PURPOSE: This study examined the effect on uterine contraction frequency (UCF), blood pressure (BP), heart rate (HR), fetal heart rate (FHR) patterns and psychophysical symptoms (physical discomfort, anxiety, and depression) of structured bed exercise (SBE) in hospitalized high-risk pregnant women prescribed bed rest. METHODS: Forty-five hospitalized high risk pregnant women at >24 weeks of pregnancy prescribed bed rest were randomly assigned to the experimental or control group. From January to May 2014, data were collected using electronic fetal monitoring and patient monitoring of UCF, BP, HR and FHR patterns, and psychophysical symptoms were measured using the antenatal physical discomfort scale, state-trait anxiety scale, and Edinburgh postnatal depression scale. RESULTS: UCF, BP, HR, and FHR patterns (rate, variability, acceleration, and deceleration) did not differ significantly between the experimental and control groups. The experimental group showed a significant increase in baseline FHR after SBE within the normal range, and after SBE, it reduced to the FHR before SBE. The variability, acceleration and deceleration of FHR before and after SBE did not differ significantly between two groups. Moreover, there was no statistically significant difference before and after SBE in the experimental group. Also, the experimental group showed statistically significant decreases in physical discomfort score. However, there were no significant differences in depression and anxiety score between two groups. CONCLUSIONS: SBE in hospitalized high-risk pregnant women under bed rest did not increase the risk to the fetus, and relieved physical discomfort and anxiety. Therefore, SBE should be considered as a nursing intervention in hospitalized high-risk pregnant women.
Acceleration ; Anxiety ; Bed Rest ; Blood Pressure ; Cardiotocography ; Deceleration ; Depression ; Depression, Postpartum ; Female ; Fetal Heart* ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Monitoring, Physiologic ; Nursing ; Pregnancy ; Pregnancy, High-Risk ; Pregnant Women* ; Reference Values ; Uterine Contraction*

BACKGROUND: Hemodynamic and functional evaluation with Doppler and tissue Doppler study as a part of comprehensive echocardiography is essential but normal reference values have never been reported from Korean normal population especially according to age and sex. METHODS: Using Normal echOcaRdiographic Measurements in a KoreAn popuLation study subjects, we obtained normal reference values for Doppler and tissue Doppler echocardiography including tricuspid annular velocities according to current guidelines and compared values according to gender and age groups. RESULTS: Mitral early diastolic (E) and late diastolic (A) velocity as well as E/A ratio were significantly higher in women compared to those in men. Conversely, mitral peak systolic and late diastolic annular velocity in both septal and lateral mitral annulus were significantly lower in women compared to those in men. However, there were no significant differences in both septal and lateral mitral early diastolic annular (e') velocity between men and women. In both men and women, mitral E velocity and its deceleration time as well as both E/A and E/e' ratio considerably increased with age. There were no significant differences in tricuspid inflow velocities and tricuspid lateral annular velocities between men and women except e' velocity, which was significantly higher in women compared to that in men. However, changes in both tricuspid inflow and lateral annular velocities according to age were similar to those in mitral velocities. CONCLUSION: Since there were significant differences in Doppler and tissue Doppler echocardiographic variables between men and women and changes according to age were even more considerable in both gender groups, normal Doppler echocardiographic values should be differentially applied based on age and sex.
Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Female ; Hemodynamics ; Humans ; Male ; Reference Values

BACKGROUND: We sought to assess echocardiographic predictors of left ventricular (LV) adverse remodeling after successfully reperfused acute ST elevation myocardial infarction (STEMI). LV remodeling is commonly found in STEMI patients and it may suggest adverse outcome in acute myocardial infarction. We sought to identify whether 2D strain and torsion be independent parameters for prediction of LV adverse remodeling. METHODS: We investigated 208 patients with low-risk STEMI patients who had follow up echocardiography at 6 or more months. After clinical assessments, all patients received revascularization according to current guideline. LV remodeling was defined as > 20% increase in end-diastolic volume (EDV) at follow up. RESULTS: During the follow-up (11.9 ± 5.3 months), 53 patients (25.5%) showed LV remodeling. In univariate analysis, EDV, end-systolic volume, deceleration time (DT), CK-MB, and global longitudinal strain (GLS) were associated with LV remodeling. In multivariate analysis, EDV [hazard ratio (HR): 0.922, 95% confidence interval (CI): 0.897-0.948, p< 0.001], GLS (HR: 0.842, 95% CI: 0.728-0.974, p = 0.020), DT (HR: 0.989, 95% CI: 0.980-0.998, p = 0.023) and CK-MB (HR: 1.003, 95% CI: 1.000-1.005, p = 0.033) independently predicted LV remodeling. However, global circumferential strain, net twist, and twist or untwist rate were not associated with remodeling. CONCLUSION: Of various parameters of speckle strain, only GLS predicted adverse remodeling in STEMI patients.
Deceleration ; Echocardiography* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Myocardial Infarction* ; Ventricular Remodeling*

OBJECTIVES: The purpose of the present study is to emphasize the efficacy of the myocardial performance index and tricuspid annular plane systolic excursion (TAPSE) in the determination of impaired cardiac functions and recovery period following the treatment in children with adenoid and/or tonsillar hypertrophy. METHODS: Fifty-three healthy children after routine laboratory, imaging and clinical examinations, with adenoid and/or tonsillar hypertrophy were evaluated before and 3 months after adenotonsillectomy for cardiac functions using M mode and Doppler echocardiography. RESULTS: The mean age of cases was 6.4±3.0 years, 34 (65%) were male, and 19 (35%) were female. Pulmonary hypertension was observed to be mild in 3 patients and moderate in 1 patient preoperatively. When the preoperative and postoperative echocardiographic measurements of the patients were compared, the tricuspid valve E wave velocity, the E/A ratio (E, early diastolic flow rate; A, late diastolic flow rate), and the TAPSE values were determined to be significantly higher postoperatively (P<0.05). The tricuspid valve deceleration time, the isovolumetric relaxation time and the systolic pulmonary artery pressure were found to be significantly lower compared to the preoperative values (P<0.05). CONCLUSION: Adenoidectomy and/or tonsillectomy may prevent cardiac dysfunctions that can develop in the later periods due to adenoid and/or tonsil hypertrophy in children, before the appearance of the clinical findings of cardiac failure.
Adenoidectomy* ; Adenoids ; Child* ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Female ; Heart Failure ; Heart Ventricles* ; Humans ; Hypertension, Pulmonary ; Hypertrophy ; Male ; Palatine Tonsil ; Pulmonary Artery* ; Relaxation ; Tonsillectomy* ; Tricuspid Valve

The seat belt is designed for safety in a motor vehicle and should be worn to prevent severe injuries. But, the seat belt itself can be an injury factor in combination with deceleration forces applied to fixation points of mobile viscera. Here, we present a 23-year-man with traumatic transection of the appendix, highly mobile viscera, following seat belt injury.
Appendix ; Deceleration ; Motor Vehicles ; Seat Belts* ; Viscera

BACKGROUND: In adults, tissue Doppler imaging (TDI) is a recommended component of routine echocardiography. However, TDI velocities are less accepted in pediatrics, due to their strong variability and age dependence in children. This study examines the distribution of myocardial tissue Doppler velocities in healthy children to assess the effect of age with cardiac growth on the various echocardiographic measurements. METHODS: Total 144 healthy children were enrolled in this study. They were recruited from the pediatric outpatient clinic for routine well-child visits. The statistical relationships between age and TDI values were analyzed. Also, the statistical relationships between body surface area (BSA) and TDI values, left ventricle end-diastolic dimension (LVEDD) and TDI values were analyzed. Also, we conducted multivariate analysis of cardiac growth parameters such as, age, BSA, LVEDD and TDI velocity data. RESULTS: All of the age, BSA, and LVEDD had positive correlations with deceleration time (DT), pressure half-time (PHT), peak early diastolic myocardial velocity, peak systolic myocardial velocity, and had negative correlations with peak late diastolic velocity (A) and the ratio of trans-mitral inflow velocity to early diastolic velocity of mitral annulus (E/E'). In the multivariate analysis, all of the age, BSA, and LVEDD had positive correlations with DT, PHT, and negative correlations with A and E/E'. CONCLUSION: The cardiac growth parameters related alterations of E/E' may suggest that diastolic myocardial velocities are cardiac growth dependent, and diastolic function has positive correlation with cardiac growth in pediatric group. This cardiac growth related myocardial functional variation would be important for assessment of cardiac involvement either in healthy and sick child.
Adult ; Ambulatory Care Facilities ; Body Surface Area ; Child* ; Deceleration ; Echocardiography ; Heart Ventricles ; Humans ; Multivariate Analysis ; Pediatrics

BACKGROUND AND OBJECTIVES: Empirical evidence is lacking on the cumulative disease burden of obesity and hypertension and its impact on cardiac function and exercise capacity. The purpose of this study was to determine whether the presence of obesity and hypertension together was associated with cardiac dysfunction and exercise capacity. SUBJECTS AND METHODS: Using a retrospective study design, medical records were reviewed for echocardiographic and treadmill exercise stress test data. Subjects were grouped according to four categories: normal control, obese, hypertensive, or obese and hypertensive. RESULTS: Obese, hypertensive persons showed significantly lower Ea and E/A ratio and greater E/Ea ratio, deceleration time, left ventricular (LV) mass, and LV mass index compared to their counter parts (normal control, obese and/or hypertensive) (all p<0.05), after controlling for age and sex. After controlling for age and sex, significant differences in exercise capacity indices were found, with the obese group having shorter exercise time, lower metabolic equivalents, and lower maximal oxygen uptake than the normal control, hypertensive, or both groups (all p<0.05). The hypertensive or obese and hypertensive group had greater maximal blood pressure compared with the normal control group (all p<0.001). Obese and hypertensive persons were approximately three times more likely to have diastolic dysfunction (odd ratio=2.96, p=0.001), when compared to the reference group (normotensive, non-obese, or hypertensive only persons). CONCLUSION: Diastolic dysfunction was associated with obesity and/or hypertension. The cumulative risk of obesity and hypertension and their impact on diastolic dysfunction which could be modifiable could reduce exercise capacity.
Blood Pressure ; Deceleration ; Echocardiography ; Exercise Test ; Humans ; Hypertension* ; Medical Records ; Metabolic Equivalent ; Obesity* ; Oxygen ; Retrospective Studies

Glucagon-like peptide 1 (GLP-1) is an incretin hormone that is released from enteroendocrine L-cells upon nutrient absorption; it stimulates glucose-dependent insulin secretion from pancreatic betacells. GLP-1 has pleiotropic effects including deceleration of gastric emptying, decreased appetite, and increased satiety. Treatment with GLP-1 receptor agonists (GLP-1RAs) improves glycemic control in patients with type 2 diabetes without increasing the risk of hypoglycemia or weight gain. Current GLP-1RAs can be classified by their structure (exendin-4-based or human GLP-1-based), duration of action, and molecular size. Different GLP-1RAs exhibit different pharmacokinetics and pharmacodynamics. Herein we review the characteristics of available GLP-1RAs and discuss current issues such as insulin combination therapy and anti-obesity effects.
Absorption ; Appetite ; Deceleration ; Diabetes Mellitus, Type 2 ; Gastric Emptying ; Glucagon-Like Peptide 1* ; Humans ; Hypoglycemia ; Incretins ; Insulin ; Obesity ; Pharmacokinetics ; Weight Gain ; Glucagon-Like Peptide-1 Receptor

In traffic accidents, wearing a seatbelt can cause abdominal aortic injury due to an abrupt deceleration. We report a case of abdominal aorta dissection caused by a seat belt in a frontal motor vehicle collision. The initial symptoms and signs were vague or uncertain. However, he complained severe abdominal pain with seat belt sign below the umbilicus. Abdominal computed tomography scans showed an initial flap of the abdominal aorta with hematoma and hazy stranding of the mesentery.
Abdominal Pain ; Accidents, Traffic ; Aorta, Abdominal* ; Deceleration ; Hematoma ; Mesentery ; Motor Vehicles* ; Seat Belts* ; Umbilicus

Although the innominate artery is protected by a bony structure, traumatic injury of this vessel has been reported. These injuries usually occur after blunt chest trauma or sudden deceleration, and are often coupled with other associated injuries. However, we experienced an unusual occurrence where a deceased patient with no history of blunt trauma and no apparent injury on the chest, head, or neck showed an isolated injury of the innominate artery with extensive hemorrhage at the postmortem examination. In the present report, we describe the present case, indicating the characteristics of the innominate artery injury, and review the associated literature.
Autopsy ; Brachiocephalic Trunk ; Deceleration ; Glycosaminoglycans ; Head ; Hemorrhage ; Humans ; Neck ; Thorax