Korean Circulation Journal 

About: Korean Circulation Journal is an academic journal published by Korean Society of Circulation. The journal publishes majorly in the area(s): Myocardial infarction & Coronary artery disease. It has an ISSN identifier of 1738-5520. Over the lifetime, 4036 publications have been published receiving 23219 citations.

Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia.

Abstract: Background and Objectives: With the increasing survival of preterm infants, pulmonary hypertension (PH) related to bronchopulmonary dysplasia (BPD) has become an important complication. The aim of this study was to investigate the characteristics and outcome of PH in preterm infants with BPD and to identify the risk factors for PH. Subjects and Methods: We reviewed the records of 116 preterm infants with BPD cared for at a single tertiary center between 2004 and 2008. Results: Twenty-nine (25%) infants had PH >2 months after birth. PH occurred initially at a median age of 65 days (range, 7-232 days). Severe BPD, a birth weight <800 g, long-term ventilator care and oxygen supplementation, a high ventilator setting, infection, and a patent ductus arteriosus (PDA) were related to PH based on univariate analysis (p<0.05). The infants who had longer oxygen supplementation were significantly more likely to have PH (odds ratio, 18.5; 95% confidence interval, 4.1-84.6; p<0.001). PH was improved in 76% of infants after a median of 85 days (range, 20-765 days). Four infants (14%) died. The death of 3 infants was attributed to PH. Conclusion: BPD was frequently complicated by PH. Although PH resolved in the majority of infants, PH in preterm infants with BPD can be fatal. Regular screening for PH and adequate management are required. (Korean Circ J 2010;40:131-136)

Metabolic Syndrome and Cardiovascular Disease

Abstract: Insulin resistance is characterized by an impaired physiological response to insulin. The constellation of insulin resistance, and several other metabolic and vascular disorders, is known as the insulin resistance syndrome, or metabolic syndrome. The characteristic features of metabolic syndrome include；central obesity, hypertension, dyslipidemia and glucose intolerance, and abnormalities in both the endothelial cells and vascular function. Several studies have shown that insulin resistance is a predictor of coronary artery disease (CAD). Recent studies have described relationships between the entire constellation of components in metabolic syndrome and the risk of CAD. The increasing prevalence of the insulin resistance syndrome, and its strong association with risk of CAD, has highlighted the potential importance of its early diagnosis and aggressive treatment. The managements of metabolic syndrome include lifestyle interventions, aggressive treatment of the identified CAD risk factors, and the treatments of abnormal glucose tolerance and insulin resistance. The connection between insulin resistance, metabolic syndrome and coronary disease must be recognized, and it is important not only to manage the obviously apparent CAD risk factors, but also to identify and manage other sought factors. (Korean Circulation

Decreased Number and Impaired Angiogenic Function of Endothelial Progenitor Cells in Patients with Chronic Renal Failure

Abstract: Objective—Increased risk of cardiovascular disease in patients with chronic renal failure (CRF) has been explained by accelerated atherosclerosis and impaired angiogenesis, in which endothelial progenitor cells (EPCs) may play key roles. We hypothesized that altered EPC biology may contribute to the pathophysiology of CRF. Methods and Results—EPCs were isolated from CRF patients on maintenance hemodialysis (n44) and from a normal control group (n30). CRF patients showed markedly decreased numbers of EPC (44.6%) and colonies (75.3%) when compared with the controls (P0.001). These findings were corroborated by 30.5% decrease in EPC migratory function in response to vascular endothelial growth factor (VEGF) (P0.040) and 48.8% decrease in EPC incorporation into human umbilical vein endothelial cells (HUVEC) (P0.001). In addition, Framingham’s risk factor score of both CRF (r0.461, P0.010) and normal group (r0.367, P0.016) significantly correlated with the numbers of EPC. Indeed, the number of circulating EPC was significantly lower in CRF patients than in normal group under the same burden of risk factors (P0.001). A significant correlation was also observed between dialysis dose (Kt/V) and EPC incorporation into HUVEC (r0.427, P0.004). Conclusions—EPC biology, which is critical for neovascularization and the maintenance of vascular function, is altered in CRF. Our data strongly suggest that dysfunction of circulating EPC has a role in the progression of cardiovascular disease in patients with CRF. (Arterioscler Thromb Vasc Biol. 2004;24:1246-1252.)

Atherosclerotic Cardiovascular Disease Beginning in Childhood

Abstract: Although the clinical manifestations of cardiovascular disease (CVD), such as myocardial infarction, stroke, and peripheral vascular disease, appear from middle age, the process of atherosclerosis can begin early in childhood. The early stage and progression of atherosclerosis in youth are influenced by risk factors that include obesity, hypertension, dyslipidemia, and smoking, and by the presence of specific diseases, such as diabetes mellitus and Kawasaki disease (KD). The existing evidence indicates that primary prevention of atherosclerotic disease should begin in childhood. Identification of children at risk for atherosclerosis may allow early intervention to decrease the atherosclerotic process, thereby preventing or delaying CVD. This review will describe the origin and progression of atherosclerosis in childhood, and the identification and management of known risk factors for atherosclerotic CVD in children and young adults.

Clinical Characteristics and Outcome of Acute Heart Failure in Korea: Results from the Korean Acute Heart Failure Registry (KorAHF)

Abstract: Background and objectives The burden of heart failure has increased in Korea. This registry aims to evaluate demographics, clinical characteristics, management, and long-term outcomes in patients hospitalized for acute heart failure (AHF). Subjects and methods We prospectively enrolled a total of 5625 consecutive subjects hospitalized for AHF in one of 10 tertiary university hospitals from March 2011 to February 2014. Descriptive statistics were used to determine the baseline characteristics of the study population and to compare them with those from other registries. Results The mean age was 68.5±14.5 years, 53.2% were male, and 52.2% had de novo heart failure. The mean systolic and diastolic blood pressures were 131.2±30.3 mmHg and 78.6±18.8 mmHg at admission, respectively. The left ventricular ejection fraction was ≤40% in 60.5% of patients. Ischemia was the most frequent etiology (37.6%) and aggravating factor (26.3%). Angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and aldosterone antagonists were prescribed in 68.8%, 52.2%, and 46.6% of the patients at discharge, respectively. Compared with the previous registry performed in Korea a decade ago, extracorporeal membrane oxygenation (ECMO) and heart transplantation have been performed more frequently (ECMO 0.8% vs. 2.8%, heart transplantation 0.3% vs. 1.2%), and in-hospital mortality decreased from 7.6% to 4.8%. However, the total cost of hospital care increased by 40%, and one-year follow-up mortality remained high. Conclusion While the quality of acute clinical care and AHF-related outcomes have improved over the last decade, the long-term prognosis of heart failure is still poor in Korea. Therefore, additional research is needed to improve long-term outcomes and implement cost-effective care.