Images in cardiology: giant left main coronary artery aneurysm with organized thrombus.
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Biomedical subjects
Publications and source records attributed to Pai-Feng Hsu.
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BACKGROUND: General obesity and its progression are major predictors of future hypertension. It has not been established whether abdominal obesity contributes to the development of hypertension. METHODS: A community-based study population of 2377 normotensive nondiabetic Chinese adults aged >or=30 years were re-examined 10 years after their baseline examination. RESULTS: The 10-year cumulative incidence of hypertension was 25.9%. The standardized parameters for the prediction of follow-up systolic blood pressure (BP) for baseline body mass index (BMI), change in BMI, baseline homeostasis model assessment of insulin resistance (HOMA-IR), change in HOMA-IR, baseline waist circumference (WC), and change in WC were 0.19 (P < .001), 0.09 (P < .001), 0.11 (P < .001), 0.08 (P < .001), 0.16 (P < .001), and 0.07 (P < .001), respectively, when age, sex, and baseline systolic BP were accounted for. By stepwise linear regression analysis, age, baseline systolic BP, baseline BMI, change in BMI, baseline WC, and change in WC were significant predictors of the follow-up systolic BP. Both baseline WC and change in WC were significant predictors of follow-up systolic BP or incident hypertension when age, sex, baseline systolic BP, BMI, and change in BMI were accounted for. In a subgroup of younger adults with normal BMI and BP<130/85 mm Hg, baseline systolic BP, change in HOMA-IR, baseline WC, and change in WC were significantly independent predictors of follow-up systolic BP. CONCLUSION: Abdominal obesity and its progression are predictors of future BP and hypertension incidence, independent of the effects of general obesity.
The usefulness of automated measurements of the systolic time intervals in community screening deserves investigation. The systolic time intervals, including pre-ejection period (PEP), the left ventricular ejection time (LVET), and PEP/LVET were automatically and rapidly determined from signals of electrocardiography, phonocardiography, and pulse volume recording in 1087 residents aged > or = 40 years in a community of homogeneous Chinese. Receiver operating characteristics analysis was performed to determine the cutoff values for PEP, ET, and PEP/LVET in predicting high N-terminal pro-brain natriuretic peptide (NT-proBNP). The prevalence of high NT-proBNP was 12.3% in men and 8.3% in women. NT-proBNP was linearly related to both PEP and PEP/LVET, while there was a U-shaped relationship between NT-proBNP and LVET. In men, the sensitivity and specificity in predicting high NT-proBNP levels were 60% and 60%, respectively, for PEP > or = 89 ms; 60% and 62% for PEP/LVET > or = 0.31; and 63% and 60% for LVET < 272 ms or LVET > or = 310 ms. Various combinations of the criteria further improved either sensitivity or specificity. Women had slightly different cutoff values and performance for the various criteria of abnormal systolic time intervals and their combinations. Automated systolic time intervals appear to be useful in the screening of subjects with high NT-proBNP in a community.
Coronary artery dissection is a common occurrence after percutaneous transluminal coronary angioplasty (PTCA). However, we report herein a rare case of double-barrel coronary artery dissection occurring 1 year after PTCA for stenosis in the left circumflex coronary artery. The case history and angiographic findings are reported, and relevant literature is reviewed.
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