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Biomedical subjects

C Kangkagate

Publications and source records attributed to C Kangkagate.

At least 37 records · Page 2Linked to original sources
PubMed2000

Obesity and risk factors of coronary heart disease in healthy Thais: a cross-sectional study.

Association between obesity and conventional risk factors for coronary artery disease is well established. Obesity is currently considered an independent risk for coronary artery disease. The relationship between body mass index (BMI) and fasting plasma lipids and glucose and blood pressures in non-obese subjects is not established. The authors studied relationships between BMI and lipids, and glucose, and blood pressure levels in healthy a population. The authors measured the weights and heights of 3,615 employees of a company during a routine yearly health examination. There were 1,250 males aged 31.3 +/- 6.6 and 2,365 females aged 29.3 +/- 4.9 years old. The average BMI for males and females were 23.5 +/- 3.6 and 20.1 +/- 3.0 respectively. The levels of total cholesterol (Chol), LDL-cholesterol, and triglyceride (TG), fasting plasma glucose (FPG) had a positive relationship with BMI (r = 0.22, 0.26, 0.41, 0.20; p < 0.001). HLD-cholesterol had a negative correlation with BMI (r = -0.36, p < 0.001). Both systolic (SBP) and diastolic (DBP) blood pressures had a positive correlation with BMI. The association persisted after all values were adjusted by age and sex. BMI has a significant positive relationship with the conventional risk factors for coronary artery disease and a negative relationship with HDL-cholesterol.

Adult↗
PubMed2000

Utility of intraoperative transesophageal echocardiogram in congenital heart disease.

Intraoperative transesophageal echocardiogram (TEE) has improved the perioperative outcome in adult patients. The purpose of the current study was to assess the benefit of intraoperative TEE in patients with congenital heart disease undergoing surgical correction (repair). The results of the patients who had consecutively undergone intraoperative TEE during their congenital heart surgery between January 1998 to June 2000 were reviewed. There were 104 patients (whose ages ranged from one week old to 50 years old (median 5 years old) and their weights from 3 kg to 79 kg (median 15 kg). A significant impact was said to have occurred if these findings prompted a change in surgical procedure following a prebypass study or rebypass for repair of a residual defect. Prebypass TEE had a significant impact in seven patients (6.7%). TEE could be used as a guide to help repair in three patients. The postbypass TEE examination had a significant impact in 15 patients (14.4%). Of these 15 patients, eight were detected primarily by TEE examination. The group of patients in whom TEE had the most significant impact was in patients who had surgery related to the repair of the atrioventricular valve (complete or partial atrioventricular (AV) canal repair, Ebstein's anomaly; 9 out of 22 patients; 41%). A less significant impact was found in surgery for other complex congenital defects (single ventricle or complete transposition of great arteries; eight out of 46 patients; 17.4%). TEE had limited impact in simple congenital lesion. Intraoperative TEE is valuable in the perioperative care of patients with congenital heart defects. We found the most benefit in patients with complete or partial AV canal and Ebstein's anomaly.

Adolescent↗
PubMed2000

A 5-year prospective study of conventional risk factors of coronary artery disease in Shinawatra employees: a preliminary prevalence survey of 3,615 employees.

We conducted a prevalence survey of conventional risk factors of coronary artery disease in 3,615 Shinawatra employees and we planned to prospectively follow up this population to determine the impact of the risk factors in the development of coronary disease. The prevalence of hypertension, diabetes mellitus, hyperlipidemia, obesity, physical inactivity and smoking were 7.4 per cent, 1.4 per cent, 21.1 per cent, 13.9 per cent, 76.3 per cent and 16.3 per cent respectively. The awareness of hypertension, diabetes mellitus and hyperlipidemia were 42.2 per cent, 78 per cent and 32.9 per cent respectively. The prevalence of the risk factors was more common in males and increased with increasing age. Dependent variables which were associated with hypertension included: excessive weight; male sex; increasing age; hypercholesterolemia and diabetes mellitus. Variables which were associated with diabetes mellitus were hypertriglyceridemia, hypertension, male sex, increasing age and excessive weight.. Variables which were associated with hypercholesterolemia were hypertriglyceridemia, high HDL-cholesterol, increasing age, excessive weight and hematocrit level while overweight, hypercholesterolemia, low HDL-cholesterol, smoking, hematocrit level, low income and increasing age were associated with hypertriglyceridemia. Excessive weight was associated with hypertriglyceridemia, low HDL-Cholesterol, presence of hypertension, hypercholesterolemia, diabetes mellitus, increasing age and low education.

Adolescent↗
PubMed2000

Radiofrequency catheter ablation in pediatrics: experience at Siriraj Hospital.

UNLABELLED: Tachyarrhythmia is one of the life threatening cardiac electrophysiology problems in children. It also affects quality of life of the patients. Radiofrequency catheter ablation (RFCA) has made a significant impact in the treatment of tachyarrhythmia since 1989. The present report is the first and largest report in Thai children. There have been 24 RFCA procedures in 21 children since it was initially performed at Siriraj Hospital from January 1996 to December 1999. The electrophysiology studies and medical records were analyzed retrospectively. Median age and weight at the time of the procedure were 11 (1.1-13) years old and 38.8 (6.8-78.2) kg respectively. The presenting symptoms were palpitation 66.7 per cent, presyncope 16.7 per cent, congestive heart failure and cardiogenic shock 8.3 per cent, syncope 4.2 per cent, and chest pain 4.2 per cent. Median duration of symptom was 3.5 (0.1-8.0) years. The underlying cardiac arrhythmias were Wolff Parkinson White (WPW) syndrome 50 per cent, concealed accessory pathway 16.7 per cent, atrioventricular node re-entry tachycardia (AVNRT) 16.7 per cent, atrial ectopic tachycardia (AET) 12.5 per cent, and WPW with AVNRT 4.2 per cent. The median fluoroscopy time and procedure time were 25 (4-145) minutes and 125 (60-320) minutes respectively. The median tachycardia cycle length was 332.5 (220-460) seconds. The immediate success rate was 21/24 (87.5%) procedures. The procedural complication was 1/24 (4.2%). Two patients (8.3%) had recurrences of tachycardia and were successfully controlled with antiarrhythmic drugs. CONCLUSION: RFCA is a safe, effective, and curative procedure with high success rate for pediatric tachyarrhythmias.

Adolescent↗
PubMed2000

Hyperhomocysteinemia in patients with coronary artery disease.

Hyperhomocysteinemia has been recognized as a risk factor of atherosclerosis. This study was aimed to measure the risk of coronary artery disease in patients with hyperhomocysteinemia. Age, HDL level, tHcy level and history of DM were independent risk factors for coronary artery disease. The level of tHcy of 11.0 mmol/L provides the best sensitivity and specificity of predicting coronary artery disease.

Adult↗
PubMed1998

Radiofrequency catheter ablation for frequent premature ventricular contractions: a preliminary report of 15 cases.

Between February 1995 and March 1997, 15 patients, 13 women and 2 men, underwent radiofrequency catheter ablation (RFCA) for symptomatic frequent premature ventricular contractions (PVC's). The mean age was 43.3 +/- 11.9 years. Thirteen patients (86.7%) had right PVC's and the remainder had both right and left PVC's. RFCA were done under local anesthesia, using both earliest endocardial activation time and pace mapping in complement. The immediate success rate was 14/15 (93%) with only minor complications in 2 patients (13.3%). The fluoroscopic and procedure times were 40.6 +/- 24.0 and 170.7 +/- 81.2 minutes, respectively. From the Holter monitoring, total PVC count, per cent of PVC per total heart beat in 24 hours and couplets count were significantly reduced, (more than 90%, p < 0.05), by RFCA. Triplets and repetitive ventricular tachycardia were totally abolished. During the follow-up period of 10.1 +/- 7.5 months, 2 patients (14.3%) had recurrences of right PVC's within 2 weeks after ablation. Reablation was successfully done in both patients without recurrence, giving the final success rate of 93 per cent. In conclusion, RFCA could be safely performed with a high success rate in patients with symptomatic frequent PVC's. It can be considered an alternative treatment in patients resistant to medical therapy.

Adult↗
PubMed1998

Short-term effects of atenolol in patients with dilated cardiomyopathy.

Dilated cardiomyopathy is a common cause of heart failure with systolic dysfunction. Medications used to treat this condition are usually for symptomatic relief. We studied the effect of atenolol in heart failure caused by dilated cardiomyopathy in a double blinded randomized fashion. There were 17 males and 5 females. All patients underwent right and left heart catheterization, coronary angiography, endomyocardial biopsy, exercise testing and doppler echocardiography. By 3 months, atenolol significantly reduced resting and exercise heart rate and pulmonary capillary wedge pressure. There was no difference in exercise capacity. We conclude from this study that atenolol improve hemodynamic condition in patients with dilated cardiomyopathy without improving exercise capacity during this short observation period.

Adrenergic beta-Antagonists↗
PubMed1998

Results of rapid two-stage arterial switch operation in patients with transposition of the great arteries: one-year postoperation.

The rapid two-stage arterial switch operation is an alternative therapy for patients with simple transposition of the great arteries who present beyond the neonatal period and have low left ventricular pressure. It provides normal ventricular function compared to the atrial switch operation. Between July 1994 and February 1997, there were 13 such infants who had rapid two-stage arterial switch operation performed at Siriraj Hospital. There was 1 late death (11 months after the operation). All 12 survivors (mean age 22.4 +/- 5.7 months) were clinically evaluated and had echocardiography performed at 14.8 +/- 4.9 months after the operation. All were asymptomatic. Echocardiogram revealed a residual small atrial septal defect (1 case), small ventricular septal defect (1 case), mild supravalvar neopulmonary stenosis (2 cases), bicuspid neoaortic valve without stenosis (2 cases), dilated neoaortic sinus of Valsalva (6 cases, 50%) and mild neoaortic insufficiency (11 cases, 91.7%). The left ventricular function was hyperdynamic after pulmonary artery banding and significantly decreased to normal level at the time of study (shortening fraction of 43.8 +/- 10.7 vs 29.2 +/- 3.8%, respectively, p = 0.0005). The wall thickness was significantly increased after pulmonary artery banding and decreased overtime (0.48 +/- 0.08 vs 0.32 +/- 0.05 cm, respectively, p < 0.0005). The left ventricular dimension was significantly increased both after pulmonary artery banding and at the time of study (2.06 +/- 0.42 vs 3.32 +/- 0.30 cm, respectively, p < 0.0005). The left ventricular mass was significantly increased after pulmonary artery banding and at the time of study (21.79 +/- 7.79 vs 33.08 +/- 7.40 g/m2, respectively, p = 0.0005). The mortality and morbidity of rapid two-stage arterial switch operation are low. However, long-term follow-up should be monitored.

Cardiac Surgical Procedures↗
PubMed1997

Radiofrequency catheter ablation in symptomatic ventricular arrhythmia.

BACKGROUND: Radiofrequency catheter ablation (RFCA) is an effective method to cure both supraventricular and ventricular arrhythmia (VA) in certain centres. AIM: To assess the results of RFCA in VA at Siriraj Hospital. METHOD: Electrophysiologic study, mapping, using both earliest endocardial activation and pace mapping, and ablation were performed. RESULTS: Thirty patients with symptomatic VA underwent RFCA. The mean age was 44 years. Eight patients had underlying heart disease (two prolapsed mitral valve, three myocarditis, two dilated cardiomyopathy and one mitral stenosis). Thirty-six morphologies of VA were detected from the study. Thirty-three morphologic tachycardias attempted were successfully ablated; 17, 10 and six were right VT, left VT and premature ventricular contraction (PVC), respectively. Failure of ablation occurred in one patient with left VT. Only minor complications occurred in this study. There was no difference in cycle length and endocardial activation time between right and left VT. 12/12 identical pace mapping was more easily performed in right VT than in left VT. The fluoroscopic and procedure times in left VT were significantly longer than in right VT. Relapse occurred in six patients. Re-ablation was successfully performed in four patients, giving a final success rate of 93%. CONCLUSION: RFCA is an effective treatment and should be considered as an alternative method to cure VT and refractory PVC.

Adolescent↗
PubMed1997

Ticlopidine in the prevention of thrombus formation after percutaneous transluminal coronary angioplasty (PTCA).

We studied the additive effect of ticlopidine to aspirin compared with aspirin in the prevention of thrombus formation after PTCA in two groups of 21 patients who underwent PTCA at Her Majesty's Cardiac Centre, Siriraj Hospital from January to April 1993. Patients in both groups were comparable in baseline patient data and characteristics of angiographic lesions. There was no difference in angiographic outcome including the presence of intracoronary thrombus between the two groups. We concluded that ticlopidine had no additive effect to aspirin in the prevention of thrombus formation after PTCA.

Angioplasty, Balloon, Coronary↗
PubMed1997

Percutaneous balloon pulmonary valvuloplasty in children: experience at Siriraj Hospital.

Twenty-seven children with pulmonary valvar stenosis with pressure gradient (PG) > or = 40 mmHg underwent percutaneous balloon pulmonary valvuloplasty (PBPV) at Siriraj Hospital between February 1993 and August 1996. There were 13 males and 14 females, with an age range from 2 months to 14 years, and body weight from 4.7 to 42.1 kg. The majority (92.6%) were asymptomatic. Before the PBPV, the pulmonary valve annulus (PVA) measured by echocardiography was significantly greater than that measured by cardiac catheterization (15.2 +/- 3.7 vs 14.5 +/- 3.9 mm, P = 0.006). However, there was linear association (r = 0.972) between the two methods. The PG obtained by the two methods showed no significant difference (90.8 +/- 35.3 by echocardiography vs 97.3 +/- 47.2 mmHg by catheterization, P = 0.266). Immediately after PBPV, the right ventricular systolic pressure (113.7 +/- 41.1 pre vs 62.3 +/- 28.1 mmHg post) and the PG 103.4 +/- 43.4 pre vs 49.0 +/- 31.1 mmHg post) were significantly reduced (p < or = 0.0005). At 6-mo follow-up echocardiography, the PG was 28.6 +/- 17.6 mmHg and was significantly reduced (P = 0.0005). The PVA significantly increased at the 12 mo follow-up (15.2 +/- 3.6 pre vs 17.6 +/- 3.8 mm post, P = 0.001). Only minor complications were reported in the present study; bleeding (3.7%), transient bradycardia (7.4%) and pulmonary regurgitation not more than moderate severity (79%). The immediate and intermediate results of PBPV are excellent with a success rate of 85 per cent.

Adolescent↗
PubMed1996

Relationship between exercise capacity and left ventricular function in aortic and mitral regurgitation.

The exercise capacity as assessed by treadmill exercise or functional class from clinical history cannot predict standard echocardiographic findings in patients with AR/MR, in terms of EF, LVDs, ESVI. Therefore, exercise capacity cannot be used to predict the timing for surgery in those patients. However, symptomatic patients with dilated LV usually have low LVEF such as in our group.

Adolescent↗
PubMed1996

Left ventricular hypertrophy: relationship of echocardiographic and electrocardiographic findings in idiopathic dilated cardiomyopathy.

Diagnosis of left ventricular hypertrophy is important in patients with cardiac disease. To test the correlation of echocardiographic and electrocardiographic findings for diagnosis of left ventricular hypertrophy in Idiopathic Dilated Cardiomyopathy (IDC), 18 patients with proven IDC were examined. There were 15 males and 3 females, ages ranged from 22-60 years (mean 43 +/- 10.7). LV mass index ranged from 134.4-421.2 g/m2 (mean 187.8 +/- 68.6). All 18 patients had LVH by echocardiography but only 10 patients (55.6%) had LVH by using ECG Romhilt-Estes scoring system. The correlation between echocardiographic and electrocardiographic findings for diagnosis LVH was not significant (r = 0.026; p = 0.935) and echocardiography was better than electrocardiography for diagnosis of LVH in IDC.

Adult↗
PubMed1995

Randomized double-blind, placebo-controlled trial of oral atenolol in patients with unexplained syncope and positive upright tilt table test results.

The objective of this investigation was the assessment of the response rate of oral atenolol in patients with vasovagal syncope after 1 month of treatment. We randomized into two groups all patients referred to our unit who had had at least one episode of syncope or two episodes of presyncope 1 month before presentation and had a positive isuprel Tilt Table Test (TTT). Group 1 (Gr 1) received oral atenolol, and group 2 (Gr 2) received placebo medication. After a 1-month period patients were reassessed for degree of their symptoms and underwent repeated TTT. Forty-two patients were enrolled in the study. Gr 1 and Gr 2 were comparable in age (38 +/- 13 years vs 43 +/- 14 years, p = 0.216 and sex (male/female = 6:15 vs 10:11, p = 0.204). The severity of attack was similar in both groups. Eight patients in Gr 1 and six patients in Gr 2 had mitral valve prolapse (p = 0.5). No significant differences were seen in systolic blood pressure (122 +/- 17 vs 117 +/- 16 mmHg, p = 0.334), diastolic blood pressure (70 +/- 11 vs 72 +/- 11 mm Hg, p = 0.677), and heart rate (79 +/- 12 vs 79 +/- 13, p = 0.98) between the two groups. The response rates (negative TTT) after 1 month of treatment were 62% versus 5% (p = 0.0004) in the atenolol and control group, respectively. Moreover, patients who received atenolol reported feeling better compared with those who received placebo (71% vs 29%, p = 0.02). In conclusion, atenolol significantly improved symptoms of patients with vasovagal syncope.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1990

Multivariate analysis in the prediction of death in hospital after acute myocardial infarction.

Prognostic factors in patients with acute myocardial infarction based on clinical and investigative data on admission were evaluated prospectively in 111 consecutive patients. Seventeen patients (15.3%) died during hospital stay. Age, a previous infarct, high Killip class, cardiomegaly, high serum concentrations of cardiac enzymes, a low ejection fraction, and a high wall motion score index correlated significantly with in-hospital mortality; whereas sex, risk factors, and pericardial effusion did not. Multivariate analysis showed that age and the wall motion score index were the best predictors of death in hospital. Wall motion detected by cross sectional echocardiography may reflect the extent of myocardial involvement. Age and wall motion score index predicted in-hospital mortality with a sensitivity of 76.5%, a specificity of 91.5%, and a predictive accuracy of 89.2%. Age and the wall motion score index can be determined on admission and are useful for identifying patients at high risk of cardiac death who might benefit from early intervention.

Adult↗