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Tsung-Hsien Lin

Publications and source records attributed to Tsung-Hsien Lin.

44 records · Page 3Linked to original sources

Ankle-brachial pressure index measured using an automated oscillometric method as a predictor of the severity of coronary atherosclerosis in patients with coronary artery disease.

Ankle-brachial pressure index (ABI) measured using a conventional Doppler method is an independent predictor of the number of coronary vessels affected in coronary artery disease (CAD). Recently, a new clinical device has been developed to measure ABI using an oscillometric method. It is unclear whether ABI measured using this device is a significant predictor of the severity of coronary atherosclerosis. We retrospectively included 87 patients from our outpatient clinic who had ever undergone coronary angiography. ABI was determined in all subjects using the new ABI-form device. The lower value of ABI in either limb was used for analysis. We divided our subjects into two groups, with either ABI less than 0.9 or at least 0.9, and compared basal characteristics between groups. We analyzed the relationship between ABI and the severity of CAD. In addition, we calculated the sensitivity, specificity, and positive and negative predictive values of ABI less than 0.9 in predicting multivessel (two-vessel + three-vessel) involvement in our patients. There were 15 patients with ABI less than 0.9 and 72 with ABI at least 0.9. Patients with ABI less than 0.9 were older and had higher plasma levels of uric acid. The prevalence of diabetes mellitus, hypertension, smoking, and diuretic use was significantly higher in patients with ABI less than 0.9. In addition, the group with ABI less than 0.9 had a lower prevalence of one-vessel CAD and higher prevalence of three-vessel or multivessel CAD. The sensitivity, specificity, and positive and negative predictive values of ABI less than 0.9 in predicting multivessel CAD were 22%, 96%, 93%, and 34%, respectively. In conclusion, ABI measured using the automated oscillometric method can be used to predict the severity of coronary atherosclerosis in patients with CAD.

Aged↗

Coronary artery aneurysms in a young patient with acute myocardial infarction: a case report.

Coronary artery aneurysms are not uncommon. They are usually arteriosclerotic in origin, and may be congenital or secondary to injury, dissection, infection, inflammation, or Kawasaki disease (KD). Herein, we report a case involving a 25-year-old male smoker with acute myocardial infarction (AMI). Coronary angiography showed triple-vessel disease, coronary artery aneurysms, and diffuse ectasia. Coronary artery bypass grafting was performed without complications. Based on his history, serologic examinations, and angiographic findings, we suspected that his coronary artery aneurysms and ectasia were the adult sequelae of KD. This case is a good reminder that KD victims may suffer from young-onset AMI.

Adult↗

High prevalence of isovolumic relaxation flow in healthy subjects.

BACKGROUND: Inhomogenous left ventricular activation-inactivation has been suggested to play a role in the genesis of segmental early relaxation and in turn of isovolumic relaxation flow (IRF). The spatial distribution of conduction system in the left ventricle leads to heterogenous activation sequence even in healthy subjects. This study was conducted to evaluate our hypothesis that IRF should be ubiquitous in healthy subjects. METHODS: This prospective study included 126 healthy subjects (aged 15-81 years) free of acute or chronic illness by history and physical examination. No significant abnormality appeared in the resting 12-lead electrocardiogram or transthoracic echocardiogram. With the pulsed-wave Doppler echocardiography, the sample volume was placed at the mid-ventricle to detect the IRF. RESULTS: An apically directed IRF, with the velocity 17-101 cm/sec and the duration 57-145 ms, could be detected in all the study subjects. There was no inter-sex difference in such characteristics of IRF. However, its duration and velocity got longer and higher with aging. The fractional shortening of the left ventricle and the interventricular septal thickness were stepwisely selected as the determinants of the IRF velocity, and the transmitral E-to-A wave velocity ratio, the left ventricular inflow propagation velocity, and the interventricular septal thickness as the determinants of the IRF duration. CONCLUSIONS: IRF is ubiquitous in healthy subjects. Both the duration and the velocity of IRF present an aging trend and may be mainly related to left ventricular diastolic and systolic performance, respectively.

Adolescent↗

Spontaneous left main coronary artery dissection: a case report.

Coronary artery dissection is a devastating disease, but spontaneous left main coronary artery dissection is extremely rare. We present the case of a 58-year-old diabetic man who was found to have primary spontaneous left main coronary artery dissection during a coronary angiography examination. Although the dissecting lesion persisted, he had no peri-procedural chest discomfort or electrocardiographic change. We performed urgent coronary artery bypass grafting, which was uneventful. The patient received regular cardiovascular follow-up and did not complain of any postoperative chest discomfort. He had an uneventful recovery.

Aortic Dissection↗

Left ventricular inflow propagation velocity: comparisons between pulsed wave and color M-mode Doppler echocardiography.

Sixty-six participants (age 58 +/- 16 years) were included for evaluation of the relationship between color M-mode and pulsed wave Doppler left ventricular inflow propagation velocity (LVIPVcmm and LVIPVpw, respectively). LVIPVpw was measured through the application of the range ambiguity phenomenon, and LVIPVcmm was obtained by manually tracing the first aliasing velocity during the early filling. The variability for LVIPVpw measurements was significantly less than that for LVIPVcmm measurements. There was a significant correlation (r = 0.678, P <.001) between LVIPVcmm and LVIPVpw for all study participants. However, LVIPVpw was greater than LVIPVcmm, especially when the inflow propagation time was relatively short. Age was the only determinant of both LVIPVcmm and LVIPVpw in the control group. As for the patients with diseases retarding inflow propagation, age remained its determinant. However, its impact decreased and the end-systolic dimension and fractional shortening of the left ventricle, instead, turned out to be its major determinant. In conclusion, LVIPVpw measurements are more reproducible than LVIPVcmm measurements. LVIPVpw correlates with LVIPVcmm and their difference significantly correlates with left ventricular inflow propagation time.

Blood Flow Velocity↗

Cold effect on qt dispersion in healthy subjects.

Thirty-one healthy subjects, aged 35 +/- 6 (21 to 48) years, were included in the study to evaluate the effect of ice water immersion on QT dispersion. There was no difference in the age between females (n = 11) and males (n = 20). Baseline, stress (at the end of ice water immersion, 4 degrees C, for 3 minutes) and recovery 12-lead electrocardiograms (ECGs) were recorded on each subject. During the test, a significant variability developed in both the QT dispersion (52 +/- 17, 68 +/- 25 and 59 +/- 21 ms; p = 0.015) and the corrected QT dispersion (56 +/- 17, 76 +/- 27 and 64 +/- 23 ms; p = 0.005), but not in the heart rate (74 +/- 11, 76 +/- 9, and 74 +/- 9 bpm, respectively; p = 0.447). There was no inter-sex difference in the baseline heart rate or QT dispersion, or in their response to ice water immersion. Age significantly correlated with the variation of QT dispersion to ice water immersion (r = 0.380, p = 0.035). With 37 years of age as a separation point, the variation of QT dispersion to ice water immersion was more obvious in the older group (28 +/- 22 vs. 10 +/- 19 ms, p = 0.023). In conclusion, cold may increase QT dispersion in healthy subjects, with a more obvious effect in the older ones.

Adult↗

Changes of coronary risk factors after eradication of Helicobacter pylori infection.

Several epidemiological studies have shown a positive correlation between chronic gastric infection with Helicobacter pylori (HP) and coronary artery disease. A number of reports also claimed that there are strong relationships between HP infection and coronary risk factors. However, clinical studies concerning the changes of coronary risk factors after eradication of HP infection are few and contradictory. We conducted a prospective study aiming to compare sugar, lipid and fibrinolytic profiles before HP eradication with those after HP eradication. HP infection was confirmed by endoscope-based examinations and eradicated by a standard OAC (omeperazole-amoxicillin-clarithromycin) regimen. We measured and compared pre- and post-eradication blood sugar, lipid profiles (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride) and fibrinolytic profiles (tissue-plasminogen activator, plasminogen activator inhibitor-1, fibrinogen, and D-dimer levels). Forty-eight patients (male:female, 25:23; mean age, 50.8 +/- 11.3 years) with gastric HP infection were enrolled in this study. Although HP infection was confirmed to have been successfully eradicated, no significant changes of blood fasting sugar, lipids or fibrinolytic profiles were found in patients after treatment. Coronary risk factors including fasting sugar, lipid and fibrinolytic profiles were not changed after successful HP eradication treatment. The relationship between HP infection and coronary artery disease needs to be clarified.

Adult↗

Arrhythmogenic right ventricular cardiomyopathy: three cases.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare disease characterized by replacement of myocardium with fibrofatty tissue. It mainly involves the right ventricle (RV) and causes abnormal RV performance. ARVC is the most common cause of sudden cardiac death in young Italian athletes because it induces malignant ventricular tachyarrhythmias. Clinical manifestations of ARVC may be different between Chinese and Western patients. In this paper, we share our experience of the clinical manifestations of ARVC and review previous reports of ARVC.

Aged↗