No abstract available.
Hypertension*

No abstract available.
Asthma, Exercise-Induced*

No abstract available.
Ascites* ; Fibrosis* ; Humans ; Paracentesis*

No abstract available.
Child* ; Humans ; Nephrotic Syndrome*

No abstract available.
Humans

We measure left ventricular mass, mitral peak flow velocity and isovolumic relaxation time(IVRT) with M-mode and Doppler echocardiography to evaluate daistolic function of the heart in hypertensive patients, who are seperated into group A(18 patients) with normal electrocardiogram and group B(24 patients) with abnormal electrocardiogram. There is no difference in fractional shortening, which reflects systolic function of the heart,between normal subjects and both groups of patients(36.5+/-6.7% in group B).The left ventricular mass index in group A is higher than in normal subjects(139.8+/-33.6g/m2, 100.2+/-28.8g/m2, respectively, p<0.005). But, that is lower than group B(200.7+/-40.6g/m2, p<0.005). The sensitivity and specificity of electrocardiograohy to detect left ventricular hypertrophy in patient whose left ventricualr mass index is above 160.8g/m2, are 80% and 91%, respectively. The peak flow velocities in early diastolic(PFVE) are 0.67+/-0.15m/sec in normal subjects and 0.60+0.14m/sec in group A (p=not siginificant). In group B, that is lower than normal subjects(0.54+/-0.15m/sec, p<0.005). In both groups, the peak flow velocities in late diastole(PFVA) are higher than normal subjects(0.48+/-0.11m/sec in normal, 0.69+/-0.18m/sec in groups A, 0.71+/-0.16m/sec in group B, p<0.005). The PFVE/PFVA ratio is lower in both groups of patients(1.40+/-0.23 in normal subjects, 0.90+/-0.25 in group A, 0.77+/-0.23 in group B, p<0.005). The IVRT is also prolonged in both groups(85+/-10m/sec in normal, 112+/-16msec in group A, 123+/-23msec in group B, p<0.005). The PFVE/PFVA ratio decreases in relation with the increament of index of IVRT(r=0.60, p<0.01). The IVRT increases in relation to the left ventricular mass index in hypertensive patients(r=0.34, p<0.05), but, the PFVE/PFVA ratio reveals no relation to those. In cocclusion, the impairment of diastolic function develops before the systolic function or electrocardiogram show abnormalities in htpertensive patients.Therefore, it is importment to detect early any abnormalities in the indices of the diastolic function, such as mitral peak flow velocity and isovolumic relaxation time, in the prevention and treatment of hypertensive geart disease.
Echocardiography, Doppler ; Electrocardiography ; Heart ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Relaxation ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Unstable angina is an inhomogenous syndrome. A substantial percentage of patients, ranging from 12 to 30% in most series, develops acute myocardial infarction or dies suddenly soon after their hospitalization, while the remainder have a benign prognosis without adverse coronary events. Unstable angina is a complex condition such as angina at rest, crescendo angina, new onset angina and postinfarction angina. These variable clinical presentations suggest that unstable angina have a heterogenous pathogenesis and prognosis. We divided unstable angina into 5 groups and studied the relationship between clinical presentations and coronary angiographic morphology. METHODS: One hundred sixty six patients were selected from the patients who were diagnosed as an unstable angina between January 1989 and March 1991, at Hallym University Hospital. Angiography was performed in patient with typical angina symptoms and transient ECG changes of myocardial ischemia. Coronary angiogram was done as usual method. Calcification of coronary artery as well as the presence of collateral circulation were recorded. Ergonovine test was performed in patients with near normal or normal angiogram. Coronary lesions were morphologically classified as follows; type A is simple lesion such as symmetric, concentric narrowing and smooth border. and type B is complex lesion such as asymmetric, eccentric, ulcerated narrowing and irregular border. RESULTS: These groups were classified as follows; Group I(represented the patients with angina at rest but typical Prinzmetal angina was excluded) 30 patients, Group II(represented the patients with crescendo angina) 24 patients, Group III(represented the patients with new onset angina) 62 patients, Group IVA(represented the patients with early postinfarction angina within 2 weeks after AMI) 34 patients, Group IVB(represented the patients with delayed postinfarction angina) 16 patients, There were no significant differences in age and sex among the 5 groups. Locations of involved vessel were similar among the five groups, and left anterior descending artery was most frequently(mean 60%) involved. Single vessel disease was frequently observed in new onset angina and early postinfarction angina(Group III*, IVa** 48%, 65% VS Group II, IVB 25%, 19% respectively, *p<0.05, **p<0.005) whereas multivessel disease was frequent in crescendo angina and delayed postinfarction angina(Group II, IVB 51%, 76% VS Group II, IVA 16%, 27% respectively, p<0.005). More than two third of patients with unstable angina had complex B lesion of coronary artery (77%), but in new onset angina simple A lesion was frequently observed (Group III 45% VS Group I, IVA, IVB 16%, 10%, 13% respectively, p<0.05). The frequency of calcification increased in early postinfarction angina(Group IVA 18% VS Group III 3%, p<0.05). The frequency of coronary collateral circulation increased in cresendo angina, early postinfarction and delayed postinfarcion angina(Group II*, IVA*, IVB** 38%, 35%, 50% VS Group III 10% respectively, *p<0.005.**p<0.0001). Incidence of coronary vasospasm was higher in resting angina than the others(Group I*, III 30%, 19% VS Group II, IVA 4%, 6% respectively, *p<0.02). The coronary vasospasm was frequently observed in an insignificant lesion(insignificant lesion/total vasopasm: 12/24(50%)). Early postinfarction angina had frequent intracoronary thrombus in infact-related artery(incidence of thrombus : Group IVA*, IVB 21%, 13% VS Group I, II, III 3%, 4%, 5% respectively, *p<0.05). CONCLUSION: This study suggests that patients with unstable angina pectoris may be heterogeneous groups. Coronary angiography must be performed in patients with unstable angina, in order to classify the clinical correlates with each possible angiogrphic finding that could affect treatment modality and outcome of cardiac events.
Angina Pectoris, Variant ; Angina, Unstable* ; Angiography ; Arteries ; Collateral Circulation ; Coronary Angiography ; Coronary Vasospasm ; Coronary Vessels ; Electrocardiography ; Ergonovine ; Hospitalization ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia ; Prognosis ; Thrombosis ; Ulcer

Cardiac relaxation is impaired in many cardiac disorders and is the subject of extensive investigation. Though measurement of isovolumic relaxation time ought to prove a simple means of quantifying such abnormalities in clinical practice, the problem of defining the timing of mitral valve opening at the onset of ventricular filling has been a difficulty. previous studies have used the 'O' point of the apexcardiogram, but more recently it has been shown that this may be open to considerable error. It was the purpose of the present study to determine the duration of true isovolumic relaxation and the factors influencing its duration, and to evaluate its use as a simple noninvasive measurement of cardiac dynamics in terms of the present approach. True isovolumic relaxation time (IRT) was measured noninvasively from the onset of the aortic component of the second heart sound to the onset of rapid opening of the mitral leaflets from simultaneous recording of echocardiogram, phonocardiogram, electrocardiogram and carotid tracing in 60 normal subjects, 30 male and 30 female and in 50 with hypertension, 28 male and 22 female ranging in age from 20 to 45 years. 1. The duration of IRT was 53.6+/-9.9 msec in normal subjects with no relation to sex. 2. IRT was related to heart rate, systemic blood pressure, and systolic and diastolic time intervals. 1) IRT tended to decrease with increasing heart rate and a regression equation for predicting it in relation to heart rate was 'IRT(msec)=88.97-0.466xH.R.(beats/min)' (P<0.01). 2) IRT tended to increase with increasing systemic blood pressure and a regression equation for predicting it in relation to aortic closing pressure was 'IRT(msec)=5.09+0.459xaortic closing pressure(mmHg)' (P<0.01). IRT was prolonged in patient with hypertension. 3) IRT was in close relation to left ventricular contraction indices such as preejection period(PEP), isovolumic contraction time and preejection period/left ventricular ejection time ratio. 4) There was no relation between IRT and left ventricular pump performance indices such as stroke volume, ejection fraction, fractional shortening and left ventricular dimension. 5) There was strong association between IRT and diastolic time intervals. Authors were impressed through this study that IRT is a useful measurement of left ventricular dynamics in early diastole.
Blood Pressure ; Diastole ; Electrocardiography ; Female ; Heart Rate ; Heart Sounds ; Humans ; Hypertension ; Male ; Mitral Valve ; Relaxation* ; Stroke Volume

No abstract available.
Depression* ; Prevalence*

No abstract available.
Anxiety* ; Depression* ; Humans ; Renal Dialysis*