Atrial fibrillation (AF) is the most common arrhythmia worldwide and a potent independent risk factor for stroke. This study aimed to determine the prevalence of AF in a population-based sample of adults in a rural region of Korea. Between January 2005 and December 2009, 4,067 individuals (60.2 +/- 11.2 yr old, M: F = 1,582:2,485) over 21 who were residents of the county of Yangpyeong, Korea, participated in the study. AF was assessed on a resting 12-lead electrocardiogram (ECG) in 4,053 of the participants. Blood tests and transthoracic echocardiography (TTE) were also performed to investigate the relationship between left ventricular mass and AF in the study group. Fifty-four cases (32 men) were diagnosed as AF among the 4,053 subjects. The crude prevalence of AF was 1.3%. It was highest (2.3%) among sixty- and seventy- year olds, and higher in men than women in all age groups over 50. The prevalence in men was 2.0%, and in women 0.9%. In univariate analysis, age, male gender, body mass index, total serum cholesterol, alanine transaminase, serum creatinine, adiponectin level, and ischemic heart disease were associated with AF. Among the TTE parameters, systolic and diastolic left ventricular systolic internal dimension (LVID), and LV ejection fraction were associated with AF. In this relatively healthy population in a rural area of Korea, the prevalence of AF is 1.3%, and increases with age. Of the TTE parameters, systolic and diastolic LVID and left atrial diameter are related to prevalence of AF.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Asymptomatic Diseases/*epidemiology ; Atrial Fibrillation/*epidemiology/*ultrasonography ; Causality ; Comorbidity ; Echocardiography/*statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population/*statistics & numerical data ; Sensitivity and Specificity ; Sex Distribution ; Stroke/*epidemiology/ultrasonography ; Stroke Volume

INTRODUCTIONDeep venous thrombosis (DVT) is thought to be less common in Asians than in the Caucasian population. The incidence of asymptomatic DVT in high-risk groups in the Asian population has not been well studied. While DVT incidence among Caucasian stroke patients has been extensively studied and the need for prophylaxis established, the lack of data in Asian patients leaves physicians with no firm basis for adopting prophylactic protocols in the local population. Our aim was to prospectively establish the incidence of early DVT in immobilised stroke patients in a heterogenous Asian population.

MATERIALS AND METHODSWe screened 44 patients with significant hemiplegia from acute stroke. Doppler ultrasound, the currently accepted method of investigation for DVT, was used to study patients on admission and at 1 week post-stroke. While there was no standard prophylactic regime in use, none of the patients received heparin and only 2 were given compression stockings.

RESULTSThe incidence of DVT at 1 week was 2.4%. Review at 1 month detected another patient with DVT, bringing the overall incidence at 1 month to 4.8%. This is lower than in Caucasian populations, but is similar to another local study on a different group of high-risk patients.

CONCLUSIONThe low incidence of early DVT in hospitalised stroke patients of Asian ethnicity does not justify routine screening for this population. Further research to validate this should ideally include a comparison test for DVT as ultrasound may have inherently lower sensitivity in an asymptomatic population.

Adult ; Asian Continental Ancestry Group ; Female ; Hemiplegia ; complications ; Humans ; Immobilization ; Male ; Middle Aged ; Prospective Studies ; Stroke ; complications ; Ultrasonics ; Ultrasonography ; Venous Thrombosis ; diagnostic imaging ; epidemiology

BACKGROUND/AIMS: Increased left atrial (LA) size has been proposed as a predictor of poor cardiovascular outcome in the elderly. In the present study, we evaluated the relationship between LA size and stroke in subjects of all ages who presented with preserved left ventricular systolic function (LVSF) and sinus rhythm (SR), and investigated the relationships between LA size and other echocardiographic parameters of diastolic function. METHODS: A total of 472 subjects were enrolled in the study (161 men, 311 women) and divided into the stroke group (n=75) and control group (n=397). A conventional echocardiographic study was then performed. Subjects with valvular heart disease, atrial fibrillation, or coronary heart disease were excluded. RESULTS: The mean subject age was 65.2+/-5.1 years in the stroke group and 65.6+/-5.9 years in the control group. Mitral inflow pattern and E & A velocity showed no significant relationship with stroke (p=NS, p=NS, respectively). Left ventricular mass index and LA dimension were significantly related to stroke (p=0.003, p=0.023, respectively), and hypertension showed a marginal relationship with stroke (p=0.050). Age was not related to stroke in the present study (p=NS). CONCLUSIONS: The LA dimension is significantly related to the incidence of stroke. Therefore, strategies for prevention of stroke in patients with preserved LVSF and SR should be considered in cases of LA enlargement.
Adult ; Aged ; Echocardiography, Doppler, Pulsed ; Female ; Heart Atria/*ultrasonography ; Heart Rate/*physiology ; Heart Ventricles/physiopathology/ultrasonography ; Humans ; Incidence ; Korea/epidemiology ; Male ; Middle Aged ; Myocardial Contraction/*physiology ; Retrospective Studies ; Risk Factors ; Stroke/*epidemiology/etiology ; Stroke Volume/*physiology ; Systole ; Ventricular Function, Left/*physiology

BACKGROUND/AIMS: Diastolic dysfunction occurs frequently in patients with chronic kidney disease (CKD) and is associated with heart failure (HF) or mortality. We investigated whether the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e' ratio), estimated using tissue Doppler imaging, has prognostic value for cardiovascular morbidity and all-cause mortality in patients with CKD. METHODS: For 186 patients with CKD of stages III to V, we obtained echocardiograms with tissue Doppler imaging. A 5-year follow-up of 136 patients was performed based on hospital records and telephone interviews. The enrolled patients (79 males and 57 females) were categorized into the following CKD subgroups: stage III (n = 25); stage IV (n = 22); and stage V (n = 89). RESULTS: The average follow-up period was 30.45 months and the mean age of the patients was 61.13 years. The mortality rate after 5 years was 60.0%. The causes of death were: sepsis, 21.9%; HF, 16.2%; and sudden death, 15.2%. Age (p = 0.000), increased C-reactive protein level (p = 0.018), and increased E/e' ratio (p = 0.048) were found to correlate with mortality. Age (p = 0.000), decreased ejection fraction (p = 0.003), and increased E/e' ratio (p = 0.045) correlated with cardiovascular event. CONCLUSIONS: The E/e' ratio can predict mortality and cardiovascular events in patients with CKD who have diastolic dysfunction.
Aged ; Chi-Square Distribution ; *Echocardiography, Doppler ; Female ; Glomerular Filtration Rate ; Heart Failure, Diastolic/*mortality/physiopathology/*ultrasonography ; Humans ; Incidence ; Kaplan-Meier Estimate ; Kidney/physiopathology ; Linear Models ; Male ; Middle Aged ; Mitral Valve/physiopathology/ultrasonography ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; ROC Curve ; Renal Insufficiency, Chronic/diagnosis/*mortality/physiopathology ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Stroke Volume ; Time Factors ; Ventricular Function, Left