WCIM 2014 SEOUL KOREA 71
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0099 Cardiology
Morphological Variation of the Carotid Sinus Location
Satoshi FURUKAWA1, Satomu MORITA1, Katsuji NISHI1, Masahito HITOSUGI1 Shiga University of Medical Science, Japan1
Background: Carotid sinus massage is widely used to detect carotid sinus hypersen- sitivity in patients presenting with syncope. Recent guidelines recommend 5 to 10 seconds of carotid sinus massage in supine and upright positions with beat-to-beat monitoring, but somebody did not respond to the procedure.
Objectives: The aim of this study was to describe the common Carotid Artery Bifurca- tion (CB).
Method and result: Measurements were performed on 100 cadavers by the direct inspection method. The vertebra level of CB was differently distributed in distance of the whole neck measured along the vertebral column between upper borders of C1- C2 to lower border of C5. 54% of the level of CB was asymmetrical between the right and left side.
Conclusion: We showed the anatomical variation of carotid sinus location. Anatomical locations of the carotid sinus bifurcation indicated wide variability. This variation was found to have an impact on the pressure transmission at the carotid sinus region in those individuals that displayed the superior/inferior range of carotid sinus loci.
PS 0100 Cardiology
Features of Microcirculatory Parameters in Patients with Arterial Hypertension and Metabolic Syndrome and Subclinical Hypothyroidism
Ekaterina BYCHINA1, Ludmila PANCHENKOVA1, Ekaterina TROSHINA2
Moscow State University of Medicine and Dentistry, Russia1, Endocrinology Research Center, Russia2 Background: Data on microcirculatory changes in arterial hypertension (AH) is ade- quately represented in modern publications, but the issue of disorders of microcircu- lation in comorbid pathology, including the combination of AH within the metabolic syndrome (MS) and subclinical hypothyroidism (SH) remains poorly understood.
Methods: The study included 87 patients divided into 3 groups: 25 (28,7%) patients with AH, 37 (42,6%) patients with AH in the MS, 25 (28,7%) patients with AH as- sociated with MS and SH. Control group (CG) were 22 practically healthy people. All the patients underwent examination of the state of microcirculation by laser doppler fl owmetry.
Results: There was a statistically significant reduction of the standard deviation of microcirculation (SD M) in all major groups compared with the CG. In the group AH+MS+SH noted a signifi cant increase in heart rate indices fl uctuations (AmaxCF/3SD M) (values more 30%), respiratory rate fl uctuations (AmaxHF/3SD M) (values more 30%) and intravascular resistance (AmaxCF/M) (values more 10 perfusion units (PU)) in the analysis of the distribution of these parameters within the groups as compared to healthy individuals, patients with AH and patients with AH associated with MS. In the group AH+MS+SH revealed a statistically signifi cant decrease in the index of the effectiveness of the microcirculation (IEM) as compared in healthy and patients of the group AH+MS (1,23 [0,99; 1,65] vs 1,75 [1,23; 2,24] и 1,67 [1,31; 2,00] PU respective- ly (p<0,05)).Normotsirkulyatorny type of microcirculation signifi cantly less common in all hypertensive patients compared with controls, and the predominant type of hemo- dynamic microcirculation was spastic.
Conclusions: Microcirculation in hypertensive patients with MS and SH is particularly characterized by the redistribution mechanisms of regulation of the microcirculatory level (prevalence of passive, active suppression mechanisms), severe congestive on venular and capillary levels, worsening of the microvessels.
PS 0101 Cardiology
Intracardiac Bronchogenic Cyst: Report of a Growing Lesion
Jonghanne PARK1, Goo-Yeong CHO2, Kay-Hyun PARK3, Il-Young OH2
Seoul National University Hospital, Korea1, Seoul National University Bundang Hospital, Korea2, Seoul National University Bundang Hospital, Korea3
Introduction: Intracardiac bronchogenic cyst is a rare congenital malformation which is a remnant from abnormal budding of the embryonic foregut. As most of the intra- cardiac cysts are surgically removed promptly after detection, the natural course of intracardiac bronchogenic cyst is unknown.
Case Presentation: 35-year-old man on adjuvant chemotherapy for gastric cancer presented with rapidly growing intracardiac mass incidentally detected at follow-up CT scan. Retrospective review of his pre-op stomach CT scan and follow-up abdomen CT scan revealed that the cyst had increased up to 6-fold in volume over a period of 13 months. Transthoracic echocardiography and magnetic resonance imaging revealed a homogenous cystic mass located at the interatrial septum. The patient underwent surgical excision of the mass. Histopathology identified columnar epithelial cells with focal cilia, consistent with the diagnosis of bronchogenic cyst. At immediate post-operation, 12-lead ECG showed CAVB, which persisted 6 days after surgery. A dual-chamber pacemaker was then implanted before discharge. At two months follow up, the patient was symptom free without any evidence of cardiac tumor or gastric cancer recurrence.
Discussion: Here, we report a case of incidentally detected intracardiac bronchogenic cyst which was rapidly growing. To our knowledge, this is the fi rst report documenting growth of an intracardiac bronchogenic cyst in adult. Generally, growth of broncho- genic cyst is thought to be result of mucus accumulation, bleeding, infection or malig- nant transformation. We speculate that chronic infl ammation precipitated by adjuvant chemotherapy could be the cause of cyst growth.
