1.Treatment Outcomes in Children With Catecholaminergic Polymorphic Ventricular Tachycardia: A Single Institutional Experience
Joowon LEE ; Bo Sang KWON ; Mi Kyoung SONG ; Sang-Yun LEE ; Jung Min KO ; Gi Beom KIM ; Eun Jung BAE
Korean Circulation Journal 2024;54(12):853-864
Background and Objectives:
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a life-threatening inherited arrhythmogenic disorder. Recently, RYR2, the major CPVTcausative gene, was associated with neuropsychiatric manifestations. We aimed to analyze the clinical presentations, neuropsychiatric manifestations, and treatment outcomes of children with CPVT.
Methods:
We retrospectively reviewed 23 patients diagnosed with CPVT before 19 years of age. Genetic analysis, history of neuropsychiatric manifestations, changes in ventricular arrhythmia burden before and after treatment, occurrence of cardiac events, and overall survival (OS) were investigated.
Results:
RYR2 variants were identified in 17 patients, and 14 were classified as pathogenic or likely pathogenic. Neuropsychiatric manifestations, including intellectual disability and attention deficit hyperactivity disorder, were identified in 10 patients (43.5%). The 5-year cardiac event-free survival rate was 31.2%, and the 10-year OS rate was 73.1%. Patients diagnosed since 2009 had a higher cardiac event-free survival rate than those diagnosed before 2009 (p=0.0028).Combined beta-blocker and flecainide therapy demonstrated a lower risk of cardiac events than beta-blocker monotherapy (hazard ratio [HR], 0.08; 95% confidence interval [CI], 0.02–0.38;p=0.002). Left cardiac sympathetic denervation (LCSD) reduced the ventricular arrhythmia burden in Holter monitoring. Occurrence of near-fatal cardiac events after diagnosis was an independent predictor of death (HR, 33.40; 95% CI, 6.23–179.95; p<0.001).
Conclusions
Neuropsychiatric manifestations are common in children with CPVT. Flecainide and/or LCSD, when added to beta-blocker therapy, reduce the ventricular arrhythmia burden and cardiac events, thereby improving treatment outcomes in recent years.
2.Predictive Factors and Prognostic Relevance of Sunitinib-induced Subclinical and Overt Hypothyroidism in Korean Patients with Metastatic Renal Cell Carcinoma
Minoh KO ; Hyun Jee KIM ; In-Wha KIM ; Tae Min KIM ; Jung Mi OH
Korean Journal of Clinical Pharmacy 2024;34(3):184-193
Background:
Sunitinib, commonly used for metastatic renal cell carcinoma (mRCC), often induces hypothyroidism, affecting 27 to85% of patients. There are clues suggesting an association between sunitinib-induced hypothyroidism and improved survival outcomes. This study aims to identify the predictive factors of sunitinib-induced hypothyroidism and evaluate whether the occurrence of overt or subclinical hypothyroidism predicts tumor outcome in patients with mRCC.
Methods:
Patients administered to sunitinib for mRCC was included in this retrospective study. Log-rank test and Cox proportional hazards model were conducted to identify predictive factors of hypothyroidism and prognostic factors of progression-free survival (PFS) and overall survival (OS).
Results:
A total of 156 patients with mRCC treated with sunitinib were included. Predictive factors of sunitinib-induced hypothyroidism werefemale (odds ratio (OR), 2.77), sunitinib-induced hypertension (OR, 2.99) and dose reduction of sunitinib due to intolerance (OR, 3.57). Sunitinib-induced overt hypothyroidism was a significant prognostic factor in predicting PFS and OS (hazard ratio, 0.38 and 0.23, respectively). Thyroid hormone replacement did not have an influence on PFS and OS.
Conclusions
Female patients, patients who experienced sunitinib-induced hypertension and sunitinib dose reduction are at higher risk of hypothyroidism and need close monitoring. Overt hypothyroidism is a strong prognostic factor of sunitinib treatment outcome in mRCC patients and thyroid hor-mone replacement does not have a negative effect on tumor outcome.
3.Treatment Outcomes in Children With Catecholaminergic Polymorphic Ventricular Tachycardia: A Single Institutional Experience
Joowon LEE ; Bo Sang KWON ; Mi Kyoung SONG ; Sang-Yun LEE ; Jung Min KO ; Gi Beom KIM ; Eun Jung BAE
Korean Circulation Journal 2024;54(12):853-864
Background and Objectives:
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a life-threatening inherited arrhythmogenic disorder. Recently, RYR2, the major CPVTcausative gene, was associated with neuropsychiatric manifestations. We aimed to analyze the clinical presentations, neuropsychiatric manifestations, and treatment outcomes of children with CPVT.
Methods:
We retrospectively reviewed 23 patients diagnosed with CPVT before 19 years of age. Genetic analysis, history of neuropsychiatric manifestations, changes in ventricular arrhythmia burden before and after treatment, occurrence of cardiac events, and overall survival (OS) were investigated.
Results:
RYR2 variants were identified in 17 patients, and 14 were classified as pathogenic or likely pathogenic. Neuropsychiatric manifestations, including intellectual disability and attention deficit hyperactivity disorder, were identified in 10 patients (43.5%). The 5-year cardiac event-free survival rate was 31.2%, and the 10-year OS rate was 73.1%. Patients diagnosed since 2009 had a higher cardiac event-free survival rate than those diagnosed before 2009 (p=0.0028).Combined beta-blocker and flecainide therapy demonstrated a lower risk of cardiac events than beta-blocker monotherapy (hazard ratio [HR], 0.08; 95% confidence interval [CI], 0.02–0.38;p=0.002). Left cardiac sympathetic denervation (LCSD) reduced the ventricular arrhythmia burden in Holter monitoring. Occurrence of near-fatal cardiac events after diagnosis was an independent predictor of death (HR, 33.40; 95% CI, 6.23–179.95; p<0.001).
Conclusions
Neuropsychiatric manifestations are common in children with CPVT. Flecainide and/or LCSD, when added to beta-blocker therapy, reduce the ventricular arrhythmia burden and cardiac events, thereby improving treatment outcomes in recent years.
4.Predictive Factors and Prognostic Relevance of Sunitinib-induced Subclinical and Overt Hypothyroidism in Korean Patients with Metastatic Renal Cell Carcinoma
Minoh KO ; Hyun Jee KIM ; In-Wha KIM ; Tae Min KIM ; Jung Mi OH
Korean Journal of Clinical Pharmacy 2024;34(3):184-193
Background:
Sunitinib, commonly used for metastatic renal cell carcinoma (mRCC), often induces hypothyroidism, affecting 27 to85% of patients. There are clues suggesting an association between sunitinib-induced hypothyroidism and improved survival outcomes. This study aims to identify the predictive factors of sunitinib-induced hypothyroidism and evaluate whether the occurrence of overt or subclinical hypothyroidism predicts tumor outcome in patients with mRCC.
Methods:
Patients administered to sunitinib for mRCC was included in this retrospective study. Log-rank test and Cox proportional hazards model were conducted to identify predictive factors of hypothyroidism and prognostic factors of progression-free survival (PFS) and overall survival (OS).
Results:
A total of 156 patients with mRCC treated with sunitinib were included. Predictive factors of sunitinib-induced hypothyroidism werefemale (odds ratio (OR), 2.77), sunitinib-induced hypertension (OR, 2.99) and dose reduction of sunitinib due to intolerance (OR, 3.57). Sunitinib-induced overt hypothyroidism was a significant prognostic factor in predicting PFS and OS (hazard ratio, 0.38 and 0.23, respectively). Thyroid hormone replacement did not have an influence on PFS and OS.
Conclusions
Female patients, patients who experienced sunitinib-induced hypertension and sunitinib dose reduction are at higher risk of hypothyroidism and need close monitoring. Overt hypothyroidism is a strong prognostic factor of sunitinib treatment outcome in mRCC patients and thyroid hor-mone replacement does not have a negative effect on tumor outcome.
5.Evaluation of Burnout and Contributing Factors in Imaging Cardiologists in Korea
You-Jung CHOI ; Kang-Un CHOI ; Young-Mee LEE ; Hyun-Jung LEE ; Inki MOON ; Jiwon SEO ; Kyu KIM ; So Ree KIM ; Jihoon KIM ; Hong-Mi CHOI ; Seo-Yeon GWAK ; Minkwan KIM ; Minjeong KIM ; Kyu-Yong KO ; Jin Kyung OH ; Jah Yeon CHOI ; Dong-Hyuk CHO ; On behalf of the Korean Society of Echocardiography Heart Imagers of Tomorrow
Journal of Korean Medical Science 2024;40(5):e21-
Background:
We aimed to examine the prevalence of burnout among imaging cardiologists in Korea and to identify its associated factors.
Methods:
An online survey of imaging cardiologists affiliated with university hospitals in Korea was conducted using SurveyMonkey ® in November 2023. The validated Korean version of the Maslach Burnout Inventory-Human Service Survey was used to assess burnout across three dimensions: emotional exhaustion, depersonalization, and lack of personal accomplishment. Data on demographics, work environment factors, and job satisfaction were collected using structured questionnaires.
Results:
A total of 128 imaging cardiologists (46.1% men; 76.6% aged ≤ 50 years) participated in the survey. Regarding workload, 74.2% of the respondents interpreted over 50 echocardiographic examinations daily, and 53.2% allocated > 5 of 10 working sessions per week to echocardiographic laboratory duties. Burnout levels were high, with a significant proportion of participants experiencing emotional exhaustion (28.1%), depersonalization (63.3%), and a lack of personal accomplishment (92.2%). Younger age (< 50 years) was correlated with higher emotional exhaustion risk, while more research time was protective against burnout in the depersonalization domain. Factors, such as being single, living with family, and specific job satisfaction facets, including uncontrollable workload and value mismatch, were associated with varying levels of burnout risk across different dimensions
Conclusion
Our study underscores the high burnout rates among Korean imaging cardiologists, attributed to factors such as the subjective environment and job satisfaction.Hence, evaluating and supporting cardiologists in terms of individual values and subjective factors are important to effectively prevent burnout..
6.Evaluation of Burnout and Contributing Factors in Imaging Cardiologists in Korea
You-Jung CHOI ; Kang-Un CHOI ; Young-Mee LEE ; Hyun-Jung LEE ; Inki MOON ; Jiwon SEO ; Kyu KIM ; So Ree KIM ; Jihoon KIM ; Hong-Mi CHOI ; Seo-Yeon GWAK ; Minkwan KIM ; Minjeong KIM ; Kyu-Yong KO ; Jin Kyung OH ; Jah Yeon CHOI ; Dong-Hyuk CHO ; On behalf of the Korean Society of Echocardiography Heart Imagers of Tomorrow
Journal of Korean Medical Science 2024;40(5):e21-
Background:
We aimed to examine the prevalence of burnout among imaging cardiologists in Korea and to identify its associated factors.
Methods:
An online survey of imaging cardiologists affiliated with university hospitals in Korea was conducted using SurveyMonkey ® in November 2023. The validated Korean version of the Maslach Burnout Inventory-Human Service Survey was used to assess burnout across three dimensions: emotional exhaustion, depersonalization, and lack of personal accomplishment. Data on demographics, work environment factors, and job satisfaction were collected using structured questionnaires.
Results:
A total of 128 imaging cardiologists (46.1% men; 76.6% aged ≤ 50 years) participated in the survey. Regarding workload, 74.2% of the respondents interpreted over 50 echocardiographic examinations daily, and 53.2% allocated > 5 of 10 working sessions per week to echocardiographic laboratory duties. Burnout levels were high, with a significant proportion of participants experiencing emotional exhaustion (28.1%), depersonalization (63.3%), and a lack of personal accomplishment (92.2%). Younger age (< 50 years) was correlated with higher emotional exhaustion risk, while more research time was protective against burnout in the depersonalization domain. Factors, such as being single, living with family, and specific job satisfaction facets, including uncontrollable workload and value mismatch, were associated with varying levels of burnout risk across different dimensions
Conclusion
Our study underscores the high burnout rates among Korean imaging cardiologists, attributed to factors such as the subjective environment and job satisfaction.Hence, evaluating and supporting cardiologists in terms of individual values and subjective factors are important to effectively prevent burnout..
7.Evaluation of Burnout and Contributing Factors in Imaging Cardiologists in Korea
You-Jung CHOI ; Kang-Un CHOI ; Young-Mee LEE ; Hyun-Jung LEE ; Inki MOON ; Jiwon SEO ; Kyu KIM ; So Ree KIM ; Jihoon KIM ; Hong-Mi CHOI ; Seo-Yeon GWAK ; Minkwan KIM ; Minjeong KIM ; Kyu-Yong KO ; Jin Kyung OH ; Jah Yeon CHOI ; Dong-Hyuk CHO ; On behalf of the Korean Society of Echocardiography Heart Imagers of Tomorrow
Journal of Korean Medical Science 2024;40(5):e21-
Background:
We aimed to examine the prevalence of burnout among imaging cardiologists in Korea and to identify its associated factors.
Methods:
An online survey of imaging cardiologists affiliated with university hospitals in Korea was conducted using SurveyMonkey ® in November 2023. The validated Korean version of the Maslach Burnout Inventory-Human Service Survey was used to assess burnout across three dimensions: emotional exhaustion, depersonalization, and lack of personal accomplishment. Data on demographics, work environment factors, and job satisfaction were collected using structured questionnaires.
Results:
A total of 128 imaging cardiologists (46.1% men; 76.6% aged ≤ 50 years) participated in the survey. Regarding workload, 74.2% of the respondents interpreted over 50 echocardiographic examinations daily, and 53.2% allocated > 5 of 10 working sessions per week to echocardiographic laboratory duties. Burnout levels were high, with a significant proportion of participants experiencing emotional exhaustion (28.1%), depersonalization (63.3%), and a lack of personal accomplishment (92.2%). Younger age (< 50 years) was correlated with higher emotional exhaustion risk, while more research time was protective against burnout in the depersonalization domain. Factors, such as being single, living with family, and specific job satisfaction facets, including uncontrollable workload and value mismatch, were associated with varying levels of burnout risk across different dimensions
Conclusion
Our study underscores the high burnout rates among Korean imaging cardiologists, attributed to factors such as the subjective environment and job satisfaction.Hence, evaluating and supporting cardiologists in terms of individual values and subjective factors are important to effectively prevent burnout..
8.Treatment Outcomes in Children With Catecholaminergic Polymorphic Ventricular Tachycardia: A Single Institutional Experience
Joowon LEE ; Bo Sang KWON ; Mi Kyoung SONG ; Sang-Yun LEE ; Jung Min KO ; Gi Beom KIM ; Eun Jung BAE
Korean Circulation Journal 2024;54(12):853-864
Background and Objectives:
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a life-threatening inherited arrhythmogenic disorder. Recently, RYR2, the major CPVTcausative gene, was associated with neuropsychiatric manifestations. We aimed to analyze the clinical presentations, neuropsychiatric manifestations, and treatment outcomes of children with CPVT.
Methods:
We retrospectively reviewed 23 patients diagnosed with CPVT before 19 years of age. Genetic analysis, history of neuropsychiatric manifestations, changes in ventricular arrhythmia burden before and after treatment, occurrence of cardiac events, and overall survival (OS) were investigated.
Results:
RYR2 variants were identified in 17 patients, and 14 were classified as pathogenic or likely pathogenic. Neuropsychiatric manifestations, including intellectual disability and attention deficit hyperactivity disorder, were identified in 10 patients (43.5%). The 5-year cardiac event-free survival rate was 31.2%, and the 10-year OS rate was 73.1%. Patients diagnosed since 2009 had a higher cardiac event-free survival rate than those diagnosed before 2009 (p=0.0028).Combined beta-blocker and flecainide therapy demonstrated a lower risk of cardiac events than beta-blocker monotherapy (hazard ratio [HR], 0.08; 95% confidence interval [CI], 0.02–0.38;p=0.002). Left cardiac sympathetic denervation (LCSD) reduced the ventricular arrhythmia burden in Holter monitoring. Occurrence of near-fatal cardiac events after diagnosis was an independent predictor of death (HR, 33.40; 95% CI, 6.23–179.95; p<0.001).
Conclusions
Neuropsychiatric manifestations are common in children with CPVT. Flecainide and/or LCSD, when added to beta-blocker therapy, reduce the ventricular arrhythmia burden and cardiac events, thereby improving treatment outcomes in recent years.
9.Predictive Factors and Prognostic Relevance of Sunitinib-induced Subclinical and Overt Hypothyroidism in Korean Patients with Metastatic Renal Cell Carcinoma
Minoh KO ; Hyun Jee KIM ; In-Wha KIM ; Tae Min KIM ; Jung Mi OH
Korean Journal of Clinical Pharmacy 2024;34(3):184-193
Background:
Sunitinib, commonly used for metastatic renal cell carcinoma (mRCC), often induces hypothyroidism, affecting 27 to85% of patients. There are clues suggesting an association between sunitinib-induced hypothyroidism and improved survival outcomes. This study aims to identify the predictive factors of sunitinib-induced hypothyroidism and evaluate whether the occurrence of overt or subclinical hypothyroidism predicts tumor outcome in patients with mRCC.
Methods:
Patients administered to sunitinib for mRCC was included in this retrospective study. Log-rank test and Cox proportional hazards model were conducted to identify predictive factors of hypothyroidism and prognostic factors of progression-free survival (PFS) and overall survival (OS).
Results:
A total of 156 patients with mRCC treated with sunitinib were included. Predictive factors of sunitinib-induced hypothyroidism werefemale (odds ratio (OR), 2.77), sunitinib-induced hypertension (OR, 2.99) and dose reduction of sunitinib due to intolerance (OR, 3.57). Sunitinib-induced overt hypothyroidism was a significant prognostic factor in predicting PFS and OS (hazard ratio, 0.38 and 0.23, respectively). Thyroid hormone replacement did not have an influence on PFS and OS.
Conclusions
Female patients, patients who experienced sunitinib-induced hypertension and sunitinib dose reduction are at higher risk of hypothyroidism and need close monitoring. Overt hypothyroidism is a strong prognostic factor of sunitinib treatment outcome in mRCC patients and thyroid hor-mone replacement does not have a negative effect on tumor outcome.
10.Evaluation of Burnout and Contributing Factors in Imaging Cardiologists in Korea
You-Jung CHOI ; Kang-Un CHOI ; Young-Mee LEE ; Hyun-Jung LEE ; Inki MOON ; Jiwon SEO ; Kyu KIM ; So Ree KIM ; Jihoon KIM ; Hong-Mi CHOI ; Seo-Yeon GWAK ; Minkwan KIM ; Minjeong KIM ; Kyu-Yong KO ; Jin Kyung OH ; Jah Yeon CHOI ; Dong-Hyuk CHO ; On behalf of the Korean Society of Echocardiography Heart Imagers of Tomorrow
Journal of Korean Medical Science 2024;40(5):e21-
Background:
We aimed to examine the prevalence of burnout among imaging cardiologists in Korea and to identify its associated factors.
Methods:
An online survey of imaging cardiologists affiliated with university hospitals in Korea was conducted using SurveyMonkey ® in November 2023. The validated Korean version of the Maslach Burnout Inventory-Human Service Survey was used to assess burnout across three dimensions: emotional exhaustion, depersonalization, and lack of personal accomplishment. Data on demographics, work environment factors, and job satisfaction were collected using structured questionnaires.
Results:
A total of 128 imaging cardiologists (46.1% men; 76.6% aged ≤ 50 years) participated in the survey. Regarding workload, 74.2% of the respondents interpreted over 50 echocardiographic examinations daily, and 53.2% allocated > 5 of 10 working sessions per week to echocardiographic laboratory duties. Burnout levels were high, with a significant proportion of participants experiencing emotional exhaustion (28.1%), depersonalization (63.3%), and a lack of personal accomplishment (92.2%). Younger age (< 50 years) was correlated with higher emotional exhaustion risk, while more research time was protective against burnout in the depersonalization domain. Factors, such as being single, living with family, and specific job satisfaction facets, including uncontrollable workload and value mismatch, were associated with varying levels of burnout risk across different dimensions
Conclusion
Our study underscores the high burnout rates among Korean imaging cardiologists, attributed to factors such as the subjective environment and job satisfaction.Hence, evaluating and supporting cardiologists in terms of individual values and subjective factors are important to effectively prevent burnout..

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