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Chung Il Noh

Publications and source records attributed to Chung Il Noh.

10 recordsLinked to original sources
PubMed2006

Impaired vascular function in patients with Fontan circulation.

BACKGROUND: This study was performed to evaluate the endothelial function in Fontan patients, and to investigate the associated factors which influence the endothelial function in these patients. METHODS: Flow mediated dilatation (FMD) and nitroglycerin induced dilatation (NG) of the brachial artery, and intima media thickness (IMT) of common carotid artery (CCA) were measured in nonselected Fontan patients (n=44, age 5 to 29 years, median 14 years, 18 females) by means of high-resolution ultrasound according to the standard protocols. The results were compared to age and sex matched controls (n=25, age 5 to 27 years, median 13 years, 10 females). RESULTS: Fontan patients presented significantly reduced FMD and NG compared with controls (FMD; 6.5+/-2.4 vs. 11.1+/-1.4%, p<0.001, NG; 13.3+/-5.2 vs. 19.4+/-6.2%; p=0.035). Twenty two percent of Fontan patients presented pure endothelial dysfunction, and 34% of patients presented combined endothelial and smooth muscle dysfunction. Although there was no correlation between FMD and IMT, Fontan patients presented increased carotid IMT (0.44+/-0.07 vs. 0.38+/-0.06 mm, p=0.008). In multivariate analysis, duration of exposure to chronic hypoxia was inversely correlated with FMD (p=0.117, hazards ratio=1.294, 95% confidence interval=0.938-1.786). There was higher FMD in patients receiving angiotensin-converting enzyme inhibitors (ACEi) compared with those not receiving ACEi (7.0+/-2.5 vs. 5.5+/-2.2%, p=0.069). CONCLUSIONS: Endothelial dysfunction is more prevalent in Fontan patients compared with healthy controls, and the previous hypoxia is an independent factor. Although it is not statistically significant, those patients on treatment with ACEi seem to have better endothelial function.

Administration, Sublingual↗
PubMed2005

Mid-term follow-up of neoaortic regurgitation after the arterial switch operation for transposition of the great arteries.

OBJECTIVE: The aim of this study was to determine the outcome of the neoaortic valve after the arterial switch operation for transposition of the great arteries. METHODS: A retrospective review of arterial switch operations that were performed during the period from 1991 to 2003 was conducted. We followed patients with echocardiography. When regurgitation of the neoaortic valve was observed we analyzed the risk factors. RESULTS: One hundred and three patients underwent a successful arterial switch operation. Eighty-one males and 22 females participated in the study. Follow-up period was 77+/-42 months. The age and body weight at the time of the arterial switch operation were 1.4+/-2.8 months and 3.8+/-1.0 kg, respectively. Preoperative pulmonary valve regurgitation was found in six patients (two patients had grade I and four patients had grade II). In the postoperative echocardiography, 52 patients demonstrated neoaortic valve regurgitation (26 patients had grade I, 25 patients had grade II, and 1 patient had grade III). At the last follow-up visit, 61 patients demonstrated neoaortic regurgitation (18 patients had grade I, 37 patients had grade II, 5 patients had grade III, and 1 patient had grade IV). Neoaortic valve regurgitation increased progressively with follow-up (p-value<0.01). The size discrepancy between the aorta and the pulmonary artery was correlated with neoaortic valve regurgitation (p-value=0.02). The age and body surface area, relationship of the great arteries, coronary arterial pattern, pulmonary artery banding, use of trap-door technique, myocardial ischemic time, use of total circulatory arrest, and existence of ventricular septal defect were not significant risk factors. CONCLUSIONS: Neoaortic valve regurgitation progressed after the arterial switch operation. The degree of regurgitation was more severe in patients with a size discrepancy between the aorta and the pulmonary artery preoperatively.

Aortic Valve↗
PubMed2005

Fontan conversion with arrhythmia surgery.

OBJECTIVE: Hemodynamic abnormalities and refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with Fontan conversion and concomitant arrhythmia surgery. METHODS: Between January 1996 and February 2004, 16 patients underwent Fontan conversion and arrhythmia surgery. Mean age at the initial Fontan operation was 5.1+/-3.5 (range: 2-15) years and mean age at Fontan conversion was 17.0+/-5.8 (range: 6-30). The initial Fontan operations were atriopulmonary connections in 14 patients, extracardiac lateral tunnel in 1, and intracardiac lateral tunnel in 1. The types of arrhythmia included atrial flutter in 10 patients and atrial fibrillation in 3. Fontan conversion operation was performed with intracardiac lateral tunnel in 5 patients and extracardiac conduit in 11. Arrhythmia surgery included isthmus cryoablation in 10 patients and right-sided maze in 3. RESULTS: There has been no mortality. At Fontan conversion operation, 7 patients required permanent pacemaker. All patients have improved to New York Heart Association class I or II. With a mean follow-up of 26.9+/-30.6 (range:1-87) months, 16 patients had sinus rhythm, 2 patients had transient atrial flutter which was well controlled, and 2 patients required permanent pacemaker during follow-up. CONCLUSIONS: Fontan conversion with concomitant arrhythmia surgery and permanent pacemaker placement is safe, improves New York Heart Association functional class, and has a low incidence of recurrent arrhythmias. In most patients, concomitant permanent pacemakers are needed.

Adolescent↗
PubMed2004

Repair of transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction.

OBJECTIVES: This study was undertaken to compare the outcomes of the Lecompte procedure and Rastelli repair in the transposition of the great arteries (TGA) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) and to determine the risk factors associated with unfavorable events. METHODS: Over a 12-year period (April 1990-October 2002), 35 patients underwent complete repair for TGA, VSD, and LVOTO. Twenty-five patients (71%) underwent the Lecompte modification, and mean age and weight were 23.4+/-18.2 months and 10.2+/-3.0 kg. Ten patients (29%) underwent the Rastelli operation, and mean age and weight were 39.1+/-36.1 months and 13.8+/-6.8 kg. RESULTS: One early death (3%) occurred after the Lecompte procedure and no late death. The mean follow-up was 5.9+/-3.8 years. Eight patients in the Rastelli group (80%) underwent a late reoperation for obstruction of the extracardiac conduit, and in four of these patients, a reoperation for LVOTO was concomitantly required. Reoperation was also required in six patients of the Lecompte group (25%); five for right ventricular outflow tract obstruction (RVOTO) including one for LVOTO and two for VSD leakage, and one for mitral regurgitation and left pulmonary artery stenosis. The interval prior to reoperation ranged from 1.6 to 11.1 years, with a mean of 5.7+/-3.1 years. The actuarial figures for freedom from reoperation at 5 and 10 years were 40.0+/-15.5 and 26.7+/-15.0% after the Rastelli operation and 95.7+/-4.3 and 63.5+/-12.6% after the Lecompte procedure (P = 0.02). Multivariate analysis by Cox regression analysis revealed that the risk factors of RVOTO were a younger age at operation, the Rastelli operation, and ductus ligation during the operation. CONCLUSIONS: The Lecompte procedure and Rastelli repair provide satisfactory early and late results. However, substantial late morbidity is more associated with conduit obstruction, and LVOTO in Rastelli repair rather than Lecompte procedure.

Abnormalities, Multiple↗
PubMed2004

Elastic properties of the ascending aorta in young children after successful coarctoplasty in infancy.

BACKGROUND: Based on the hypothesis that vascular dysfunction in the ascending aorta can cause morbidity, we undertook this study on the elastic properties of ascending aorta and left ventricular (LV) function in young children who received coarctoplasty in early infancy. METHODS: Blood pressures (BP) in the right arm and ascending aortic internal diameters determined by M-mode ultrasound at rest and after exercise were measured in 25 patients (mean age, 6.4+/-3 years) and 22 control subjects (mean age, 5.8+/-2.4 years). Ascending aortic stiffness index and distensibility were calculated using BP measurements and ascending aortic internal diameters. In addition, LV parameters (systolic and diastolic function, mass index) were evaluated. RESULTS: Compared with control subjects, patients had increased stiffness index (at rest: 4.87+/-1.94 versus 3.57+/-1.19, P=0.021; after exercise: 4.33+/-1.91 versus 3.2+/-1.26, P=0.034) and decreased distensibility (at rest: 6.90+/-3.15 versus 8.72+/-2.77, P=0.02; after exercise: 5.69+/-2.39 versus 7.88+/-3.44 cm2 dyn(-1) 10(-6), P=0.023). BP and LV parameters showed no consistent differences between the two groups. In patients, distensibility was significantly correlated with systolic BP (at rest: P=0.008; after exercise: P=0.014) and pulse pressure (at rest: P=0.013; after exercise: P=0.001). CONCLUSIONS: This study suggests that vasculopathy of ascending aorta is possible in some young children despite early correction. However, long-term tracking study is needed to clarify the significance of the study.

Aorta↗
PubMed2004

The usefulness of surface electrocardiogram as a prognostic predictor in children with idiopathic dilated cardiomyopathy.

We investigated the interrelations between surface electrocardiographic changes and clinical outcomes in children with idiopathic dilated cardiomyopathy (DCMP). 33 patients (19 boys, 14 girls) were classified into two groups; group I (15) who were in poor clinical status or dead; and group II (18) who showed good clinical status. Group I had larger LV dimensions compared to group II (Gr I vs. Gr II; LVEDD, 52 +/-11 vs. 42+/-7 (mm); LVESD, 43+/-12 vs. 30+/-5 (mm); p<0.05). QRS duration was prolonged in Gr I compared to Gr II and normal (Gr I, 84+/-28; Gr II, 66+/-12; normal control, 67+/-9). The QRS duration was correlated with the dimensions of left ventricle (LV). Corrected QT and JT interval and dispersions of QT in the DCMP group showed a significant difference compared to the normal control, however there was no significant difference between Gr I and II. In conclusion, QRS duration was correlated with ventricular dimension and clinical outcome in children with idiopathic dilated cardiomyopathy. Irrespective of increased ventricular inhomogeneity, QT dispersion could not be used to predict long-term prognosis.

Cardiomyopathy, Dilated↗
PubMed2003

The effect of beta adrenergic stimulation on QT and QTc interval in syncope children with or without coexisting ventricular arrhythmias.

We investigated the effect of beta-adrenergic stimulation on the heart rate and QT interval in syncope children with or without coexisting ventricular arrhythmias (VA). Of the 24 children who presented with syncope or presyncope and showed negative tilt test, 13 were classified into a group with VA and the remaining 11 without VA. The provocative test was performed in bolus infusion and continuous infusion. RR, QT, and QTc intervals on routine 12-lead surface electrocardiogram were obtained during each stage of isoproterenol infusion. In all cases, malignant ventricular arrhythmia and syncope were not induced by isoproterenol provocative test. RR and QT intervals were shortened and QTc intervals were prolonged as the isoproterenol dose was increased in both groups and methods. The QTc interval reached its peak level after the bolus injection of 1.0 microgram and during the continuous infusion of 0.03 microgram/kg/min. The two groups showed no significant difference in the QTc interval change according to the infusion methods. This study indicates that changes in the heart rate and QT interval by beta-adrenergic stimulation were not different according to the coexisting ventricular arrhythmias in syncope children with negative head-up tilt test.

Adolescent↗
PubMed2002

Modified extracardiac Fontan in a patient with separate hepatic venous drainage.

We describe an alternative technique to the extracardiac Fontan procedure in a patient with a univentricular heart, in which the inferior caval vein and the hepatic vein drained separately into the common atrium and the intraatrial orifice of the hepatic vein was adjacent to the opening of the left lower pulmonary vein.

Fontan Procedure↗
PubMed2002

Septal stunning by dipyridamole stress shown on quantitative gated perfusion SPECT in a child with hypertrophic cardiomyopathy.

PURPOSE: Myocardial ischemia is an important problem in hypertrophic cardiomyopathy. Stunning is an important mechanism in progressive dysfunction of the ischemic myocardium. In this report, the authors found prolonged myocardial stunning in a child with hypertrophic cardiomyopathy that was induced by dipyridamole stress on quantitative gated SPECT. MATERIALS AND METHODS: A 6-year-old boy with septal hypertrophy underwent rest and dipyridamole stress gated myocardial SPECT. Software was used to quantify automatically segmental perfusion and function at rest and after stress. RESULTS: Perfusion imaging showed a reversible perfusion decrease in the hypertrophic septum. Cine-gated imaging of the septum showed dyskinesia and a severe abnormality of systolic thickening during the poststress period, whereas it showed nearly complete recovery at rest. Quantified regional perfusion and function indices also showed this perfusion decrease and myocardial dysfunction after dipyridamole stress. CONCLUSION: In a child with hypertrophic cardiomyopathy, myocardial stunning was induced by dipyridamole stress, in accordance with decreased perfusion reserve.

Cardiomyopathy, Hypertrophic↗