Publications by authors named "Heesun Lee"
Importance: Myocardial fibrosis in aortic stenosis (AS) may exhibit sex differences. However, its prognostic significance in women with AS remains unclear.
Objective: To investigate sex differences in myocardial fibrosis assessed by cardiovascular magnetic resonance (CMR) and evaluate its prognostic value in women and men with AS.
The Close Link Between Obesity and Cardiovascular Disease: Current Insights and Remaining Challenges.
Endocrinol Metab Clin North Am
March 2025
Obesity is a global public health crisis, contributing to chronic disease development and poor prognosis. A large body of evidence consistently demonstrates that increased adiposity leads to many cardiovascular diseases (CVDs) and complications, such as coronary artery disease, heart failure, and arrhythmias, via direct and indirect mechanisms. Therefore, weight management is crucial to reduce and prevent cardiovascular risk.
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- Researchers examined how genetic risk for cardiovascular diseases (CVDs) interacts with air pollution exposure to influence CVD outcomes.
- Using data from the UK Biobank involving over 249,000 participants, they found that individuals with high genetic risk who were also exposed to high levels of particulate matter (PM) faced significantly increased risks of cardiovascular death.
- The study suggests that reducing PM exposure and tailoring preventive strategies for those at high genetic risk could improve cardiovascular health outcomes.
Article Synopsis
- Arterial stiffness, linked to age and cardiovascular risk, was analyzed in a study of 195,405 healthy Korean adults to observe annual changes over time.
- The results indicated that arterial stiffness, measured by baPWV, increases with age, especially pronounced in the 70-79 age group, and differs between men and women.
- The findings underscore the progressive nature of arterial stiffness as people age, with men showing consistent increases across all age groups while women experience a significant rise only after age 50.
Article Synopsis
- The study evaluated the effectiveness of fimasartan, an antihypertensive medication, by comparing its impact on patients transitioning to three-drug therapy with calcium channel blockers (CCBs) vs. other angiotensin receptor blockers (ARBs).
- Data was collected from a large cohort of 34,422 patients in South Korea who were prescribed ARBs and CCBs, with a focus on those taking fimasartan and those taking other ARBs, over a follow-up period of 2.5 years.
- Results showed that patients on fimasartan had a significantly lower rate of needing additional antihypertensive medications, suggesting fimasartan may be more effective for managing hypertension compared
Aims: Recently, deep learning artificial intelligence (AI) models have been trained to detect cardiovascular conditions, including hypertrophic cardiomyopathy (HCM), from the 12-lead electrocardiogram (ECG). In this external validation study, we sought to assess the performance of an AI-ECG algorithm for detecting HCM in diverse international cohorts.
Methods And Results: A convolutional neural network-based AI-ECG algorithm was developed previously in a single-centre North American HCM cohort (Mayo Clinic).
Article Synopsis
- The study aimed to investigate if managing dyslipidaemia with fibrates could influence the expression of hypertrophic cardiomyopathy (HCM) in patients, particularly those with obesity and metabolic issues.
- Researchers analyzed data from a large cohort of fibrate users, matching them with a similar group who did not use fibrates, to identify new cases of clinical HCM over a median follow-up of almost 4 years.
- The results showed that fibrate use significantly reduced the risk of developing clinical HCM, especially in individuals who were obese or had poor metabolic health, highlighting the potential benefits of fibrates in these populations.
Background: Amputation confers disabilities upon patients and is linked to substantial morbidity and death attributed to heart disease. While some studies have focused on traumatic amputees in veterans, few studies have focused on traumatic amputees within the general population. Therefore, the present study aimed to assess the risk of heart disease in patients with traumatic amputation with disability within the general population using a large-scale nationwide population-based cohort.
View Article and Find Full Text PDFAims: As lifetime accumulation of cardiovascular risk factors is gaining importance, early identification and management of risk factors are being emphasized. The global prevalence of metabolic syndrome (MetS), a constellation of these risk factors, is increasing, particularly among young adults. In this study, we aim to investigate the association between cumulative exposure to metabolic risk and cardiovascular disease (CVD) in young adults.
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- - This study investigates the higher incidence of heart diseases, specifically myocardial infarction, heart failure, and atrial fibrillation, in spinal cord injury (SCI) survivors compared to a matched group of non-SCI individuals.
- - Results indicate that SCI survivors face significantly increased risks for these heart conditions, especially among those with severe disabilities, with cervical and lumbar injuries showing the highest risks.
- - The findings highlight the urgent need for healthcare providers to focus on heart health in SCI patients, as they are at a notably greater risk for these diseases than the general population.
Aims: Clonal haematopoiesis of indeterminate potential (CHIP), defined as a clonal expansion of age-related recurrent somatic mutations, has recently emerged as a novel cardiovascular risk factor. However, the precise role of CHIP in the development of atherosclerotic cardiovascular disease (ASCVD) remains unclear.
Methods And Results: Among 4300 asymptomatic Korean participants aged 40-79 years, we investigated the risk of ASCVD by CHIP and the interplay between CHIP and conventional risk factors in ASCVD development.
Background: Meta-analyses of large clinical trials investigating SGLT2 (sodium-glucose cotransporter-2) inhibitors have suggested their protective effects against atrial fibrillation in patients with type 2 diabetes. However, the results were predominantly driven from trials involving dapagliflozin.
Methods And Results: We used a nationwide, population-based cohort of patients with type 2 diabetes who initiated either dapagliflozin or empagliflozin between May 2016 and December 2018.
Background And Aims: Both clonal haematopoiesis of indeterminate potential (CHIP) and atrial fibrillation (AF) are age-related conditions. This study investigated the potential role of CHIP in the development and progression of AF.
Methods: Deep-targeted sequencing of 24 CHIP mutations (a mean depth of coverage = 1000×) was performed in 1004 patients with AF and 3341 non-AF healthy subjects.
Article Synopsis
- Heart failure (HF) is a common issue for individuals with type 2 diabetes, and the study investigates how changes in smoking habits can affect the risk of developing HF in this group.
- A retrospective cohort study tracked over 365,000 smokers with type 2 diabetes, revealing that quitting smoking reduced the risk of HF, while increasing smoking levels raised the risk, especially for heavy smokers.
- The findings underscore that cessation of smoking is beneficial for reducing HF risk, whereas cutting down smoking doesn't necessarily lead to improved outcomes.
Background: Previous studies have shown that the clinical expression of hypertrophic cardiomyopathy (HCM) can be determined by obesity and metabolic syndrome. The present study aimed to investigate the association between triglyceride and high-density lipoprotein cholesterol (HDLC) level, the two dyslipidemia-related components of metabolic syndrome, and the incidence of HCM. We also explored an age-dependent association between them.
View Article and Find Full Text PDFBackground: Sacubitril acts to inhibit neprilysin and as neprilysin is involved in amyloid-beta degradation in the central nervous system, and there is concern that sacubitril/valsartan may increase the risk of dementia. We aimed to compare the risk of incident dementia associated with sacubitril/valsartan and angiotensin II receptor blockers (ARBs).
Methods: Patients with heart failure with reduced ejection fraction treated with either sacubitril/valsartan or ARB, identified from the Korean National Health Insurance Service database, were matched in a 1:2 ratio using propensity scores (6789 on sacubitril/valsartan and 13,578 on ARBs) and followed up for incident dementia.
Article Synopsis
- The study looked at how having bad cholesterol levels affects heart health in young adults aged 20-45, especially focusing on coronary artery calcification (CAC), which is a sign of heart problems.* -
- Out of 2,940 participants, only 477 had healthy cholesterol levels, and those with bad levels were more likely to have worsening heart health over time.* -
- The findings suggest that even younger people can be at risk for heart problems if they have bad cholesterol, highlighting the need for regular check-ups and healthy lifestyle choices.*
Article Synopsis
- Researchers studied two medications, dapagliflozin and empagliflozin, to see how they affect heart health in people with type 2 diabetes in South Korea.
- They looked at data from lots of patients and found that both medicines had similar overall heart health benefits, but patients taking dapagliflozin had a lower risk of heart failure and cardiovascular death.
- The study helps understand how these medications work in different groups of people, especially since some groups, like Asian females, were not represented enough in earlier studies.
Introduction: Clonal hematopoiesis of indeterminate potential (CHIP) is associated with atherosclerosis and cardiovascular disease. It has been suggested that CHIP may be related to diabetes, so we investigated the association between CHIP and new-onset type 2 diabetes.
Methods: This study included 4,047 subjects aged >=40 years without diabetes.
Hypertension is a chronic disease that requires long-term follow-up in many patients, however, optimal visit intervals are not well-established. This study aimed to evaluate the incidences of major cardiovascular events (MACEs) according to visit intervals. We analyzed data from 9894 hypertensive patients in the Korean Hypertension Cohort, which enrolled and followed up 11,043 patients for over 10 years.
View Article and Find Full Text PDFObjective: To determine whether retinal vessel geometry is associated with systemic arterial stiffness, as determined by the cardio-ankle vascular index (CAVI).
Methods: This single-center retrospective cross-sectional study included 407 eyes of 407 subjects who underwent routine health exams, including CAVI and fundus photography. Retinal vessel geometry was measured using a computer-assisted program (Singapore "I" Vessel Assessment).
Background: Although coronary computed tomography angiography (CCTA) is currently utilized as the frontline test to accurately diagnose coronary artery disease (CAD) in clinical practice, there are still debates regarding its use as a screening tool for the asymptomatic population. Using deep learning (DL), we sought to develop a prediction model for significant coronary artery stenosis on CCTA and identify the individuals who would benefit from undergoing CCTA among apparently healthy asymptomatic adults.
Methods: We retrospectively reviewed 11,180 individuals who underwent CCTA as part of routine health check-ups between 2012 and 2019.
Introduction: Low-density lipoprotein (LDL) cholesterol-lowering treatment is beneficial for the secondary or primary prevention of high-risk atherosclerotic cardiovascular disease (ASCVD). However, the prognostic implications of low LDL cholesterol levels in patients without previous ASCVD and without statin use remain elusive.
Methods: From a nationwide cohort, 2,432,471 participants without previous ASCVD or statin use were included.
Limited data are available on the long-term outcomes in patients with hypertrophic cardiomyopathy (HCM) patients with significant coronary artery disease (CAD) requiring revascularization. We investigated the risk of cardiovascular outcomes in HCM patients who underwent coronary revascularization compared to the control group without HCM. HCM patients aged ≥ 20 years were enrolled from the Korean National Health Insurance Database.
View Article and Find Full Text PDFImportance: Selecting the optimal antiplatelet agent in patients who have received percutaneous coronary intervention is especially important in those with diabetes due to the heightened risk of ischemic events in this population. Studies on the efficacy and safety of clopidogrel vs aspirin for long-term maintenance after percutaneous coronary intervention in patients with diabetes are lacking.
Objective: To investigate cardiovascular outcomes with clopidogrel vs aspirin in patients with and without diabetes.