Korean Circulation Journal最新文献

{"title":"Enhancing Familial Hypercholesterolemia Detection in South Korea: A Targeted Screening Approach Integrating National Program and Genetic Cascade Screening.","authors":"Jung-Ho Yang, Kyung Hoon Cho, Young Joon Hong, Ju Han Kim, Hye-Yeon Kim, Min-Ho Shin","doi":"10.4070/kcj.2024.0107","DOIUrl":"10.4070/kcj.2024.0107","url":null,"abstract":"<p><strong>Background and objectives: </strong>Familial hypercholesterolemia (FH) increases the risk of premature cardiovascular disease through disrupted low-density lipoprotein cholesterol (LDL-C) metabolism. Although FH is a severe condition, it remains widely underdiagnosed, which can be attributed to barriers in genetic testing and a lack of awareness. This study aims to propose and evaluate a targeted screening program for FH in South Korea by integrating the General Health Screening Program (GHSP) with cascade genetic screening.</p><p><strong>Methods: </strong>The study included individuals with LDL-C levels ≥190 mg/dL identified during the 2021 GHSP (primary participants). Data on demographics, lifestyle, medical history, and family history were collected through questionnaires. Targeted next-generation sequencing was used to identify pathogenic mutations in the <i>PCSK9</i>, <i>APOB</i>, <i>LDLRAP1</i>, and <i>LDLR</i> genes associated with FH. Pathogenic mutations found in primary participants were confirmed in their relatives (secondary participants) using Sanger sequencing. Participant characteristics were analyzed based on the presence of pathogenic mutations.</p><p><strong>Results: </strong>Among 83 individuals with severe hypercholesterolemia identified through the GHSP, 7 primary participants (8.4%) carried pathogenic mutations in the <i>LDLR</i> and <i>PCSK9</i> genes. In secondary participants, pathogenic mutations were identified in 61.1% of the relatives of 4 patients with pathogenic mutations. The prevalence of pathogenic mutations was significantly higher in primary participants compared to secondary participants.</p><p><strong>Conclusions: </strong>Integrating community resources with FH screening can enhance the early detection and treatment of FH. By utilizing GHSP data and adding genetic screening, the proposed model provides a strategy to reduce the cardiovascular risks associated with FH, supporting its wider adoption at the national level.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"726-738"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demystifying the Quandary of Ostial Stenting.","authors":"Debabrata Dash, Rohit Mody, Umanshi Dash, Yashas Prasad Mylarappa, Bhavya Mody","doi":"10.4070/kcj.2024.0158","DOIUrl":"10.4070/kcj.2024.0158","url":null,"abstract":"<p><p>Accurate stent placement is known to be hampered by the anatomical nature of percutaneous coronary intervention (PCI) of ostial lesions, such as aorta-ostial lesions and Medina 001 bifurcation lesions. The Ostial Pro device, the aorta floating wire technique, the stent pull-back technique, the Szabo (tail-wire) techniques, the marker wire technique, the T-stent and small protrusion technique, the cross-over 1-stent technique, and new dedicated ostial stents are some of the techniques used to achieve perfection in precise ostial stent placement. The current state of knowledge about ostial PCI and novel approaches for optimizing these procedures are compiled in this review.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"677-692"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Aortic Root Diameters on Echocardiography and MRI During Pregnancy in Mosaic Turner Syndrome.","authors":"Josef Finsterer","doi":"10.4070/kcj.2024.0250","DOIUrl":"10.4070/kcj.2024.0250","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"760-761"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragile Arteries in Loeys-Dietz Syndrome.","authors":"Chaojie Wang, Wenqian Zhang, Ge Wang, Zengxiao Zou, Man Chen, Hao Zhang, Shanlin Qin, Xiaoping Fan","doi":"10.4070/kcj.2024.0219","DOIUrl":"10.4070/kcj.2024.0219","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"764-766"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Artificial Intelligence-Based Automated Echocardiographic Analysis: Enhancing Efficiency and Prognostic Evaluation in Patients With Revascularized STEMI.","authors":"Yeonggul Jang, Hyejung Choi, Yeonyee E Yoon, Jaeik Jeon, Hyejin Kim, Jiyeon Kim, Dawun Jeong, Seongmin Ha, Youngtaek Hong, Seung-Ah Lee, Jiesuck Park, Wonsuk Choi, Hong-Mi Choi, In-Chang Hwang, Goo-Yeong Cho, Hyuk-Jae Chang","doi":"10.4070/kcj.2024.0060","DOIUrl":"10.4070/kcj.2024.0060","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although various cardiac parameters on echocardiography have clinical importance, their measurement by conventional manual methods is time-consuming and subject to variability. We evaluated the feasibility, accuracy, and predictive value of an artificial intelligence (AI)-based automated system for echocardiographic analysis in patients with ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>The AI-based system was developed using a nationwide echocardiographic dataset from five tertiary hospitals, and automatically identified views, then segmented and tracked the left ventricle (LV) and left atrium (LA) to produce volume and strain values. Both conventional manual measurements and AI-based fully automated measurements of the LV ejection fraction and global longitudinal strain, and LA volume index and reservoir strain were performed in 632 patients with STEMI.</p><p><strong>Results: </strong>The AI-based system accurately identified necessary views (overall accuracy, 98.5%) and successfully measured LV and LA volumes and strains in all cases in which conventional methods were applicable. Inter-method analysis showed strong correlations between measurement methods, with Pearson coefficients ranging 0.81-0.92 and intraclass correlation coefficients ranging 0.74-0.90. For the prediction of clinical outcomes (composite of all-cause death, re-hospitalization due to heart failure, ventricular arrhythmia, and recurrent myocardial infarction), AI-derived measurements showed predictive value independent of clinical risk factors, comparable to those from conventional manual measurements.</p><p><strong>Conclusions: </strong>Our fully automated AI-based approach for LV and LA analysis on echocardiography is feasible and provides accurate measurements, comparable to conventional methods, in patients with STEMI, offering a promising solution for comprehensive echocardiographic analysis, reduced workloads, and improved patient care.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"743-756"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Hospital Delay and Outcomes in Myocardial Infarction With Nonobstructive Coronary Arteries.","authors":"Seok Oh, Kyung Hoon Cho, Min Chul Kim, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong","doi":"10.4070/kcj.2024.0085","DOIUrl":"10.4070/kcj.2024.0085","url":null,"abstract":"<p><strong>Background and objectives: </strong>Real-world evidence on the relationship between delayed hospitalization and outcomes in myocardial infarction with nonobstructive coronary arteries (MINOCA) is lacking. Hence, we aimed to evaluate the clinical characteristics of patients with MINOCA and the 2-year mortality outcomes in this patient population according to the symptom-to-door time (SDT).</p><p><strong>Methods: </strong>Overall, 861 patients with MINOCA from 2 Korean nationwide observational registries (2011-2020) were included and categorized as early or late presenters. Late presentation was defined as SDT ≥12 hours in patients with ST-segment elevation myocardial infarction (STEMI) and SDT ≥24 hours in patients with non-STEMI. The primary outcome was 2-year all-cause mortality. Propensity score matching (PSM) and age-sex adjusted analysis were used to determine whether late presentation independently affected mortality. Multivariate logistic regression analysis was used to examine the independent factors correlated with late presentation.</p><p><strong>Results: </strong>In unadjusted data, late presenters had a notably higher risk of 2-year all-cause mortality than early presenters (hazard ratio [HR], 2.44; 95% confidence interval [CI], 1.47-4.08). This trend persisted in age-sex adjusted analysis (adjusted HR, 2.29; 95% CI, 1.36-3.84) and PSM-adjusted analysis (adjusted HR, 2.18; 95% CI, 1.05-4.53). The positive independent factors for late presentation included female sex, no emergency medical service use and high creatinine level, whereas the negative independent factor was a dyslipidemia.</p><p><strong>Conclusions: </strong>Late presentation is associated with higher mortality in patients with MINOCA. Multidisciplinary efforts are needed to reduce pre-hospital delay, thereby improving the clinical outcomes in these patients.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"693-706"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Based Automated Echocardiographic Analysis is Expected to Revolutionize Clinical Practice.","authors":"SungA Bae","doi":"10.4070/kcj.2024.0303","DOIUrl":"10.4070/kcj.2024.0303","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"54 11","pages":"757-759"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 25-Year Journey in the Fight Against Pulmonary Arterial Hypertension at a Korean Center: What Has Changed and What Is Missing?","authors":"Jung Hyun Choi, Jae Hyeong Park","doi":"10.4070/kcj.2024.0314","DOIUrl":"10.4070/kcj.2024.0314","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"54 10","pages":"651-652"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Long-term Outcomes and Risk Factors of Complications After Fontan Surgery: From the Korean Fontan Registry (KFR).","authors":"Sang-Yun Lee, Soo-Jin Kim, Chang-Ha Lee, Chun Soo Park, Eun Seok Choi, Hoon Ko, Hyo Soon An, I Seok Kang, Ja Kyoung Yoon, Jae Suk Baek, Jae Young Lee, Jinyoung Song, Joowon Lee, June Huh, Kyung-Jin Ahn, Se Yong Jung, Seul Gi Cha, Yeo Hyang Kim, Youngseok Lee, Sanghoon Cho","doi":"10.4070/kcj.2023.0211","DOIUrl":"10.4070/kcj.2023.0211","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries.</p><p><strong>Methods: </strong>The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed.</p><p><strong>Results: </strong>Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration.</p><p><strong>Conclusions: </strong>In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"653-668"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Retrieval of an Embolized MitraClip in the Left Atrium.","authors":"Jinho Lee, Ga Yun Kim, Jae Suk Yoo, Dae-Hee Kim, Do-Yoon Kang","doi":"10.4070/kcj.2024.0088","DOIUrl":"10.4070/kcj.2024.0088","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"672-675"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}