Journal of Yeungnam Medical Science

Original articles

Prognostic impact of chromogranin A in patients with acute heart failure: Hong Nyun Kim, Dong Heon Yang, Bo Eun Park, Yoon Jung Park, Hyeon Jeong Kim, Se Yong Jang, Myung Hwan Bae, Jang Hoon Lee, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2021;38(4):337-343. Published online July 8, 2021; DOI: https://doi.org/10.12701/yujm.2020.00843

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Background
Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure.
Methods
We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization.
Results
In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors.
Conclusion
The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

Citations

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The Role of Congestion Biomarkers in Heart Failure with Reduced Ejection Fraction
Michele Correale, Francesco Fioretti, Lucia Tricarico, Francesca Croella, Natale Daniele Brunetti, Riccardo M. Inciardi, Anna Vittoria Mattioli, Savina Nodari
Journal of Clinical Medicine.2023; 12(11): 3834. CrossRef
Novel Biomarkers of Renal Dysfunction and Congestion in Heart Failure
Agata Zdanowicz, Szymon Urban, Barbara Ponikowska, Gracjan Iwanek, Robert Zymliński, Piotr Ponikowski, Jan Biegus
Journal of Personalized Medicine.2022; 12(6): 898. CrossRef

Perioperative outcomes of interrupted anticoagulation in patients with non-valvular atrial fibrillation undergoing non-cardiac surgery: Bo Eun Park, Myung Hwan Bae, Hyeon Jeong Kim, Yoon Jung Park, Hong Nyun Kim, Se Yong Jang, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2020;37(4):321-328. Published online July 16, 2020; DOI: https://doi.org/10.12701/yujm.2020.00353

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Abstract PDF

Background
This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery.
Methods
A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding.
Results
The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.85%; three strokes and one systemic embolization) and three major bleeding events (1.39%) were observed. The high CHA2DS2-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA2DS2-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events.
Conclusion
Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

Citations

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Bleeding risk in female patients undergoing intravesical injection of onabotulinumtoxinA for overactive bladder: a Danish retrospective cohort study
Meryam El Issaoui, Sophia Elissaoui, Marlene Elmelund, Niels Klarskov
International Urogynecology Journal.2023; 34(10): 2581. CrossRef

Case report

Rectus abdominis muscle atrophy after thoracotomy: Jang Hoon Lee, Seok Soo Lee; Yeungnam Univ J Med. 2020;37(2):133-135. Published online November 27, 2019; DOI: https://doi.org/10.12701/yujm.2019.00381

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Abstract PDF

Intercostal nerve injury is known to occur during thoracotomy; however, rectus abdominis muscle atrophy has rarely been reported. We describe a 52-year-old man who underwent primary closure of esophageal perforation and lung decortication via left thoracotomy. He was discharged 40 days postoperatively without any complications. He noticed an abdominal bulge 2 months later, and computed tomography revealed left rectus abdominis muscle atrophy. We report thoracotomy induced denervation causing rectus abdominis muscle atrophy.

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Ingenuity of minimally invasive thoracoscopic lobectomy for undiagnosed pulmonary tumour
Sumitaka Yamanaka, Takashi Yoshimatsu, Takeaki Miyata, Hanae Higa
Respirology Case Reports.2020;[Epub] CrossRef

Case Report

Cardiovascular beriberi: rare cause of reversible pulmonary hypertension.: Joon Hyuk Song, Sang Soo Cheon, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2014;31(1):38-42. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.38

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Abstract PDF

Cardiovascular beriberi is caused by thiamine deficiency and usually presents as high cardiac output failure associated with predominantly right-sided heart failure and rapid recovery after treatment with thiamine. Because of its rarity in developed countries, the diagnosis can often be delayed and missed. We recently experienced a case of cardiovascular beriberi with pulmonary hypertension which successfully treated with thiamine infusion. A 50-year-old man with chronic heavy alcoholics was refered to our department for dyspnea with mental change. Echocardiography showed marked right ventricular (RV) dilatation and flattening of the interventricular septum with a D-shaped deformation of the left ventricle. Moderate tricuspid valve regurgitation was found and estimated RV systolic pressure was 52 mm Hg. Because of his confused mentality and history of chronic alcohol intake, neurological disorder due to thiamine deficiency was suspected and intravenous thiamine was administered and he continuously received a daily dose of 100 mg of thiamine. Follow up echocardiography showed marked reduction of RV dilatation and improvement of a D-shaped deformation of the left ventricle. He finally diagnosed as cardiovascular beriberi on the basis of dramatic response to intravenous thiamine. Thiamine deficiency can cause reversible pulmonary hypertension, and can still be encountered in the clinical setting. Thus high index of suspicion is critically needed for diagnosis.

Citations

Citations to this article as recorded by

Beriberi: A Reversible Cause of Acute Severe Pulmonary Hypertension
Mei L Tan, Christopher G Willis
Cureus.2022;[Epub] CrossRef
Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure
Jeong Ho Eom, Myung Goo Lee, Chang Youl Lee, Kyong Min Kwak, Won Jae Shin, Jung Wook Lee, Seong Hoon Kim, Sang Hyeon Choi, So Young Park
Yeungnam University Journal of Medicine.2015; 32(2): 106. CrossRef

Review

Perioperative Management of Lung Resection Patients.: Jang Hoon Lee; Yeungnam Univ J Med. 2012;29(1):9-13. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.9

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Abstract PDF

Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Perioperative management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.

Citations

Citations to this article as recorded by

Case Report of a Soeumin Patient with Yang Collapse Syndrome Mistreated with Soeumin Gwakhyangjunggi-san
Ji-eun Lee, Min-woo Kim, Se-eun Chun, Yong-jeen Shin, Sun-ho Shin
The Journal of Internal Korean Medicine.2021; 42(2): 95. CrossRef
Factors Influencing Complications after Therapeutic Lung Resection in Lung Cancer Patients
Soojin Son, Jihyun Kim
Journal of Korean Academy of Fundamentals of Nursing.2020; 27(2): 106. CrossRef

Original Articles

Predictors of Weight Reduction and Smoking Cessation in Overweight and Obese Patients with Acute Myocardial infarctions.: Jung Kyu Kang, Jang Hoon Lee, Su Young Ha, Myung Hwan Bae, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae, Jae Eun Jun; Yeungnam Univ J Med. 2011;28(1):20-30. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.20

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Abstract PDF: BACKGROUND
Little is known about predictors of lifestyle modification in overweight or obese patients with acute myocardial infarctions. METHODS: Between October 2005 and May 2007, 311 overweight or obese patients with an AMI visited Kyungpook National University Hospital. Among them, 216 patients (63+/-11 years old, 144 males) with > or =1 year of follow-up were included. RESULTS: Body weight of all patients showed a significant decrease and 20% showed a >3% weight reduction at 1 year of follow-up. Ninety-six (44%) patients were smoking at baseline, and 52% of them had quit by 1 year of follow-up. Only six smokers were successful with both a >3% weight reduction and smoking cessation. In multivariate analysis, age (OR 1.084, 95% CI 1.028-1.144, p=0.003) and smoking cessation (OR 0.167, 95% CI 0.048-0.575, p=0.005) were independent predictors of weight reduction. Abdominal circumference was a negative predictor of smoking cessation (OR 0.903, 95% CI 0.820-0.994, p=0.037). CONCLUSIONS: Mean body weight of all patients showed a significant decrease at follow-up. Smoking cessation and age were independent predictors of weight reduction, and abdominal circumference was a negative predictor of smoking cessation.

Comparison of Postoperative Results after Pneumonectomy between Lung Cancer and Infectious Lung Disease Groups: Jang Hoon Lee, Jung Cheul Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S304-309. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S304

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Abstract PDF: Background
：Pneumonectomy has been known with higher rate of morbidity and mortality. Thereby, we evaluated patients who received pneumonectomy for lung cancer and infectious lung disease related to postoperative morbidity and mortality. Materials and methods：The retrospective study was undertaken in 55 patients who had undergone pneumonectomy at Yeungnam University Hospital from January 1996 to December 2004. We devided into two groups, lung cancer group (group A, n=40) and infectious lung disease group (group B, n=15) and then compared and analyzed.
Results
：The mean age was higher in group A and there was statistical significance (60.8 9.4 vs 45.7 12.1, p<0.001). With preoperative pulmonary function test, FEV1, FVC were higher in group A and there were statistical significane (p<0.001, p=0.006). With preoperative lung perfusion scan, the perfusion ratio of affected lung and postoperative predicted FEV1 were higher in group A and there were statistical significance (p<0.001, p=0.007). According to MRC dyspnea scale, change of respiratory difficulty of group A had statistical significance (p<0.001). There were a total 20 postoperative complications (36.4%) of which arrhythmia 7, postoperative bleeding 5, empyema and/or bronchopleural fistula 3, pneumonia 2, adult respiratory distress syndrome 1, vocal cord palsy 1. The postoperative complication rate was no difference between two groups (37.5% vs 33.3%) but arrhythmia developed in group A only. There were 3 postoperative mortalities, all in group A.
Conclusion
：Preoperative pulmonary function test and postoperative predicted FEV1 were lower in group B, however, postoperative complication rate was no difference between two groups and mortality developed in group A only. Because of lesser resected lung volume and well adopted in long term diseased period, there was lesser hemodynamic change in infectious lung disease. So postoperative mortality not developed in infectious lung disease group due to arrhythmia and respiratory failure.

Clinical Analysis of Patch Repair of Ventricular Septal Defect in Infant.: Tae Eun Jung, Jang Hoon Lee, Dong Hyup Lee, Jung Cheul Lee, Sung Sae Han, Sae Yeun Kim, Dae Lim Ji; Yeungnam Univ J Med. 2002;19(2):99-106. Published online December 31, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.2.99

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Abstract PDF: BACKGROUND
Simple ventricular septal defect(VSD) is the most common congenital heart disease. Although closure of VSD is currently associated with a relatively low risk, experience with younger and smaller infants has been variably less satisfactory. We assessed the results of surgical closure of VSD in infant. MATERIALS AND METHODS: Between 1996 and 2000, 45 non-restrictive VSD patients underwent patch repair and retrospective analysis was done. Patients were divided into two groups based on weight: group I infants weighed 5kg or less(n=16), and group II infants weighed more than 5kg(n=29). Both groups had similar variation in sex, VSD location, aortic cross clamp time and total bypass time. But combined diseases (ASD, PDA, MR) were more in group I. We closed VSD with patch and used simple continuous suture method in all patients. RESULTS: There were no operative mortality, no reoperation for hemodynamically significant residual shunt and no surgically induced complete heart block. As a complication, pneumonia(group I: 2 cases, group II: 2 cases), transient seizure(group II: 2), wound infection(group I: 1, group II: 1), urinary tract infection(group I: 1) and chylopericardium(group I: 1) developed, and there was no significant difference between two groups(p>0.05). CONCLUSION: Early primary closure with simple continuous suture method was applicable in all patients with non-restrictive VSD without any serious complications.

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