Korean Circulation Journal最新文献

{"title":"Nationwide Birth Prevalence of Crucial Congenital Heart Defects From 2014 to 2018 in Korea.","authors":"Kee Soo Ha, Chan Mi Park, JungHwa Lee, Jeonghee Shin, Eui Kyung Choi, Miyoung Choi, Jimin Kim, Hong Ju Shin, Byung Min Choi, Soo-Jin Kim","doi":"10.4070/kcj.2024.0105","DOIUrl":"10.4070/kcj.2024.0105","url":null,"abstract":"<p><strong>Background and objectives: </strong>A comprehensive survey of congenital heart disease (CHD) prevalence has not yet been conducted in South Korea. This study aimed to investigate the prevalence of CHDs in Korean children and lay the foundation for national CHD epidemiology.</p><p><strong>Methods: </strong>Target patients were infantile crucial CHDs, which include critical CHDs (requiring urgent procedures after birth with common hypoxemic defects) and diverse categorical defects excluding simple shunt defects. Data were obtained from the National Health Insurance Service over a 5-year period (2014-2018). Birth prevalence (new cases per 1,000 live births) of CHDs in Korea was analyzed and compared with that of other countries.</p><p><strong>Results: </strong>The birth prevalences of right heart obstructive defects (pulmonary valve stenosis and pulmonary atresia), conus anomalies (tetralogy of Fallot and double outlet right ventricle), and total anomalous pulmonary venous return showed significant increases in the East Asian group (<i>P</i><0.001), whereas those of left heart obstructive defects (coarctation of aorta, aortic stenosis, and hypoplastic left heart syndrome), truncus anomalies (D-transposition of great artery and persistent truncus arteriosus), atrioventricular septal defect, and hypoplastic right heart syndrome were significantly decreased in the East Asian group (<i>P</i><0.001).</p><p><strong>Conclusions: </strong>The overall birth prevalence of crucial CHDs in Korea was similar to that of critical CHDs in previous studies from other countries. Some subtypes of right heart obstructive defects, left heart obstructive defects, and conotruncal anomalies showed significant differences between East Asian and Western populations. This study contributes to a foundation for national CHD epidemiology in Korean children.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"838-850"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036229","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":"Management of Pediatric Heart Failure.","authors":"Anne I Dipchand","doi":"10.4070/kcj.2024.0320","DOIUrl":"10.4070/kcj.2024.0320","url":null,"abstract":"<p><p>Heart failure (HF) in children is a complex syndrome with multiple diverse etiologies and both acute and chronic presentations. Chronic presentations can persist throughout childhood and adolescence, and require diligent management with ongoing reassessment to maximize survival and quality of life. Stages of HF are key to recognize as they guide both management and inform prognosis. In more severe cases, children can present with signs of low cardiac output and circulatory collapse with potential to transition either to a chronic HF stage or progress to a need for advanced HF therapies. Morbidity and mortality are high. Managing HF requires a multi-disciplinary approach that can adapt to the needs of the different phases of childhood and adolescence. Treatment can include medications, nutritional support, activity modifications, and potentially surgical intervention, pacemaker, respiratory or mechanical support, or even heart transplantation. Limited evidence exists for almost all medical therapies used in the management of HF in children and approaches are predominantly extrapolated from extensive adult experience. There are multiple maladaptive pathways in the failing heart; medications that modify these maladaptive pathways promote \"reverse remodelling\" of the myocardium and are key to the management, forming the basis for \"guideline directed medical therapy\". The purpose of this review is to summarize the current state of the art management of systolic HF in children.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":"54 12","pages":"794-810"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903264","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":"2024 Korean Society of Myocardial Infarction/National Evidence-Based Healthcare Collaborating Agency Guideline for the Pharmacotherapy of Acute Coronary Syndromes.","authors":"Hyun Kuk Kim, Seungeun Ryoo, Seung Hun Lee, Doyeon Hwang, Ki Hong Choi, Jungeun Park, Hyeon-Jeong Lee, Chang-Hwan Yoon, Jang Hoon Lee, Joo-Yong Hahn, Young Joon Hong, Jin Yong Hwang, Myung Ho Jeong, Dong Ah Park, Chang-Wook Nam, Weon Kim","doi":"10.4070/kcj.2024.0257","DOIUrl":"10.4070/kcj.2024.0257","url":null,"abstract":"<p><p>Many countries have published clinical practice guidelines for appropriate clinical decisions, optimal treatment, and improved clinical outcomes in patients with acute coronary syndrome. Developing guidelines that are specifically tailored to the Korean environment is crucial, considering the treatment system, available medications and medical devices, racial differences, and level of language communication. In 2017, the Korean Society of Myocardial Infarction established a guideline development committee. However, at that time, it was not feasible to develop guidelines, owing to the lack of knowledge and experience in guideline development and the absence of methodology experts. In 2022, the National Evidence-Based Healthcare Collaborating Agency collaborated with a relevant academic association to develop internationally reliable guidelines, with strict adherence to the methodology for evidence-based guideline development. The first Korean acute coronary syndrome guideline starts from the 9 key questions for pharmacotherapy.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"767-793"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468955","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":"Insights for Tailoring Exercise Recommendations in Home-based Cardiac Rehabilitation: Patients' Perspectives.","authors":"Jinsung Jeon, Eung Ju Kim","doi":"10.4070/kcj.2024.0265","DOIUrl":"10.4070/kcj.2024.0265","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"836-837"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468961","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":"Pulmonary Artery Dissection: Less Is Better When You Are Blue.","authors":"Merna Abdou, Justin Shipman, Francois Marcotte, Clinton Jokerst, David S Majdalany","doi":"10.4070/kcj.2024.0212","DOIUrl":"10.4070/kcj.2024.0212","url":null,"abstract":"","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"868-869"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590916","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 Efficacy and Safety of NOAC in Very Elderly Atrial Fibrillation Patients: Data From the Korean National Health Insurance Cohort Registry.","authors":"Seong Huan Choi, Yeong Chan Lee, Yong-Soo Baek","doi":"10.4070/kcj.2024.0073","DOIUrl":"10.4070/kcj.2024.0073","url":null,"abstract":"<p><strong>Background and objectives: </strong>We investigated the clinical benefit of anticoagulation with non-vitamin K antagonist oral anticoagulant (NOAC) in very elderly atrial fibrillation (AF) patients through national healthcare insurance registry.</p><p><strong>Methods: </strong>Clinical data was acquired from the National Health Insurance Service of south Korea. Medical records of 862,935 patients who were diagnosed with AF from 2015 to 2020 were collected for analysis. Patients under the age of 85, prior history of intracranial hemorrhage, gastrointestinal bleeding and prior prescription days of aspirin, warfarin or NOAC exceeding 90 along with follow up period less than 90 days were excluded.</p><p><strong>Results: </strong>A total of 10,625 patients were eligible for analysis. Patients with oral anticoagulant (hazard ratio [HR], 0.60, 95% confidence interval [CI], 0.53-0.69, p<0.001) showed higher efficacy regarding cerebrovascular accident (CVA) compared to aspirin (HR, 0.84, 95% CI, 0.74-0.95, p=0.008) and no treatment group. Individual comparison of NOAC and aspirin via propensity score matching showed that patients with NOAC (HR, 0.71, 95% CI, 0.61-0.85, p<0.001) showed higher event free survival regarding CVA compared to aspirin. Bleeding risk was also higher for NOAC (HR, 1.28, 95% CI, 1.07-1.56, p=0.006) group but did not result in commensurate increase in mortality (HR, 0.60, 95% CI, 0.45-0.81, p<0.001).</p><p><strong>Conclusions: </strong>Anticoagulation with NOAC in very elderly patient showed higher event free survival regarding CVA. Despite having higher event rate of bleeding, eventual death was lower for NOAC.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"811-821"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468964","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":"Escalating Lipid Therapy After Achieving LDL-C <70 mg/dL With Moderate-Intensity Statins in High-Risk Patients.","authors":"Geunhee Park, Eui-Young Choi, Sang-Hak Lee","doi":"10.4070/kcj.2024.0218","DOIUrl":"https://doi.org/10.4070/kcj.2024.0218","url":null,"abstract":"<p><strong>Background and objectives: </strong>Guidelines recommend target levels of low-density lipoprotein cholesterol (LDL-C) and intensive lipid-lowering therapy (LLT) in high-risk patients. However, the value of escalating LLT when the LDL-C targets are achieved with moderate-intensity statins is unknown. We aimed to evaluate the benefits of LLT escalation in this population.</p><p><strong>Methods: </strong>In this retrospective propensity score-matched study, we screened data from two university hospitals between 2006 and 2021. Of the 54,069 patients with atherosclerotic cardiovascular disease (ASCVD), 3,205 who achieved LDL-C levels <70 mg/dL with moderate-intensity statins were included. After 1:3 matching, 1,315 patients (339 with LLT escalation and 976 without) were ultimately examined. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE)1 (cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke) and all-cause death.</p><p><strong>Results: </strong>During a median follow-up of 5.7 years, the MACCE1 rate was not significantly lower in the escalation group than in the non-escalation group (9.8 and 14.3/1,000 person-years, respectively; hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.43-1.09; p=0.11). Kaplan-Meier curves showed similar results (log-rank p=0.11). The risk of all-cause death did not differ between the groups. MACCE2 rate, which additionally includes coronary/peripheral revascularization, was lower in the escalation group (24.5 and 35.4/1,000 person-years, respectively; HR, 0.70; 95% CI, 0.52-0.94; p=0.017).</p><p><strong>Conclusions: </strong>LLT escalation did not significantly lower hard cardiovascular outcomes and all-cause death in patients with ASCVD achieving LDL-C levels <70 mg/dL with moderate-intensity statins. However, it had benefit in reducing revascularization rates in this population.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LncRNA uc003pxg.1 Interacts With miR-339-5p Promote Vascular Endothelial Cell Proliferation, Migration and Angiogenesis.","authors":"Ping Li, Feng Wang, Anna Yue, Yanling Xuan, Ying Huang, Jingyi Xu, Jiayi Weng, Yuan Li, Kangyun Sun","doi":"10.4070/kcj.2024.0153","DOIUrl":"https://doi.org/10.4070/kcj.2024.0153","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to investigate the roles of lncRNA uc003pxg.1 and miR-339-5p in regulating the occurrence and development of coronary heart disease.</p><p><strong>Methods: </strong>First, the expression levels of uc003pxg.1 and miR-339-5p were verified in peripheral blood mononuclear cells of clinical samples. Then, the target gene was identified using high-throughput sequencing combined with bioinformatics. Human umbilical vein endothelial cells (HUVECs) were transfected with si-uc003pxg.1, miR-339-5p mimic and miR-339-5p inhibitor, and the expression of related genes was detected by reverse transcription-quantitative polymerase chain reaction and western blotting. EdU, CCK-8, Cell scratch and Transwell assays were used to analyze the effects of uc003pxg.1 and miR-339-5p on cell proliferation and migration.</p><p><strong>Results: </strong>The expression of uc003pxg.1 and miR-339-5p was negatively correlated in clinical samples and HUVECs. The si-uc003pxg.1 and miR-339-5p mimic decreased the proliferation and migration of HUVECs and decreased the expression of transforming growth factor (TGF)-β1 and α-smooth muscle actin (SMA). The protein expression levels of TGF-β1, α-SMA, CD31, collagen I, collagen III and endoglin were decreased, and angiogenesis was weakened. The miR-339-5p inhibitor had the opposite effect.</p><p><strong>Conclusions: </strong>Our study revealed that upregulation of uc003pxg.1 and downregulation of miR-339-5p in vitro promote cell proliferation, cell migration and angiogenesis and upregulate the expression of TGF-β1, α-SMA, CD31, collagen I, collagen III and endoglin, which may lead to the development of vascular atherosclerosis.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Etiologies and Risk Factors of Survival Outcomes After Resuscitation for Out-of-Hospital Cardiac Arrest: Data From the KoCARC Registry.","authors":"Joo Hee Jeong, Kyongjin Min, Jong-Il Choi, Su Jin Kim, Seung-Young Roh, Kap Su Han, Juhyun Song, Sung Woo Lee, Young-Hoon Kim","doi":"10.4070/kcj.2024.0243","DOIUrl":"https://doi.org/10.4070/kcj.2024.0243","url":null,"abstract":"<p><strong>Background and objectives: </strong>The outcomes and characteristics of out-of-hospital cardiac arrest (OHCA) vary across geographic regions. The etiologies and prognoses of OHCA in Asian populations remain less established. This study aimed to investigate the etiologies and clinical characteristics of patients successfully resuscitated after OHCA and to identify predictors of survival outcomes.</p><p><strong>Methods: </strong>Data were extracted from a South Korean multicenter prospective registry of OHCA that included 64 tertiary hospitals from 2015 to 2018 (n=7,577). The primary outcome was in-hospital mortality, and the secondary outcome was a Cerebral Performance Category (CPC) score of grade 1 at discharge.</p><p><strong>Results: </strong>Of the 7,577 patients, 2,066 achieved return of spontaneous circulation (ROSC) and were hospitalized. A total of 915 (44.2%) presented with ventricular arrhythmia (VA) as their initial rhythm or on admission. The leading cause was obstructive coronary artery disease (n=413; 20.0%). Sudden unexplained death syndrome (SUDS) accounted for 67.5% of survivors and was significantly less common in patients with VA (82.7% vs. 48.3%, p<0.001). VA was an independent predictor of in-hospital mortality (adjusted hazard ratio, 0.774; 95% confidence interval [CI], 0.633-0.946; p=0.012) and the grade-1 CPC score at discharge (odds ratio, 2.822; 95% CI, 1.909-4.172; p<0.001). Other predictors of in-hospital mortality included age, diabetes mellitus, witnessed cardiac arrest, ROSC on arrival, total arrest time, alertness on admission, extracorporeal membrane oxygenation use, targeted temperature management, and coronary reperfusion.</p><p><strong>Conclusions: </strong>SUDS was common in patients with ROSC after OHCA. VA was independently associated with favorable survival outcomes at discharge. Prompt clinical intervention may improve clinical outcomes in patients with OHCA, particularly those with VA.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Distal Radial Access in High Bleeding Risk Patients Who Underwent Percutaneous Coronary Intervention.","authors":"In Tae Jin, Ji Woong Roh, Oh-Hyun Lee, Eui Im, Deok-Kyu Cho, Jun-Won Lee, Bong-Ki Lee, Sang-Yong Yoo, Sang Yeub Lee, Chan Joon Kim, Han-Young Jin, Jin Sup Park, Jung Ho Heo, Do Hoi Kim, Jin Bae Lee, Dong-Kie Kim, Jun Ho Bae, Sung-Yun Lee, Seung-Hwan Lee, Yongcheol Kim","doi":"10.4070/kcj.2024.0239","DOIUrl":"https://doi.org/10.4070/kcj.2024.0239","url":null,"abstract":"<p><strong>Backgrounds and objectives: </strong>The distal radial access (DRA), a potential alternative to the trans-radial approach (TRA), may offer advantages in terms of access site complications due to its smaller vessel diameter, especially for high bleeding risk (HBR) patients. This study aims to investigate the feasibility of DRA in HBR patients.</p><p><strong>Methods: </strong>Based on data from the KODRA registry, a prospective, multicenter cohort, this study analyzed 1,586 patients who underwent successful percutaneous coronary intervention (PCI) via DRA. Patients were categorized into HBR and non-HBR groups. The primary endpoint of the study is DRA-related bleeding, and the secondary endpoints of the study are overall access site complications and each component of the access site complications. To reduce the effect of potential confounders, a multivariable adjustment analysis was performed.</p><p><strong>Results: </strong>The mean age of the total population was 71.1±10.8 years, and 40.3% of patients were female. Both DRA-related bleeding (odds ratio [OR], 1.15; 95% confidence interval [CI], 0.67-1.97; p=0.616) and overall access site complications (OR, 1.08; 95% CI, 0.67-1.72; p=0.761) were not significantly different between the HBR group and non-HBR group after multivariable adjustment. No major bleeding before discharge was observed in both groups. Furthermore, the incidence of distal and conventional radial artery occlusion was less than 1% at 1-month follow-up in both groups.</p><p><strong>Conclusions: </strong>Our study results showed the safety of DRA for both DRA-related bleeding and access site complications among HBR patients who underwent PCI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04080700.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}