Since the introduction of percutaneous coronary interventions, the restenosis has been a major limitation of this therapeutic technique. Until recently, multiple mechanical and pharmacological interventions have proven ineffective in reducing restenosis in a systematic and convincing fashion. Consequently, the interventional community turned their attention to radiotherapy, which has an established role for the treatment of various neoplastic diseases. After several years of extremely rapid development, the first randomized trials of intravascular radiotherapy have been completed with unprecedented success in reducing restenosis after percutaneous coronary interventions. New catheter-based delivery systems for intracoronary use are currently being developed and the first devices for delivery of intravascular radiation therapy have been made commercially available in multiple countries. In response to the growing enthusiasm for this approach, studies on larger populations are needed to determine whether this new strategy will influence the restenosis rate and clinical events after angioplasty and, in a broader sense, the field of interventional cardiology.
Angioplasty ; Cardiology ; Percutaneous Coronary Intervention* ; Radiotherapy

Comparative assessment of left ventricular volume curves using echocardiography, gated radionuclide angiography, and contrast left ventriculography was done in 11 cases of valvular heart disease. The parameters obtained from the left ventricular volume curves are enddiastolic volume (EDV), endsystolic volume(ESV), stroke volume(SV), and ejection fraction(EF). The parameters obtained from derivative curves of the left ventricular volume curves are peak ejection rate(PER), peak filling rate(PFR), time to peak ejection rate(TTPER), and time to peak filling rate(TTPFR). All the parameters(EDV, ESV, SV, and EF) obtained from left ventricular volume curves using three methods relate significantly each to each. The shapes of the left ventricular volume curves obtained from three methods were similar to each other. Without significant differences, noninvasive methods can be applied for serial and repetitive left ventricular volume curve analysis.
Echocardiography* ; Gated Blood-Pool Imaging* ; Heart Valve Diseases ; Stroke

A clinical study was made on 434 patients of valvular heart disease admitted to the Seoul National University Hospital during the period of November 1971-February 1978. The results were obtained as follows: 1) The number of valvular heart disease was 434 patients, which accounts for 2.6% of the total hospitalized patients during the same period. The sex incidence of valvular heart disease were female 48.6%, male 51.4%. The incidences of each valvular heart disease were mitral stenoinsufficiency 31.8%, mitral stenosis 24.2%, mitral insufficiency 21.0%, combined valvular heart disease 12.2%, aortic insufficiency 7.1%, aortic stenoinsufficiency 1.6%, pulmonic stenosis 1.4%, and aortic stenosis 0.7%, in order. 61.5% of all were in third to fifth decade in age distribution. 2) The following were found as etiological factors: rheumatic fever 36.4%, atherosclerosis 1.6%, syphilis 0.9%, and unknown and others 61.3%. 3) The main subjective symptoms were dyspnea, palpitation, cough, orthopnea, sputum, chest pain, fatigue, blood tinged sputum, dizziness, and headache. And the main objective finding were hepatomegaly, venous engorgement, edema, pulmonary congestion, thrill, ascites, splenomegaly, malar flush, and finger clubbing. 5) The disturbance of liver function were found in about 30% of valvular heart disease. 6) The abnormalities of electrocardiographic findings were observed as follows: atrial fibrillation 55.1%, ventricular premature beat 15.2%, first degree atrioventricular block 8.5%, incomplete right bundle branch block 4.1%, complete right bundle branch block 1.4%, second degree atrioventricular block 0.9%, and left bundle branch block 0.9%, in rhythm and conduction disturbance, and left ventricular hypertrophy 44%, right ventricular hypertrophy 18.2%, biventricular hypertrophy 4.6%, left atrial enlargement 19.8%, and right atrial enlargement 3.2%, in chamber enlargement.
Age Distribution ; Aortic Valve Stenosis ; Ascites ; Atherosclerosis ; Atrial Fibrillation ; Atrioventricular Block ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Chest Pain ; Cough ; Dizziness ; Dyspnea ; Electrocardiography ; Estrogens, Conjugated (USP) ; Fatigue ; Female ; Fingers ; Headache ; Heart Valve Diseases* ; Hepatomegaly ; Humans ; Hyperemia ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Liver ; Male ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Pulmonary Edema ; Pulmonary Valve Stenosis ; Rheumatic Fever ; Seoul ; Splenomegaly ; Sputum ; Syphilis ; Tolnaftate

Echocardiographic right ventricular systolic time invervals were measured in 69 cases of congenital and acquired valvular heart disease, who have neither arrhythmia nor conduction disturbances. The results were as follows: 1) Right ventricular preejection periord(RVPEP) relates with main pulmonary arterial systolic pressure (MPA(s)), main pulmonary arterial diastolic pressure (MPA(d)), main pulmonary arterial mean pressure (MPA(m)), pulmonary vascular resistance (Rp), and the ratio of pulmonary systemic vascular resistance (Rp/Rs) (r=0.746, 0.738, 0.755, 0.721, 0.687). 2) Rifht ventricular ejection time relates with MPA (s), MPA (d), MPA (m), Rp, and Rp/Rs (r=-0.580, -0.541, -0.544, -0.577, -0.420). 3) The ratio of right ventricular preejection period-right ventricular ejection time (RVPEP/RVET) relates with MPA (s), MPA (d), MPA (m), Rp and Rp/Rs (r=0.789, 0.784, 0.781, 0.778, 0.695). 4) Pulmonary hypertension and increased pulmonary vascular resistance can be predicted, when RVPEP/RVET is over 0.3. 5) By serial preoperative and postoperative measurements, pulmonary hypertension and increased pulmonary vascular resistance were relieved in the cases of mitral stenosis. But in the cases of congenital heart diseas there were no significant change in RVPEP/RVET ratio.
Adult* ; Arrhythmias, Cardiac ; Blood Pressure ; Echocardiography* ; Heart ; Heart Valve Diseases ; Humans ; Hypertension, Pulmonary ; Mitral Valve Stenosis ; Systole* ; Vascular Resistance

BACKGROUND: Spontaneous echo contrast(SEC) is known to predict the increased incidence of thromboembolism in a variety of heart diseases. Transesophageal echocardiography can be useful for the detection of SEC due to proximity of the probe to the left atrium. We performed this study (1) to evaluate the incidence of SEC in mitral stenosis and its relation to the past history of thromboembolism and (2) to characterize the echocardiographic and hemodynamic indices in patients with SEC compared with those without SEC. METHODS: Transesophageal and thransthoracic echocardiographies were done in 89 patients with mitral stenosis. Biplane probe was used in transesophageal echocardiography. In 47patients cardiac catheterization and angiography were performed. RESULTS: (1) SEC was found in 56 out of 89 patients(63%), and left atrial thrombus was found in 32 patients. (2) Left atrial dimension was larger in patients with SEC than in patients without SEC(57.3%+/-8.4mm vs 49.3+/-6.8mm, p<0.05) and mitrial valve area was smaller in patients with SEC than in patients without SEC(0.85+/-0.27cm2 vs 0.97+/-0.24cm2) (3) Association of SEC to thrombi or previous history of arterial embolism showed a high sensitivity and negative predictive value. CONCLUSION: SEC was an useful finding to predict the increased risk of thromboembolism in patients with mitral stenosis. Patients with SEC had severe mitral stenosis than patients without SEC.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Atria ; Heart Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Stenosis ; Thromboembolism ; Thrombosis

Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, ntimalhyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.
Angioplasty* ; Animals ; Brachytherapy ; Coronary Artery Disease ; Coronary Restenosis ; Coronary Stenosis ; Humans ; Isotopes ; Myocytes, Smooth Muscle ; Radiation, Ionizing

BACKGROUND AND OBJECTIVES: Dual isotope myocardial SPECT, rest thallium-201/dipyridamole stress Tc-99m sestamibi is used to diagnose coronary artery disease. We examined predictive value of myocardial SPECT for the prognosis of patients having or suspected coronary artery disease. MATERIALS AND METHOD: We examined 692 patients referred for dipyridamole stress myocardial perfusion SPECT. Cardiac events (hard and soft events) were followed up with medical record review and telephone interview. Survival analysis and multivariate Cox proportional hazard model were used to find significant predictors and the incremental predictive value of myocardial SPECT. Patients with coronary angiography (n=246) were analyzed in separate group. RESULTS: There were 4 hard events and 3 soft events in 341 normal SPECT group (1.20%/yr). There were 5 hard events and 21 soft events in 351 abnormal SPECT group (4.69%/yr). Survival curve was separated between normal SPECT group and abnormal SPECT group (p<0.01). In univariate analysis, smoking, history of myocardial infarction, typical chest pain and SPECT findings were important variables. In multivariate analysis, SPECT result was the single most independent predictor. Large reversible perfusion abnormality predicted worse prognosis. In patients with coronary angiography, SPECT did not add statistically significant predictive value to the coronary angiography. CONCLUSION: Dipyridamole stress Tl-201/ MIBI dual isotope myocardial perfusion SPECT provided excellent prognostic information. Extent of reversible perfusion decrease was the independent predictor of future cardiac events.
Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Dipyridamole ; Humans ; Interviews as Topic ; Medical Records ; Multivariate Analysis ; Myocardial Infarction ; Perfusion ; Prognosis ; Proportional Hazards Models ; Smoke ; Smoking ; Tomography, Emission-Computed, Single-Photon*

The antihypertensive effects fo aldactazide and serum electrolytes changes before and after treatment with aldactazide were observed. The followings were obtained: 1. Results of antihypertensive therapy with aldactazide in 23 hypertensive patients revealed good effects in 52.17%, fair in 26.09%, poor in 8.7%, and failure in 13.04% of cases. In 78.26% of cases, good or fair control of blood pressure was obtained. 2. Daily doses of aldactazide ranged from 25mg to 50mg depending upon the level of blood pressure. The antihypertensive effects were appeared after average 11 days of administration. 3. The side effects during treatment with aldactazide were dizziness, weakness, indigestion, headache, and restlessness in 26.28% of cases (6 of 23 cases). 4. No significant changes in serum Na and K values were observed before and after treatment with aldactazide for average 23 days.
Blood Pressure ; Dizziness ; Dyspepsia ; Electrolytes ; Headache ; Humans ; Psychomotor Agitation

The antihypertensive effects of once-daily 50mg dose of atenolol(Tenormin(R)) were observed in 28 cases of essential hypertension, and the results were as follows. 1. Mean drop in systolic and diastolic pressure were 19mmHg and 16mmHg respectively. 2. In 85.7% of the cases good or fair control of blood pressure was resulted. 3. Transient indigestion and fatigue were complained by 3 patients, but subsided spontaneously with continuous treament.
Blood Pressure ; Dyspepsia ; Fatigue ; Humans ; Hypertension

The antihypertensive effect of labetalol was evaluated in 25 cases of essential hypertension. 1. Age distribution was from 38 to 71 years. Thirteen cases were female and 12 cases were male. 2. The daily effective doses were ranged from 300 to 600mg. Total duration of medication were from 1 week to 12 weeks(mean 5 wks). 3. The 10 cases of 25 showed good antihypertensive effect, and 9(36%) showed fair. In 76% of the cases showed effective antihypertensive effect. 4. Two cases were suffered from side effects, such as mild orthostatic hypotension and dizziness.
Age Distribution ; Dizziness ; Female ; Humans ; Hypertension ; Hypotension, Orthostatic ; Labetalol ; Male