insufficiency ; Echocardiography, Doppler* ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis*

The incidence of transient bacteremia following esophageal variceal sclerotherapy (EVS) was evaluated in 29 patients. These 29 patients underwent a total of 83 sclerotherapy sessions.Prior to EVS, all instruments were sterilized. Blood cultures were drawn pre-EVS and post-EVS.All pre-EVS and post-EVS blood cultures were negative. In conclusion, it was found bacteremia following sclerotherapy is not easily developed, if a vigorous approach of using well cleaned equipment is used. Unless there is a cardiac prothesis or valvular heart disease, antibiotic prophylaxis is not warranted.
Antibiotic Prophylaxis ; Bacteremia* ; Esophageal and Gastric Varices* ; Heart Valve Diseases ; Humans ; Incidence ; Sclerotherapy*

We present the methods of analysis of left ventricular wall motion by 2-dimensional echocardiography using computerized system. Quantiative analysis of left ventricular wall motion abnormalities depents on the used reference method, because the heart shifts and rotates within thorax during the cardiac cycle. To access left ventricular wall motion abnormalities, we studied 60 subjects(normal; 30 subjects, abnormal; 30 subjects)with 5 different floating reference methods correcting for traslation and/or rotation in two echocardiographic views. (apical 4-chamber view and apical 2-chamber view) In the first the endocardial tracings of enddiastole and endsystole in 30 normal subjects were stored in VAX-11-780 main computer and the data of these 30 normal subjects were plotted to obtain a 95% confidence interval for measured normal fractional change every five degree according to 5 reference methods. In the second, 30 patients with abnormal left ventricular wall motion analyzed and the results were compared with a 95% confidence interval. We assessed that left ventricular wall motion by visual and computerized quantitative anlysis were in close relationship according to optimal reference method. We suggested that computerized quantitative analysis of left ventricular wall motion by 2-dimensional echocardiography was clinically useful method and translation of the midpoint of mitral anulus with rotation according to center of mass was the most specific and sensitive new method of evaluating left ventricular wall motion abnormalities.
Echocardiography* ; Heart ; Humans ; Thorax

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Echocardiography, Stress*

BACKGROUND: Hypertension is the most common cause of left ventricular hypertrophy(LVH). Increased left ventricular mass(LVM) carries independent risk for congestive heart failure, coronary artery disease, sudden death, reduction of coronary reserve. The importance of treatment in systemic hypertension for cardiovascular morbidity and mortality has been estabilished. Regression of LVM occurs with a number of antihypertensive drugs. This study was designed to explore the relation between blood pressure control, LVM and left ventricular filling dynamics. METHODS: Twenty five patients (12 men, 13 women) with estabilished hypertension were studied. No patients had a previous history of antihypertensive therapy. We obtained the basal echocardiography at the diagnosis which were disclosed no definite LVH, and the follow-up echocardiography after 6 months antihypertensive therapy with angiotension converting enzyme inhibitor, fosinopril, in patients with untreated essential hypertension. RESULTS: 1) Baseline blood pressure was 150/125mmHg and fell to 104/85mmHg (p<0.001). There was no siginificant reduction in heart rate. LVM were reduced from 153gr/m2 to 129gr/m2. 2) Peak E velocity and Peak A velocity was 82.9cm/sec, 74.9cm/sec and reduced to 67.2cm/sec, 62.3cm/sec, (p<0.001). 3) Time velocity integral dimension E (Ei) and time velocity integral dimension A (Ai) was 13.0cm, 9.0cm and reduced to 8.6cm, 4.5cm respectively. But there was no significant inteval change in peak E/A velocity. Ei/Ai was increased from 1.7 to 2.1 (p<0.01). CONCLUSIONS: These results suggested that antihypertensive therapy with ACE inhibitor for 6 months reduced significantly the left ventricular mass in patients with untreated essential hypertension.
Antihypertensive Agents ; Blood Pressure ; Coronary Artery Disease ; Death, Sudden ; Diagnosis ; Echocardiography ; Follow-Up Studies ; Fosinopril ; Heart Failure ; Heart Rate ; Humans ; Hypertension* ; Male ; Mortality

To assess the etiology and clinical course of moderate and severe pericardial effusions, we reviewed 118 consecutive patients seen in the cardiology department of the Kyunghee Medical Center from January, 1984 to July, 1988. 1) The common etiologies of pericardial effusions were tuberculosis(25.4%), malignancy(18.8%), uremia(16.2%), heart failure(14.4%), idiopathic(7.7%) and collagen vascular disease(5.1%). The lung cacer(77.2%) and breast cancer(9.1%) comprised most of the etiology of malignant pericardial effusion. The adenocarcinoma was the most common histologic entity of lung cancer. 2) Collapses of right atrium, right ventricle or both were seen in 17 case(14.4%), and the causes of collapses were malignancy(35.5%), idiopathic(11.8%) and uremia(11.8%). 3) The causes of constrictive pericarditis were : tuberculosis(42.9%), idiopathic(28.6%), malignancy(14.3%) and uremia(14.3%). 4) The percentages of improved cases were determined in 55 patients by echocardiography twice, 30th day after treatment and the last follow up day. It revealed 84%/96% in tuberculosis, 85.7%/0% in malignancy, 66.7%/83.3% in uremia, 83.3%/83.3% in heart failure, 100%/100% in both myxedema and myocardial infarction, and 33.3%/33.3% in collagen vascular disease at both follow up day. We conclude that the most common etiology of the pericardial effusions is still tuberculosis in Korea and the most common etiology of cardiac tamponade is malignancy, even though the suspected patients without echocardiography have been excluded can be a limitation of this study. The pericardial effusions by tuberculosis, uremia or heart failure responded well to the adequate treatment and response in malignancy or collagen vascular disease was not good.
Adenocarcinoma ; Breast ; Cardiac Tamponade ; Cardiology ; Collagen ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Failure ; Heart Ventricles ; Humans ; Korea ; Lung ; Lung Neoplasms ; Myocardial Infarction ; Myxedema ; Pericardial Effusion* ; Pericarditis, Constrictive ; Tuberculosis ; Uremia ; Vascular Diseases

The diagnosis of atrial septal defect by transthoracic echocardiography remains difficult in a small subset of patients because of either suboptimal acoustic windows or unusual anatomy, for example, fenestrated defects. wer report the case of a 52-year-old woman with a fenestratdd atrial septal aneurysm that was incompletely visualized by transthoracic echocardiography. Subsequent transesophageal echocardiography demonstrated atrial septal defect and two fenestrations within the atrial septal aneurysm with left-to-right shunting. All echocardiographic findings were confirmed at surgery. This case demonstrates the addinional diagnostic accuracy of transesophageal echocardiography for detecting disease of the atrial septum.
Acoustics ; Aneurysm* ; Atrial Septum ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Heart Septal Defects, Atrial* ; Humans ; Middle Aged

BACKGROUND: The association between the levels of serum lipids and lipoproteins and coronary artery disease(CAD) was well established. This study examines to assess the relation of the concentrations of serum lipids and lipoproteins to the severity of coronary atherosclerosis quantified by angiography. METHODS: We studied 72 patients(men 47, women 25 and mean age 55.6 years) who underwent coronary arteriography for suspected coronary artery disease. Coronary lesion scores were represented by estimates of stenosis in four major coronary vessels. We determined the levels of serum total cholesterol, triglyceride and HDL-cholesterol by biochemical methods. Serum apolipoprotein A-I, apolipoprotein B and lipoprotein(a) were quantified by radioimmunoassay. RESULTS: The distribution of Lp(a)levels among the subject population was highly skewed, with a mean Lp(a) level of 20.0mg/dL and a median of 15.2mg/dL. Coronary lesion scores significantly correlated with Lp(a), HDL-cholesterol levels and the age of patient by univariate statistical analysis. By multivariate analysis, levels of Lp(a) were associated significantly and independently with lesion scores and tend to correlate with the presence of CAD. In men, overall lesion severity of coronary atherosclerosis was related to Lp(a) levels, whereas in women it was related to apolipoprotein B levels by multiple regression anaylsis. CONCLUSION: The serum Lp(a) may be considerably more reliable index of advanced coronary artery disease than other lipids and lipoproteins, especially in men.
Angiography* ; Apolipoprotein A-I ; Apolipoproteins ; Cholesterol ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Lipoprotein(a) ; Lipoproteins* ; Male ; Multivariate Analysis ; Radioimmunoassay ; Triglycerides