BACKGROUND: Twelve lead electrocardiagram is often used to localize the site of myocardial infarction and coronary artery stenosis. There are many studies to correlate the electrocardiographic abnormalities and the site of coronary artery stenosis in patients with ischemic heart disease. In patients with acute myocardial infarction, however, a few studies that correlate the site of coronary artery stenosis and abnormal Q wave in leads I or aVL have been reported. METHOD: In 60 patients with acute myocardial infarction(Male : Female=48 : 12), the author investigated the development of abnormal Q wave in leads I or aVL and the presence, severity and location of stenosis in left anterior descending coronary artery and its first diagonal branch, and correlated abnormal Q wave and the presence of first diagonal branch stenosis with the progression of myocardial infarction. RESULTS: The presence of first diagonal branch stenosis can be predicted in patients with acute myocardial infarction who had abnormal Q wave in leads I of aVL with sensitivity and specificity of 70% and 85% during the early stage respectively and 88% and 96% after stabilization of infarction respectively. CONCLUSION: With the presence of abnormal Q wave in leads I or aVL in patients with acute myocardial infarction, it can be predicted that there is stenosis in the first diagonal branch. Howeve, there should be more experineces and further and metriculous studies.
Constriction, Pathologic* ; Coronary Stenosis ; Coronary Vessels ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Sensitivity and Specificity

We experienced a case of pedunculated left atrial primary fibrosarcoma, which obstructed the mitral orifice and produced symptoms and manifestations of mitral stenosis clinically. There was no evidence of metastasis to adjacent tissue or distant organs. It was treated by open heart surgery.
Fibrosarcoma* ; Heart Atria* ; Mitral Valve Stenosis ; Neoplasm Metastasis ; Thoracic Surgery

We observed the motion of left ventricular posterior wall aortic root posterior wall in 20 normal persons and 20 patients with left ventricular hypertrophy during the period from March 1985 to Agust 1985. The results were as followings; 1) The percentage of rapid filling time to one cycle of heart beat obtained from the ventriculat posterior wall motion was significantly prolonged in patients with left ventricular hypertrophy(24.1+/-5.44%) than in normal persons(13.5+/-3.69%)(p<0.05) and that of slow filling time was significantly shortend in patients with left ventricular hypertrophy(27.4+/-6.10%) than in normal persons(38.7+/-9.06%)(P<0.005). 2) The rapid filling slop obtained from left ventricular postrior wall motion was significantly reduced in patients with left ventricular hypertrophy(44.0+/-12.45mm/sec)than in normal persons(91.7+/-53.16mm/sec)(P>0.005) but the slow were not signigficantly different between the two groups. 3) The left artial emptying index calculated from the aortic root posterior wall motion was significantly lower in patients with left ventricular hypertrophy(0.6+/-0.18) than in normal persons(1.1+/-0.26)(P<0.005).
Echocardiography* ; Heart ; Humans ; Hypertrophy, Left Ventricular*

Aortic root diameter by two dimensional and M-mode echocardiography in predicting prosthetic aortic valve size preoperatively was measured in 10 adult patients undergoing aortic valve replacement. Correlation of aortic root diameter measured by two dimensional echocardiography and actual prosthetic valve size implanted by aortic valve replacement was excellent. Correlation coefficient was statistically significant (r=0.91, P<0.001). Correlation of aortic root diameter measured by M-mode echocardiography and actual prosthetic valve size was also excellent. Correlation coefficient was statistically significant (r=0.86, P<0.001). This study demonstrates that aortic root diameter by two dimensional and M-mode echocardiography can accurately predict prosthetic aortic valve size in patient undergoing aortic valve replacement.
Adult ; Aortic Valve* ; Echocardiography* ; Humans

BACKGROUND: Circardian variation in the onset of cardiovascular events includig sudden cardiac death, myocardial infarction and ventricular arrhythmias has been discribed. The frequency of ventricular premature complexes has also been reported to demonstrate a pattern consisting of a daytime peak and nightime nadir. We tried to see if the same circardian pattern is found in dilated cardiomyopathy patients. We have also studed how various modifying factors such as left ventricular ejection fration and ACE inhibitor use may affect the circardian pattern. METHOD: 24-hour ambulatory electrocaridiographic monitorings were performed in 50 dilated cardiomyopathy patients and 20 control subjects. Patients were prospectively divided in 2 groups based on LVEF and ACE inhibitor use. RESULTS: In dilated cardiomyopathy patients, the expected morning increase in VPC frequency is absent and show a peak in evening. This pattern is not correlated with heart rate. Evening peak is more prominent in low LVEF group and ACE inhibitor non-user group. CONCLUSION: In dilated cardiomyopathy patients, VPC frequency show a peak in the evening.
Arrhythmias, Cardiac ; Cardiomyopathy, Dilated* ; Death, Sudden, Cardiac ; Heart Rate ; Humans ; Myocardial Infarction ; Prospective Studies ; Ventricular Premature Complexes*

We compared the left ventricular ejection fraction by echocardiography with the ejection fraction determined by computerized radionuclide ventriculography in 59 patients who were admitted to the Soon Chun Hyang University Hospotal under the impression of cardiovascular disease from May 1984 to August 1985. The results were as follow : 1) In all patients the ejection fractions by both methods were significantly correlated with each other(r=0.77, P<0.001). 2) In 10 patients with ischemic heart disease the ejection fractions by both methods were not correlated significantly(r=0.42, P>0.10). 3) Except the 10 patients with ischemic heart disease, the ejection fractions by both methods were correlated significantly(r=0.87, P<0.001). 4) In conclusion, though the ejection fraction by the above 2 methods represent the left ventricular function well, the ejection fraction by echocardiography can not represent the left ventricular function precisely in patients in patients with ischemic heart disease because of abnormal left ventricular wall motion and left ventricular function more precisely than that by echocardiography.
Cardiovascular Diseases ; Echocardiography* ; Humans ; Myocardial Ischemia ; Radionuclide Ventriculography* ; Stroke Volume ; Ventricular Function, Left

Myoglobin has been shown to be elevated in the serum after myocardial infarction. Myoglobin is one of the first to appear in the serum and its quantification may thus be used in the diagnosis of the early phase of acute myocardial infarction. The purpose of this study was to clarify the time course of myoglobin elevation in the early phase of acute myocardial infarction. We compared this with the time course of serum CPK and obtained following results: 1) Serum myoglobin becomes significantly elevated at 4 hours following onset of chest pain and apears earlier than CPK. 2) Serum myoglobin time curve peaks at 8 hours, whereas the CPK time surve peaks at 16 hours following onset of chest pain. 3) Mearsurement of serum myoglobin in the early phase of acute myocardial infarction can serve as valuable aid in diagnosis of myocardial infarction with other findings.
Chest Pain ; Diagnosis ; Myocardial Infarction* ; Myoglobin*

After the performance of 100 coronary cineangiographies in 100 paitents who were adminitted to Soonchunhyang University Hospital under the diagnosis of ischemic heart disease from July 1986 to October 1987, we observed the coronary collateral circulation and measured the ejection fraction, circumferential fiber shortening, left ventricular end-diastolic pressure and pulmonary artery wedge pressure in 52 paitents who had 50% or more stenosis in one or more coroanry arteries. The results were as follow : 1) The collaterall circulation was observed in 16 patients(30.8%) of the 52 patients and it was developed mainly(87.5) in patients with 90% or more coronary artery stenosis. In patients with stenosis of less than 90%, however, collateral circulation was observed rarely(12.5%). 2) The left ventricular wall motion abnormality was severe in the group without collateral circulation. 3) The collteral circulation was most frequently developed in patients with severe right coronary artery stenosis and most of the routes were supplied from contralateral coronary arteries. 4) There was no significant difference in ejection fraction, circumferential fiber shortening, left ventricular end-diastoic pressure and pulmonary artery wedge pressure between the 2 groups with and without coronary artery collateral circulation.
Arteries ; Cineangiography ; Collateral Circulation* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Diagnosis ; Humans ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Ventricular Function, Left*

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure

It is well known that hypertension is associated with left ventricular diastolic dysfunction which frequently precede systolic dysfunction. To determine whether nifedipine could improve left ventricular diastolic function in hypertensive patients, we studied 15 hypertensive patients and 15 normotensive subjects matched for sex, age with Doppler echocardiography. After oral administration of 10mg of nifedipine, there were no significant changes in Doppler-derived transmitral diastolic filling indexes of normotensive subjects. On the other hand, although peak flow velocity in atrial systole(PFVA), time velocity integral in atrial systole(TVIA) did not change significantly after nifedipine, nifedipine significantly increased peak flow velocity in early diastole(PFVE) from 40.2+/-6.4cm/sec to 46.5+/-10.9cm/sec(p<0.005), time velocity integral in early diastole(TVIE) from 5.24+/-1.2cm to 5.97+/-1.43cm(p<0.001), the ratio of PFVE/PFVA from 0.69+/-0.11 to 0.76+/-0.12(p<0.05), the ratio of TVIE/TVIA from 1.18+/-0.21 to 1.29+/-0.24(p<0.05), deceleration slope(DS) from 244.9+/-51.9cm/sec2 to 289.9+/-49.1cm/sec2 (p<0.001) and decreased isovolumic relaxation time(IVRT) from 132.3+/-10.3msec to 117.2+/-13.5msec(p<0.001), deceleration time(DT) from 168.8+/-30.3msec to 154.9+/-29.8msec(p<0.05) in hypertensive patients. These fimdings indicated that nifedipine improves Doppler-derived early diastolic filling indexes in hypertensive patients and may be related to improvement of active relaxation of left ventricle in early diastole.
Administration, Oral ; Deceleration ; Diastole ; Echocardiography, Doppler* ; Hand ; Heart Ventricles ; Humans ; Hypertension ; Nifedipine* ; Relaxation