1.Development of a Multi-parameter Pulmonary Function Test System.
Xilin YE ; Yueming CHEN ; Jilun YE ; Bing LIU
Chinese Journal of Medical Instrumentation 2023;47(3):268-271
		                        		
		                        			
		                        			To comprehensively evaluate the human body's respiratory, circular metabolism and other functions, and to diagnose lung disease, an accurate and reliable pulmonary function test (PFT) is developed. The system is divided into two parts:hardware and software. It realizes the collection of respiratory, pulse oxygen, carbon dioxide, oxygen and other signals, and draws flow-volume curve (FV curve), volume-time curve (VT curve), respiratory waveform, pulse wave, carbon dioxide and oxygen waveform in real time on the upper computer of the PFT system, and conducts signal processing and parameter calculation for each signal. The experimental results prove that the system is safe and reliable, it can accurately measure the basic functions of human body, and provide reliable parameters, and has good application prospects.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Carbon Dioxide
		                        			;
		                        		
		                        			Respiratory Function Tests
		                        			;
		                        		
		                        			Oxygen
		                        			;
		                        		
		                        			Heart Rate
		                        			
		                        		
		                        	
2.Association between blood pressure, inflammation and spirometry parameters in chronic obstructive pulmonary disease.
Sulhattin ARSLAN ; Gürsel YILDIZ ; Levent ÖZDEMIR ; Erdal KAYSOYDU ; Bülent ÖZDEMIR
The Korean Journal of Internal Medicine 2019;34(1):108-115
		                        		
		                        			
		                        			BACKGROUND/AIMS: Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. METHODS: We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. RESULTS: In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV₁%). Diastolic blood pressure was associated with pH and HCO₃ levels. The mean night time, day time pulse pressures and 24-hour pulse per minute values were also associated with all the parameters except FEV₁%. CONCLUSIONS: In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.
		                        		
		                        		
		                        		
		                        			Airway Obstruction
		                        			;
		                        		
		                        			Anoxia
		                        			;
		                        		
		                        			Blood Pressure*
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			C-Reactive Protein
		                        			;
		                        		
		                        			Cardiovascular Diseases
		                        			;
		                        		
		                        			Cardiovascular System
		                        			;
		                        		
		                        			Comorbidity
		                        			;
		                        		
		                        			Electrocardiography, Ambulatory
		                        			;
		                        		
		                        			Forced Expiratory Volume
		                        			;
		                        		
		                        			Heart Diseases
		                        			;
		                        		
		                        			Heart Failure
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrogen-Ion Concentration
		                        			;
		                        		
		                        			Hypercapnia
		                        			;
		                        		
		                        			Inflammation*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Pulmonary Disease, Chronic Obstructive*
		                        			;
		                        		
		                        			Reading
		                        			;
		                        		
		                        			Respiratory Function Tests
		                        			;
		                        		
		                        			Smoke
		                        			;
		                        		
		                        			Smoking
		                        			;
		                        		
		                        			Spirometry*
		                        			
		                        		
		                        	
3.Experimental study of cardiac function by high-resolution ultrasound in sepsis rats with cecal ligation and puncture.
Yawen XIAO ; Mintao GAI ; Yi WANG ; Xiaoli HUA ; Xiangyou YU
Chinese Critical Care Medicine 2019;31(11):1345-1350
		                        		
		                        			OBJECTIVE:
		                        			To evaluate the cardiac function of cecal ligation and puncture (CLP) induced sepsis rats with high-resolution ultrasound.
		                        		
		                        			METHODS:
		                        			According to the method of random number table, 48 adult male Sprague-Dawley (SD) rats were randomly divided into normal control group and sepsis 6, 12, 24, 30, 48 hours groups, with 8 rats in each group. The sepsis model was produced by CLP, and the rats in the normal control group were only anesthetized and resuscitated. The general situation after modeling in each group was observed, and the left ventricular function was assessed by high-resolution echocardiography at all the time points. The abdominal aorta blood of rats was collected, and the serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and MB isoenzyme of creatine kinase (CK-MB) were determined by enzyme-linked immunosorbent assay (ELISA). The myocardial tissue was harvested, and the pathological changes in myocardial tissue were observed by hematoxylin-eosin (HE) staining.
		                        		
		                        			RESULTS:
		                        			The rats challenged to CLP displayed symptoms of sepsis, such as depression, ruffled fur, decreased diet and activity, and the symptoms became more obvious with the extension of time. High-resolution echocardiography could clearly show the structure of left ventricle in each group and obtain satisfactory M-mode echocardiography of left ventricle. The heart rate (HR) of rats in all sepsis groups was elevated with the increase in model time as measured by high-resolution ultrasound, and it was significantly higher than that in the normal control group at 12, 24, 30 hours (bpm: 359.66±23.33, 361.35±12.85, 392.67±11.33 vs. 306.24±29.79, all P < 0.05). Stroke volume (SV) and cardiac output (CO) in sepsis rats were decreased with the increase in model time, while left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were increased first and then decreased, and SV and LVEF in sepsis 48 hours group were significantly lower than those in the normal control group [SV (μL): 78.43±17.52 vs. 122.61±15.88, LVEF: 0.763±0.018 vs. 0.902±0.011, both P < 0.05]. Left ventricular weight (LVW) in all sepsis groups was increased to different degrees as compared with that in the normal control group, as well as the left ventricular anterior and posterior wall thickness increased in diastole and systole. Compared with the normal control group, the left ventricular posterior wall thickness was increased significantly at the end of diastolic and systolic period in the sepsis 12 hours group, and the left ventricular anterior wall thickness was also increased significantly at the end of diastolic period in the sepsis 48 hours group. The serum levels of TNF-α, IL-1β and CK-MB in sepsis rats were increased first and then decreased with the extension of model making time. The above parameters in the sepsis 48 hours group were still significantly higher than those in the normal control group [TNF-α (ng/L): 61.59±3.99 vs. 16.87±4.89, IL-1β (ng/L): 255.03±13.23 vs. 119.59±10.43, CK-MB (μg/L): 1.27±0.15 vs. 0.52±0.15, all P < 0.05]. HE staining showed that the myocardial striations of the rats in the normal control group were clear and complete, with normal morphology and orderly arrangement of cardiac cells. However in the sepsis groups, myocardial cells were swollen, ruptured and necrotic, and inflammatory cells were infiltrated, with myocardial fibers ruptured and necrosis dissolved, and the above pathological manifestations gradually increased with the extension of the model making time.
		                        		
		                        			CONCLUSIONS
		                        			High-resolution ultrasound can evaluate the cardiac function of CLP induced sepsis rat model more comprehensive, and the consequence of evaluation index is consistent with the expression level of myocardial enzyme and histopathologic manifestations.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Cecum
		                        			;
		                        		
		                        			Heart/physiopathology*
		                        			;
		                        		
		                        			Heart Function Tests
		                        			;
		                        		
		                        			Ligation
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Punctures
		                        			;
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Sepsis
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha
		                        			;
		                        		
		                        			Ultrasonography
		                        			
		                        		
		                        	
4.Cardiac function associated with home ventilator care in Duchenne muscular dystrophy
Sangheun LEE ; Heeyoung LEE ; Lucy Youngmin EUN ; Seung Woong GANG
Korean Journal of Pediatrics 2018;61(2):59-63
		                        		
		                        			
		                        			PURPOSE: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. METHODS: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. RESULTS: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older (16.25±1.85 years) than those in the nonventilator group (14.73±1.36 years) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity (1,038±620.41 mL) than the nonventilator group (1,455±603.12 mL). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio (1.7±0.44) was lower in the home ventilator group than in the nonventilator group (2.02±0.62). The mitral valve annular systolic velocity was higher in the home ventilator group (estimated β, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. CONCLUSION: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.
		                        		
		                        		
		                        		
		                        			Body Surface Area
		                        			;
		                        		
		                        			Cardiomyopathies
		                        			;
		                        		
		                        			Cause of Death
		                        			;
		                        		
		                        			Cough
		                        			;
		                        		
		                        			Echocardiography
		                        			;
		                        		
		                        			Heart Function Tests
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung
		                        			;
		                        		
		                        			Mitral Valve
		                        			;
		                        		
		                        			Muscular Dystrophy, Duchenne
		                        			;
		                        		
		                        			Noninvasive Ventilation
		                        			;
		                        		
		                        			Oxygen
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Stroke Volume
		                        			;
		                        		
		                        			Ventilation
		                        			;
		                        		
		                        			Ventilators, Mechanical
		                        			;
		                        		
		                        			Vital Capacity
		                        			
		                        		
		                        	
5.Additive Benefits of Twice Forest Bathing Trips in Elderly Patients with Chronic Heart Failure.
Gen Xiang MAO ; Yong Bao CAO ; Yan YANG ; Zhuo Mei CHEN ; Jian Hua DONG ; Sha Sha CHEN ; Qing WU ; Xiao Ling LYU ; Bing Bing JIA ; Jing YAN ; Guo Fu WANG
Biomedical and Environmental Sciences 2018;31(2):159-162
		                        		
		                        			
		                        			Chronic heart failure (CHF), a clinical syndrome resulting from the consequences of various cardiovascular diseases (CVDs), is increasingly becoming a global cause of morbidity and mortality. We had earlier demonstrated that a 4-day forest bathing trip can provide an adjunctive therapeutic influence on patients with CHF. To further investigate the duration of the impact and the optimal frequency of forest bathing trips in patients with CHF, we recruited those subjects who had experienced the first forest bathing trip again after 4 weeks and randomly categorized them into two groups, namely, the urban control group (city) and the forest bathing group (forest). After a second 4-day forest bathing trip, we observed a steady decline in the brain natriuretic peptide levels, a biomarker of heart failure, and an attenuated inflammatory response as well as oxidative stress. Thus, this exploratory study demonstrated the additive benefits of twice forest bathing trips in elderly patients with CHF, which could further pave the way for analyzing the effects of such interventions in CVDs.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Chronic Disease
		                        			;
		                        		
		                        			Complementary Therapies
		                        			;
		                        		
		                        			methods
		                        			;
		                        		
		                        			Forests
		                        			;
		                        		
		                        			Heart Failure
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			therapy
		                        			;
		                        		
		                        			Heart Function Tests
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interleukin-6
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Natriuretic Peptide, Brain
		                        			;
		                        		
		                        			blood
		                        			;
		                        		
		                        			Oxidative Stress
		                        			;
		                        		
		                        			Recreation
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha
		                        			;
		                        		
		                        			blood
		                        			
		                        		
		                        	
6.Impact of Ambulatory Blood Pressure on Early Cardiac and Renal Dysfunction in Hypertensive Patients without Clinically Apparent Target Organ Damage.
Darae KIM ; Chi Young SHIM ; Geu Ru HONG ; Sungha PARK ; In Jeong CHO ; Hyuk Jae CHANG ; Jong Won HA ; Namsik CHUNG
Yonsei Medical Journal 2018;59(2):265-272
		                        		
		                        			
		                        			PURPOSE: Impaired left ventricular (LV) global longitudinal strain (GLS) and the presence of microalbuminuria indicate early cardiac and renal dysfunction. We aimed to determine the relationships among 24-h ambulatory blood pressure (BP) variables, LV GLS, and urine albumin creatinine ratio (UACR) in hypertensive patients. MATERIALS AND METHODS: A total of 130 hypertensive patients (mean age 53 years; 59 men) underwent 24-h ambulatory BP monitoring, measurements of peripheral and central BPs, and transthoracic echocardiography. Patients with apparent LV systolic dysfunction (LV ejection fraction < 50%) or chronic kidney disease were not included. LV GLS was calculated using two-dimensional speckle tracking, and UACR was analyzed from spot urine samples. RESULTS: In simple correlation analysis, LV GLS showed the most significant correlation with mean daytime diastolic BP (DBP) (r=0.427, p < 0.001) among the various BP variables analyzed. UACR revealed a significant correlation only with night-time mean systolic BP (SBP) (r=0.253, p=0.019). In multiple regression analysis, daytime mean DBP and night-time mean SBP were independent determinants for LV GLS (β=0.35, p=0.028) and log UACR (β=0.49, p=0.007), respectively, after controlling for confounding factors. Daytime mean DBP showed better diagnostic performance for impaired LV GLS than did peripheral or central DBPs, which were not diagnostic. Night-time mean SBP showed satisfactory diagnostic performance for microalbuminuria. CONCLUSION: There are different associations for daytime and night-time BP with early cardiac and renal dysfunction. Ambulatory BP monitoring provides more relevant BP parameters than do peripheral or central BPs regarding early cardiac and renal dysfunction in hypertensive patients.
		                        		
		                        		
		                        		
		                        			Blood Pressure/physiology
		                        			;
		                        		
		                        			*Blood Pressure Monitoring, Ambulatory
		                        			;
		                        		
		                        			Echocardiography
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Heart/*physiopathology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypertension/diagnostic imaging/*physiopathology
		                        			;
		                        		
		                        			Kidney/*physiopathology
		                        			;
		                        		
		                        			Kidney Function Tests
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Regression Analysis
		                        			;
		                        		
		                        			Systole/physiology
		                        			;
		                        		
		                        			Ventricular Dysfunction, Left/physiopathology
		                        			;
		                        		
		                        			Ventricular Function, Left/physiology
		                        			
		                        		
		                        	
7.Association of Time to First Morning Cigarette and Chronic Obstructive Pulmonary Disease Measured by Spirometry in Current Smokers.
Geonhyeok KIM ; Hongji SONG ; Kyunghee PARK ; Hyemi NOH ; Eunyoung LEE ; Hyoeun LEE ; Hayoon KIM ; Yujin PAEK
Korean Journal of Family Medicine 2018;39(2):67-73
		                        		
		                        			
		                        			BACKGROUND: Time to first cigarette after waking is an indicator of nicotine dependence. We aimed to identify the association between time to first cigarette and spirometry-proven obstructive respiratory impairment, especially chronic obstructive pulmonary disease, in current smokers. METHODS: We included 392 subjects who visited the comprehensive medical examination center of Hallym University Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were excluded. Obstructive pulmonary impairment was defined as < 70% of the predicted value of forced expiratory volume in 1 second/forced vital capacity. Subjects were classified into the early (≤30 minutes) and late (>30 minutes) groups based on the time to first cigarette. Logistic regression and linear regression analyses were used for data analysis. RESULTS: Ninety-eight subjects (25%) were classified into the early group. After adjusting for smoking behaviors (cigarettes per day and smoking duration), socioeconomic status (education and income), age, and physical activity, an early time to first cigarette was found to be associated with an increased risk of obstructive pulmonary impairment measured using spirometry (adjusted odds ratio, 2.84; 95% confidence interval, 1.22–6.61). CONCLUSION: Compared to current smokers with a late time to first cigarette, those with an early time to first cigarette had a higher risk of obstructive pulmonary impairment, especially chronic obstructive pulmonary disease. Classifying smoking-related behaviors, especially time to first cigarette, may help target clinical screening for chronic obstructive pulmonary disease.
		                        		
		                        		
		                        		
		                        			Anemia
		                        			;
		                        		
		                        			Forced Expiratory Volume
		                        			;
		                        		
		                        			Heart
		                        			;
		                        		
		                        			Linear Models
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Lung Diseases
		                        			;
		                        		
		                        			Mass Screening
		                        			;
		                        		
		                        			Motor Activity
		                        			;
		                        		
		                        			Odds Ratio
		                        			;
		                        		
		                        			Pulmonary Disease, Chronic Obstructive*
		                        			;
		                        		
		                        			Respiratory Function Tests
		                        			;
		                        		
		                        			Smoke
		                        			;
		                        		
		                        			Smoking
		                        			;
		                        		
		                        			Social Class
		                        			;
		                        		
		                        			Spirometry*
		                        			;
		                        		
		                        			Statistics as Topic
		                        			;
		                        		
		                        			Tobacco Products*
		                        			;
		                        		
		                        			Tobacco Use Disorder
		                        			;
		                        		
		                        			Vital Capacity
		                        			
		                        		
		                        	
8.Pulmonary Hypertension in Connective Tissue Disease is Associated with the New York Heart Association Functional Class and Forced Vital Capacity, But Not with Interstitial Lung Disease.
Ju Yang JUNG ; Chan Hee LEE ; Hyoun Ah KIM ; Sang Tae CHOI ; Joo Hyun LEE ; Bo Young YOON ; Dae Ryong KANG ; Chang Hee SUH
Journal of Rheumatic Diseases 2018;25(3):179-187
		                        		
		                        			
		                        			OBJECTIVE: Pulmonary hypertension (PH) develops frequently in connective tissue diseases (CTD) and is an important prognostic factor. The aim of this study was to assess the prevalence of PH in patients with CTD by non-invasive echocardiography and analyze the potential biomarkers for helping to detect PH. METHODS: All Korean patients with CTD who had dyspnea on exertion or interstitial lung disease (ILD) were screened for PH with echocardiography and clinical data were collected from four hospitals. RESULTS: Among 196 patients with CTD, 108 (55.1%) had ILD and 21 had PH defined as >40 mmHg. Of the 21 patients with PH, 10, 4, and 3 patients had systemic sclerosis, systemic lupus erythematosus, and mixed connective tissue disease, respectively. There was no difference in the incidence of PH according to the presence of ILD; 12 patients (11.1%) with ILD had PH and 9 patients (10.2%) without ILD had PH. The results of the pulmonary function test, total cholesterol, red cell volume distribution width, alkaline phosphatase, and the New York Heart Association (NYHA) functional class III or IV differed significantly according to the presence of PH. In multiple regression analysis, NYHA functional class III or IV (odd ratio [OR]=7.3, p=0.009) and forced vital capacity (OR=0.97, p=0.043) were independent predictive factors of PH. CONCLUSION: PH is not associated with the presence of ILD in Korean patients with CTD. On the other hand, NYHA functional class III or IV and decreased forced vital capacity indicate the presence of PH in connective tissue disease.
		                        		
		                        		
		                        		
		                        			Alkaline Phosphatase
		                        			;
		                        		
		                        			Biomarkers
		                        			;
		                        		
		                        			Cell Size
		                        			;
		                        		
		                        			Cholesterol
		                        			;
		                        		
		                        			Connective Tissue Diseases*
		                        			;
		                        		
		                        			Connective Tissue*
		                        			;
		                        		
		                        			Dyspnea
		                        			;
		                        		
		                        			Echocardiography
		                        			;
		                        		
		                        			Hand
		                        			;
		                        		
		                        			Heart*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrogen-Ion Concentration
		                        			;
		                        		
		                        			Hypertension, Pulmonary*
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Lung Diseases, Interstitial*
		                        			;
		                        		
		                        			Lupus Erythematosus, Systemic
		                        			;
		                        		
		                        			Mixed Connective Tissue Disease
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Respiratory Function Tests
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Scleroderma, Systemic
		                        			;
		                        		
		                        			Vital Capacity*
		                        			
		                        		
		                        	
9.The Effect of a Telephone-Based Self-management Program Led by Nurses on Self-care Behavior, Biological Index for Cardiac Function, and Depression in Ambulatory Heart Failure Patients.
Mi Kyoung MOON ; JongEun YIM ; Mi Yang JEON
Asian Nursing Research 2018;12(4):251-257
		                        		
		                        			
		                        			PURPOSE: This study was conducted to examine the effects of a telephone-based self-management support program led by nurses on self-care behavior, biological index for cardiac function, and depression. METHODS: This study is a quasi-experiment in nonequivalent control group design. Thirty-eight heart failure patients underwent medical treatment at the hospital (18 heart failure patients in the experimental group and 20 heart failure patients in the control group). The experimental group (n = 18) received the telephone-based self-management support program, which included a 30-minute face-to-face education session and four telephone consultation and education sessions. The face-to-face education session was conducted at the first visit to the outpatient clinic. Thereafter, weekly telephone consultations and education sessions were performed for 4 weeks. Data were analyzed using descriptive statistics, Chi-square test, Fisher's exact test, independent t test, paired t test, and repeated measures analysis of variance using the SPSS/WIN 21.0. RESULTS: The participants in the experimental group showed significantly increased self-care behavior scores (t = 6.65, p < .001), decreased N-terminal pro-brain natriuretic peptide level (U= −2.28, p = .022), improved left ventricular ejection fraction values (t = 2.24, p = .032), and decreased depression scores (t = −3.49, p = .001) compared with the control group. CONCLUSION: The findings indicate that the telephone-based self-management program is an effective intervention to improve self-management in heart failure patients.
		                        		
		                        		
		                        		
		                        			Ambulatory Care Facilities
		                        			;
		                        		
		                        			Depression*
		                        			;
		                        		
		                        			Education
		                        			;
		                        		
		                        			Heart Failure*
		                        			;
		                        		
		                        			Heart Function Tests
		                        			;
		                        		
		                        			Heart*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Referral and Consultation
		                        			;
		                        		
		                        			Self Care*
		                        			;
		                        		
		                        			Stroke Volume
		                        			;
		                        		
		                        			Telephone
		                        			
		                        		
		                        	
10.Isoflurane's Effect on Intraoperative Systolic Left Ventricular Performance in Cardiac Valve Surgery Patients
Ju Deok KIM ; Ilsoon SON ; Won kyoung KWON ; Tae Yun SUNG ; Hanafi SIDIK ; Karam KIM ; Hyun KANG ; Jiyon BANG ; Gwi Eun YEO ; Dong Kyu LEE ; Tae Yop KIM
Journal of Korean Medical Science 2018;33(4):e28-
		                        		
		                        			
		                        			BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S′) in patients undergoing cardiac surgery. METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S′ at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. RESULTS: Mean S′ values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8–12.2), 9.5 (8.3–10.8), and 8.4 (7.3–9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were −1.0 (−1.6, −0.3), −1.1 (−1.7, −0.6), and −2.1 (−3.1, −1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). CONCLUSION: Isoflurane increments (1.0–2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.
		                        		
		                        		
		                        		
		                        			Anesthesia
		                        			;
		                        		
		                        			Echocardiography
		                        			;
		                        		
		                        			Echocardiography, Transesophageal
		                        			;
		                        		
		                        			Heart Function Tests
		                        			;
		                        		
		                        			Heart Valves
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Isoflurane
		                        			;
		                        		
		                        			Multivariate Analysis
		                        			;
		                        		
		                        			Phenylephrine
		                        			;
		                        		
		                        			Thoracic Surgery
		                        			
		                        		
		                        	
            
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