116
￭ S-157 ￭
인간 면역결핍 바이러스성 심근염 1예
대동병원 내과
*윤성운, 여창우 , 강진두, 이혜원, 김수형, 김병수
HIV-associated myocarditis is defined as inflammation and damage of the myocardium due to HIV infection. Its disease progression vary, as it may be asymptomatic or manifest as dilated cardiomyopathy,heart failure A 28-year-old male presented cough that persisted for 6 months and aggravating dyspnea. Chest x-ray showed cardiomegaly and pulmonary edema. Laboratory tests revealed CK-MB 0.6 ug/L, Troponin I 0.21 ng/mL, and proBNP of 11,072 pg/mL. Echocardiography showed findings of dilated cardiomyopathy with dilated atrium, ventricles and severe left ventricular systolic dysfunction. Chest CT showed multiple ground-glass opacities. Anti-HIV Ab (ELISA) was performed, considering pneumocystis pneumonia associated with AIDS. ELISA and Western blot results were positive, HIV RNA was 122,000 copies/mL, CD4＋ lymphocytes were 27 cells/mL. The patient was diagnosed as dilated cardiomyopathy due to HIV-associated myocarditis. He afterwards complained of decreased visual acuity and was diagnosed as cy- tomegalovirus (CMV) retinitis.
￭ S-158 ￭
Arterial stiffness and left ventricular diastolic dysfunction in Korean older people
Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
*Kyung-Taek Park, Hack-Lyoung Kim, Woo-Hyun Lim, Jae-Bin Seo, Woo-Young Chung, Sang-Hyun Kim, Myung-A Kim, Joo-Hee Zo
Background: The impact of arterial stiffness on left ventricular (LV) diastolic function has not been well characterized among Koreans. This study is aimed to investigate whether arterial stiffness plays a role in progression of diastolic dysfunction in Korean older people. Methods: A total of 359 healthy subjects without known cardiovascular disease older than 50 years (mean age 57.3 ±6.3 years, 69.8% men) who underwent both transthoracic echocardiography and brachial-ankle pulse wave velocity (baPWV) at the same day for their routine check-up was analyzed. Subjects with septal an- nular peak velocity (e’) ＜8 cm/s and left atrial volume index (LAVI) ≥ 34 mL/m2 were considered as having diastolic dysfunction. Results: One hun- dred and sixty-nine subjects (63.3%) had diastolic dysfunction. Subjects with diastolic dysfunction were older and more frequently had obesity than those without.baPWV was significantly higher in subjects with diastolic dysfunction compared to those without (1,440 ± 223 cm/s vs 1,345 ± 174 cm/s, p＜0.001). Reciever-operating characteristic curve analysis showed that baPWV of 1,314 cm/s was the best cut-off value discriminating diastolic dysfunction. Multiple logistic-regression analyses demonstrated that older age, high body mass index, and high baPWV (≥ 1,314 cm/s) were in- dependent factors determining diastolic dysfunction even after controlling potential confounders including age and other factors. Conclusions: In sub- jects over 50 years, in addition to older age and more obesity, high baPWV was independent determinant of diastolic dysfunction. baPWV can be a use- ful in the assessment of diastolic function, and reducing arterial stiffness may be a potential therapeutic target in preventing diastolic dysfunction in this older people.
