164
￭ S-245 ￭
A Case of Complete Atrioventricular Block in a Patient with Ventricular Noncompaction
Department of Internal Medicine, Korea University Medical Center
*Suk-kyu Oh
1, Jong-il Choi, Hong Euy Lim, Sang Weon Park, Seong Mi Park, Choi Eun Jeong, Young-Hoon Kim
Noncompaction of ventricle is unclassified cardiomyopathy with genetic problem and associated with other congenital cardiac anomaly. Clinical manifestation of noncompaction of ventricle is variable including LV dysfunction, chest pain, thromboembolic event, and arrhythmia. We reported noncompaction with bradyarrhythmia manifestation, especially complete atrioventricular block. Male, 59 years old patient was visited outpatient with history of syncope on July, 2011. In routine check up in Autumn 2010, EKG was normal and he didn’t have any other medical history.
Initial EKG finding was complete AV block ECHO Finding : LV Ejection fraction was 25~30% with Left and Right ventricle non-compaction Permenant pacemaker was inserted for atrioventricular block Β-blocker, ACE inhibitor and Diuretics was add for LV dysfunction At dischare, he had no complaint of syncope or dyspnea. In our case, complete atrioventricular block with syncope was first manifestation of noncompaction, especially biventricular. In a near future, cardioverter will be also considered for primary prevention of ventricular arrhythmia
￭ S-246 ￭
Difference in Clinical Characteristics of Ischemic Heart Failure in Korean Patients with Acute Myocardial Infarction
The Heart Center of Chonnam National University Hospital, The Heart Research Center Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
*Minsuk Kim, Myungho Jeong, Sungsoo Kim, Mingoo Lee, Keun-ho Park, Doosun Sim, Namsik Yoon, Hyunju Yoon, Youngjoon Hong, Juhan Kim, Youngkeun Ahn, Jeonggwan Cho, Jongchun Park, Jungchae Kang,
Acute Myocardial Infarction Registry Investigators
Background: The purpose of this study is to define the differences of predictors of ischemic heart failure (IHF) in Korean patients with acute myocardial infarction (MI). Methods: Clinical characteristics analysis was performed in total 11,581 patients from the Korea Acute Myocardial Infarction Registry, who were divided into two groups according to the initial left ventricular ejection fraction (LVEF): goup 1 (LVEF<40%, N=2271) and group 2 (LVEF≥40%, N=9310). Differences in clinical characteristics were compared between the groups and 1-year major adverse cardiac events (MACE) were analyzed in group 1. Results: Average LVEF were 33.0±6.4% in group 1 and 55.9±14.1% in group 2. Group 1 showed higher prevalence of male (p=0.02), Killip class>III (p=0.034), previous history of angina pectoris (p=0.001), hypertension (p=0.034), diabetes mellitus (p=0.027), smoking (p=0.045), age>65 years (p=0.015), systolic blood pressure<80 mmHg (p=0.033), heart rate>100 beats/min (p=0.027), elevated creatine, elevated cardiac markers (creatine kinase, CK-MB, troponin-I) (p=0.001), elevated total cholesterol (p=0.031), elevated triglyceride (p=0.022), and cardiac arrest on arrival (p=0.001). The predictors of 1-year MACE in group 1 were high N-terminal pro-B-type natriuretic peptide (NT pro-BNP) (p=0.001), multivessel disease(p=0.001), cardiogenic shock (p=0.02), and elevated creatine (p=0.024).
Conclusion: Korean patients with acute MI and initial IHF were older; more likely to have multiple risk factors and comorbidities including cardiogenic shock and cardiac arrest on arrival. The predictors of 1-year MACE in patients with IHF were high NT pro-BNP, multivessel disease, cardiogenic shock, and acute kidney injury.
