1.Predisposing Risk Factors Affecting Reversibility of Left Ventricular Diastolic Filling Pattern in Patients with Preserved Ejection Fraction
Dong-Gil KIM ; Sungsoo CHO ; Seongjin PARK ; Gi Rim KIM ; Kyu-Yong KO ; Sung Eun KIM ; Ji-won HWANG ; Joon-Hyung DOH ; Sung Uk KWON ; Jae-Jin KWAK ; June NAMGUNG ; Sung Woo CHO
Yonsei Medical Journal 2025;66(1):1-8
Purpose:
Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF.
Materials and Methods:
A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020. We compared their index and follow-up echocardiography findings and determined the predisposing risk factor affecting the reversibility of LVDFP.
Results:
Comparing the index and follow-up echocardiography findings showed that 379 (63%) patients had improved to normal or impaired relaxation LVDFP (improved group) and 221 (37%) patients had maintained or worsened LVDFP (unimproved group).The incidence of paroxysmal atrial fibrillation (PAF) was significantly higher in the unimproved group than in the improved group (4.7% vs. 9.5%, p=0.026). After adjustment for relevant clinical risk factors of diastolic dysfunction, PAF was determined to be an independent predisposing risk factor for the unimproved LVDFP (odds ratio: 2.10, 95% confidence interval: 1.06–4.15, p=0.033).Among the parameters of diastolic dysfunction in follow-up echocardiography, the left atrial volume index, mean E/A ratio, and E/e' were significantly improved in patients without PAF but remained in patients with PAF.
Conclusion
We identified that PAF was an independent predisposing risk factor of the unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF. Therefore, early detection and management of PAF might be required in patients with LVDD and preserved EF to prevent adverse cardiovascular events.
2.Predisposing Risk Factors Affecting Reversibility of Left Ventricular Diastolic Filling Pattern in Patients with Preserved Ejection Fraction
Dong-Gil KIM ; Sungsoo CHO ; Seongjin PARK ; Gi Rim KIM ; Kyu-Yong KO ; Sung Eun KIM ; Ji-won HWANG ; Joon-Hyung DOH ; Sung Uk KWON ; Jae-Jin KWAK ; June NAMGUNG ; Sung Woo CHO
Yonsei Medical Journal 2025;66(1):1-8
Purpose:
Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF.
Materials and Methods:
A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020. We compared their index and follow-up echocardiography findings and determined the predisposing risk factor affecting the reversibility of LVDFP.
Results:
Comparing the index and follow-up echocardiography findings showed that 379 (63%) patients had improved to normal or impaired relaxation LVDFP (improved group) and 221 (37%) patients had maintained or worsened LVDFP (unimproved group).The incidence of paroxysmal atrial fibrillation (PAF) was significantly higher in the unimproved group than in the improved group (4.7% vs. 9.5%, p=0.026). After adjustment for relevant clinical risk factors of diastolic dysfunction, PAF was determined to be an independent predisposing risk factor for the unimproved LVDFP (odds ratio: 2.10, 95% confidence interval: 1.06–4.15, p=0.033).Among the parameters of diastolic dysfunction in follow-up echocardiography, the left atrial volume index, mean E/A ratio, and E/e' were significantly improved in patients without PAF but remained in patients with PAF.
Conclusion
We identified that PAF was an independent predisposing risk factor of the unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF. Therefore, early detection and management of PAF might be required in patients with LVDD and preserved EF to prevent adverse cardiovascular events.
3.Predisposing Risk Factors Affecting Reversibility of Left Ventricular Diastolic Filling Pattern in Patients with Preserved Ejection Fraction
Dong-Gil KIM ; Sungsoo CHO ; Seongjin PARK ; Gi Rim KIM ; Kyu-Yong KO ; Sung Eun KIM ; Ji-won HWANG ; Joon-Hyung DOH ; Sung Uk KWON ; Jae-Jin KWAK ; June NAMGUNG ; Sung Woo CHO
Yonsei Medical Journal 2025;66(1):1-8
Purpose:
Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF.
Materials and Methods:
A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020. We compared their index and follow-up echocardiography findings and determined the predisposing risk factor affecting the reversibility of LVDFP.
Results:
Comparing the index and follow-up echocardiography findings showed that 379 (63%) patients had improved to normal or impaired relaxation LVDFP (improved group) and 221 (37%) patients had maintained or worsened LVDFP (unimproved group).The incidence of paroxysmal atrial fibrillation (PAF) was significantly higher in the unimproved group than in the improved group (4.7% vs. 9.5%, p=0.026). After adjustment for relevant clinical risk factors of diastolic dysfunction, PAF was determined to be an independent predisposing risk factor for the unimproved LVDFP (odds ratio: 2.10, 95% confidence interval: 1.06–4.15, p=0.033).Among the parameters of diastolic dysfunction in follow-up echocardiography, the left atrial volume index, mean E/A ratio, and E/e' were significantly improved in patients without PAF but remained in patients with PAF.
Conclusion
We identified that PAF was an independent predisposing risk factor of the unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF. Therefore, early detection and management of PAF might be required in patients with LVDD and preserved EF to prevent adverse cardiovascular events.
4.Post-Cardiac Injury Syndrome in End Stage Renal Disease Hemodialysis Patient After Percutaneous Coronary Intervention for Non-ST Elevated Myocardial Infarction
Taesun KIM ; Kyu Yong KO ; Ji Won HWANG ; Sung Woo CHO ; Sung Eun KIM
Cardiovascular Imaging Asia 2025;9(2):15-18
Post-cardiac injury syndrome (PCIS) is an uncommon complication arising from pericardial and myocardial damage, encompassing post-cardiac surgery, percutaneous intervention (PCI) for acute coronary syndrome, cardiac device implantation, and radiofrequency ablation. The etiology of PCIS is not clearly defined, with approximately 50% of cases remaining idiopathic.Manifestations and symptoms of PCIS vary significantly among patients. Herein, we report a rare case of a 62-year-old male with PCIS that occurred after PCI for non-ST elevation myocardial infarction in an end-stage renal disease (ESRD) hemodialysis (HD) patient. He suddenly developed chest pain, fever, low blood pressure, cold sweating, tachycardia, desaturation and cardiac tamponade with cardiogenic shock after one week of PCI. After emergency pericardiocentesis, he was able to come out of cardiogenic shock. Ultimately, his clinical symptoms improved further with concurrent long-term medical treatment such as non-steroidal anti-inflammatory drugs and colchicine. This case illustrates a rare and unusual case of a relatively subacute onset PCIS in an ESRD patient on HD following emergency PCI. Although pericardial effusion is commonly detected in ESRD patients on HD, cardiologist should not overlook PCIS in dialysis patients, given the potential resemblance to uremic pericarditis or effusion. In addition, imaging modality such as transthoracic echocardiography has significantly important roles in case of urgent situation in order to make differential diagnosis as like this case.
5.Predisposing Risk Factors Affecting Reversibility of Left Ventricular Diastolic Filling Pattern in Patients with Preserved Ejection Fraction
Dong-Gil KIM ; Sungsoo CHO ; Seongjin PARK ; Gi Rim KIM ; Kyu-Yong KO ; Sung Eun KIM ; Ji-won HWANG ; Joon-Hyung DOH ; Sung Uk KWON ; Jae-Jin KWAK ; June NAMGUNG ; Sung Woo CHO
Yonsei Medical Journal 2025;66(1):1-8
Purpose:
Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF.
Materials and Methods:
A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020. We compared their index and follow-up echocardiography findings and determined the predisposing risk factor affecting the reversibility of LVDFP.
Results:
Comparing the index and follow-up echocardiography findings showed that 379 (63%) patients had improved to normal or impaired relaxation LVDFP (improved group) and 221 (37%) patients had maintained or worsened LVDFP (unimproved group).The incidence of paroxysmal atrial fibrillation (PAF) was significantly higher in the unimproved group than in the improved group (4.7% vs. 9.5%, p=0.026). After adjustment for relevant clinical risk factors of diastolic dysfunction, PAF was determined to be an independent predisposing risk factor for the unimproved LVDFP (odds ratio: 2.10, 95% confidence interval: 1.06–4.15, p=0.033).Among the parameters of diastolic dysfunction in follow-up echocardiography, the left atrial volume index, mean E/A ratio, and E/e' were significantly improved in patients without PAF but remained in patients with PAF.
Conclusion
We identified that PAF was an independent predisposing risk factor of the unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF. Therefore, early detection and management of PAF might be required in patients with LVDD and preserved EF to prevent adverse cardiovascular events.
6.Predisposing Risk Factors Affecting Reversibility of Left Ventricular Diastolic Filling Pattern in Patients with Preserved Ejection Fraction
Dong-Gil KIM ; Sungsoo CHO ; Seongjin PARK ; Gi Rim KIM ; Kyu-Yong KO ; Sung Eun KIM ; Ji-won HWANG ; Joon-Hyung DOH ; Sung Uk KWON ; Jae-Jin KWAK ; June NAMGUNG ; Sung Woo CHO
Yonsei Medical Journal 2025;66(1):1-8
Purpose:
Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF.
Materials and Methods:
A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020. We compared their index and follow-up echocardiography findings and determined the predisposing risk factor affecting the reversibility of LVDFP.
Results:
Comparing the index and follow-up echocardiography findings showed that 379 (63%) patients had improved to normal or impaired relaxation LVDFP (improved group) and 221 (37%) patients had maintained or worsened LVDFP (unimproved group).The incidence of paroxysmal atrial fibrillation (PAF) was significantly higher in the unimproved group than in the improved group (4.7% vs. 9.5%, p=0.026). After adjustment for relevant clinical risk factors of diastolic dysfunction, PAF was determined to be an independent predisposing risk factor for the unimproved LVDFP (odds ratio: 2.10, 95% confidence interval: 1.06–4.15, p=0.033).Among the parameters of diastolic dysfunction in follow-up echocardiography, the left atrial volume index, mean E/A ratio, and E/e' were significantly improved in patients without PAF but remained in patients with PAF.
Conclusion
We identified that PAF was an independent predisposing risk factor of the unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF. Therefore, early detection and management of PAF might be required in patients with LVDD and preserved EF to prevent adverse cardiovascular events.
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.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..
9.The Crucial Role of Repeated Pre-Operative Echocardiography in Detecting Spontaneous Resolution of Infective Endocarditis in a Patient With Multiple Strokes
Gi Rim KIM ; Kyu-Yong KO ; Sung Eun KIM ; Ji-Won HWANG ; Jae-Jin KWAK ; Sung Woo CHO
Cardiovascular Imaging Asia 2024;8(3):57-60
We present a case study of a 40-year-old man diagnosed with infective endocarditis (IE) who was admitted with fever and multiple cerebral infarctions. Echocardiography identified a 2.2× 1.7-cm-sized mass attached to the endocardium of the left ventricle and chordae of the mitral valve. Fulfilling the Duke criteria for definite IE, he was started on intravenous antibiotics.Despite uncompromised valve function, the potential risk of further embolization necessitated planned open-heart surgery. Yet, follow-up echocardiography just prior to surgery surprisingly showed that the vegetation had resolved, leading to cancellation of the planned surgery. After one month of antibiotic treatment, the patient was discharged without any issues.This case emphasizes the critical role of a final echocardiographic assessment before surgery in an IE patient, as it may prevent unnecessary surgical intervention.
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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