본 연구는 성인 흡연자의 심근경색증 조기 증상 인지 정도를 파악하고 인지와 관련된 요인을 분석하기 위해 진행되었다. 2021년 지역사회 건강조사 원시 자료를 활용한 서술적 조사연구로 조사 완료자 229,942명 중 본 연구에 해당하는 설문에 응답이 불충분한 대상자 18,343명을 제외한 210,899명을 연구대 상자로 선정하여 SAS 9.4 program을 이용하여 표본 분석, 빈도, 백분율 등의 기술통계, 카이 제곱 검정, 복합표본 로지스틱 회귀분석을 사용하였다. 나이, 혼인 여부, 교육수준, 금연계획 여부, 건강검진_암 검진 수검 여부, 당뇨병 진단 여부, 주관적 건강 수준, 사회 물리적 환경이 심근경색증 조기 증상 인지와 유의한 관련이 있었다. 연구 결과를 바탕으로 심근경색증 발생 위험이 높은 고위험 집단에 대한 적극적인 홍보 및 교육이 필요하다.

본 연구의 목적은 고혈압 및 당뇨병을 진단 받은 성인의 뇌졸중 및 심근경색증의 조기 증상 인지 정도를 파악하고 비인지와 관련된 요인을 분석하기 위함이다. 2017년 지역사회건강조사 원시자료를 활용하여, 40세 이상 성인 12,277명의 자료를 분석하였다. 뇌졸중 및 심근경색증의 조기 증상 인지율은 각각 53.6%와 46.8%였다. 뇌졸중 및 심근경색증 조기 증상 비인지 요인을 평가하기 위해 로지스틱 분석을 수행 하였다. 고혈압 관리 교육, 혈압 수치 및 당화혈색소 수치 인식은 다변량 분석에서 인구사회학적 변수를 보정한 후에도 뇌졸중 조기 증상 비인지와 유의한 관련이 있었다. 혈압 수치 및 당화혈색소 수치 인식은 심근 경색증 조기 증상 비인지와 유의한 관련이 있었다. 그러므로 고혈압과 당뇨병을 모두 관리해야 하는 고위험군에 대한 홍보 촉진 및 교육 강화 등 심뇌혈관질환 조기 증상 인지 수준 개선을 위한 중재 및 전략의 개발이 요구된다.

Acute myocardial infarction (AMI) is considered the major cause of mortality in the world. Tremendous animal studies are performed to develop novel therapeutics, and this study aimed to induce porcine myocardial infarction model by using polyethylene terephthalate (PET). Coronary guidewire was placed in left anterior descending artery (LAD). The balloon angioplasty catheter was inserted at the back of the PET. The balloon catheter was carefully pushed forward, until the balloon marker was located in mid-LAD. Coronary angiography was performed pre- and post-occlusion at 28 days by C-arm. Histologic analysis of heart tissue was performed 28 days after inducing AMI. Thirty three pigs were anesthetized and underwent percutaneous coronary catheterization. All pigs were successfully embolized in mid-LAD by PET. Fifteen pigs died due to ventricular fibrillation during post-anesthetic recovery time, and overall experiment mortality was 45.5%. In 2,3,5- triphenyl tetrazolium chloride staining, gross finding of the ischemic heart lesion showed firm and white area of infarction associated with the apex and left ventricular posterior wall. Infarct on H&E-stained sections demonstrated a region without myocytes and rich with cardiomyocyte with atypical nuclei. Successful induction of AMI by using PET may provide the pathophysiological information of ischemic heart disease and improvement of therapy development for AMI.

Recently, N-terminal pro-brain natriuretic peptide (NTproBNP) has been widely used in the areas of diagnosis, monitoring treatment efficiency, and prognosis for various heart diseases, especially heart failure (HF). In this paper, we try to estimate the prognostic significance of NT-proBNP as a risk evaluation marker in Non-ST-segment Elevation Myocardial Infarction (NSTEMI) patients. We selected NSTEMI patients who underwent percutaneous coronary intervention (PCI) primarily using a drug-eluting stent within 24 h after the onset of chest pain. We compared incidences of major adverse cardiac events (MACE) including death, myocardial infarction (MI), stent thrombosis (ST), and target vessel revascularization (TVR) in two patient groups according to a high or low serum concentration of NT-proBNP, which was measured in the emergency room (ER). We intend to minimize selection bias selecting comparing groups, considering covariate of observed variables together using propensity score matching (PSM) and propensity score weighting (PSW) based on propensity score (PS) to control the difference in baseline characteristics between high- and low NT-proBNP groups. We found that as the log NT-proBNP value increases by 1 through a hazard function of COX’s analysis, the risk of MACE increases by 1.312 times. This result indicated that the NT-proBNP level on ER admission can be used as a significant prognostic indicator to estimate 1 year of MACE in NSTEMI patients who were treated with PCI within 24 h after the onset of chest pain.

The purpose of this study was to investigate the effects of low-intensity cardiac rehabilitation exercise on the cardiac function and the degree of fibrosis in an older white rat model. This study used male Sprague- Dawley white rats that were 50 weeks old. After the acute myocardial infarction induction, Twenty of the rats were randomly allocated into an experimental group and a control group, and each of the groups consisted of 8 rats. In the experimental group, the exercise was conducted for six weeks, 30 minutes a day, five days a week, using a Rotarod treadmill for animals. The degree of myocardial fibrosis was significantly repressed in the experimental group(13.69±1.90%) and in the control group(15.67±1.54%)(p<0.05). However, fractional shortening and ejection fraction did not show a significant difference. The results of this study suggest that cardiac rehabilitation with low intensity treadmill exercise repress the myocardial fibrosis.

The purpose of the study was to investigate effects of Low intensity cardiac rehabilitation, using a treadmill, on the myocardial structure. We identified the effects by analyzing changes in the rats' weights and the results of biopsies. Twenty Sprague-Dawley male rats, 50 weeks old, were randomly divided into the exercise group and the control group. myocardial infarction( MI) was induced by ligaturing their left anterior descending artery. After the acute MI induction, two rats of each group began to fall dead, therefore, eight of each group completed at the end of the experiment. We used treadmills for animals for the exercise group. This exercise group performed 30 minutes of exercise five times per week for six weeks, while the control group did not perform any exercise. No statistically significant differences in weight were found in within group comparison and between group comparison. Furthermore, we observed histological changes in the myocardium using Hematoxylin & Eosin and Masson's trichrome staining in both groups. Low-intensity exercise inhibited myocardial fibrosis, may serve as a reference in the cardiopulmonary field, which plays a role in rehabilitating patients with cardiac disorders, including acute MI.

The purpose of this paper is to provide an overview of the clinical physical therapy program used at the University of Yonsei Rehabilitation Hospital, for the practicing university trained physical therapists who may be unfamiliar with patients who have suffered a myocardial infarction. The four primary phases of the cardiac physical therapy graded exercise program are: 1) coronary care unit program (phase I), 2) general ward program (phase II), 3) convalescence program (phase III), 4) maintenance program (phase IV). The exercise prescription defines the exercise intensity, duration, frequency, and mode of exercise a after pre- discharge low level graded exercise test(LL-GXT) or symptom limited maximum graded exercise test. A typical exercise routine consists of preparation warm-up exercise, therapeutic exercise, cool-down exercise. Physical therapy is involved in the acute care and rehabilitation of the patient after a myocardial infarction. Therefore, the physical therapist must throughly comprehened the cardiac anatomy, cycle, performance, conduction system, pathogenesis, risk factors, and exercise benefits.

Acute myocardial infarction (AMI) as an acute form and a catastrophic manifestation of coronary artery disease (CAD) is the major cause of morbidity and mortality worldwide. The prevalence and incidence of myocardial infarction can be influenced by demographic, biological and psychosocial factors, and it is rare in childhood and adolescent years. Contrary to the elderly, where cardiac attack is mainly caused by CAD, exercise-induced cardiac attack is relatively more prevalent in a young adult. We report here on a case of ST-segment elevation myocardial infarction (STEMI) in a young adult during vigorous physical activity and we review the relevant literatures.

Stent thrombosis (ST) is the sudden occlusion of a stented coronary artery because of thrombus formation. ST is a rare, but can result in life-threatening complications. Early stent thrombosis occurs frequently after primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). Here, we report a case of a 59-year-old man with acute stent thrombosis immediately after primary PCI with drug-eluting stent for acute STEMI.

Acute myocardial infarction (AMI) involving two simultaneous vascular territories of acute transmural ischemia is known as a double or combined myocardial infarction. This well described but extremely rare phenomenon may be related to the fact that AMI with multiple vessel obstruction often causes extensive myocardial injury and death before hospitalization. We reported the first case of 45-year-old man with AMI occluded left anterior descending artery and right coronary artery simultaneously in Korea.

A 72-year-old woman with diabetic chronic kidney disease visited the authors’ hospital with fever, dysuria, and left flank pain. She did not complain of typical angina upon her admission, however, given the presence of a new-onset left-bundle branch block, elevated cardiac enzymes, and documented E. coli septicemia, coronary angiography and percutaneous coro-nary interventions were performed for the mid-left anterior descending artery and the mid-to distal-right coronary artery. We should keep in mind that urosepsis in patients with diabetic chronic kidney disease, who are at high risk of cardiovascular disease, can be associated with painless acute myocardial Infarction.

The transplantation of bone-marrow stem cells into the heart might restore viability after myocardial infarction, and the regenerative potentials of human autologous adult stem cells with respect to myocardial regeneration and neovascularization after myocardial infarction may contribute to healing in the infarcted areas. Here, we describe the results of this method in a patient with acute myocardial infarction who exhibited quantitative improvements in ventricular geometry and contractility. Furthermore, left ventricular ejection fraction and infarct area were improved at 3 month after stem cell transplantation as compared with baseline echocardiography and myocardial single photon emission computed tomography findings.

The purpose of this study is to evaluate perfusion density of an old myocardial infarction using cardiac multidetector computed tomography (MDCT) with arterial phase. We included 56 patients with an old myocardial infarction who had undergone medical treatment, primary angioplasty or bypass graft. Cardiac MDCT without stress perfusion was used for calculation of density of myocardial perfusion and global left ventricular function in patients was also analyzed according to initial and last follow-up echocardiography. All patients showed decreased perfusion in the left ventricular wall. Densities of normal ventricular wall, cavity of the left ventricle, and infracted wall were 105±29 HU, 471±117 HU, and 11±29 HU (-64 HU-57 HU), respectively. Subendocardial fat depositions were observed in 19 patients (34%). Ejection fractions of initial and last follow-up periods near to the date of cardiac CT were 61±9 % and 57±12 %, respectively. In conclusion, decreased perfusion less than 60 HU in cardiac CT with arterial phase was helpful in diagnosus of an old myocardial infarction.

AMI로 SES 혹은 PES 시술을 시행받은 모든 환자에서 4년 이상의 임상추적 기간이 지난 환자를 대상으로 데이터 를 분석하여 두 스텐트의 안전성과 유용성을 비교해 보고자 하였다. 2004년 1월 1일부터 2006년 8월 31일까지 본원 에서 ST분절 상승 혹은 ST 분절 비상승 급성심근경색증 (STEMI or NSTEMI)로 진단되어 입원 기간 중 관동맥중재 술을 시행받은 환자 중 SES 혹은 PES 삽입술이 시행된 환자를 대상으로 후향적 분석을 시행하였다. 그리고 사망, 심 장사. 심근경색증, 표적 혈관재관류술, 스텐트 혈전증 발생에 대해 분석하였다. 연구 기간 동안 총 668명의 급성심근경색증 환자가 중 522명만 연구 대상에 포함 사망 (18.3±3.0% vs. 14.6±2.2%, p=0.26), 심장사(11.2±2.6% vs. 6.8±1.52%, p=0.39), 심근경색증 (6.4±1.8% vs. 3.3±1.1%, p=0.31), and 스텐트 혈전증 (5.4±1.7% vs. 3.2±1.1%, p=0.53) 표적 혈관재관류술(TVR) (10.0±3.0% vs. 4.0±1.2%, p=0.008) and 심혈관계 임상사건(MACE) (29.4±3.5% vs. 19.4±2.5%, p=0.003) 급성심근경색증의 초기 치료에 약물방출스텐트인 SES와 PES의 4년 장기 임상 성적을 조사한 본 연구를 통해 전체 환자를 대상으로 분석하였을 때 두 스텐트의 장기 사망률, 심장사. 심근경색증, 표적 혈관재관류술, 스텐트 혈전증의 발생은 차이가 없었으나 TVR 및 MACE의 발생은 PES 삽입 환자가 SES삽입 환자보다 유의하게 높았다.