Publications by authors named "Jong Won Ha"
Novel algorithm for non-invasive estimation of left atrial pressure in patients with atrial fibrillation.
Eur Heart J Cardiovasc Imaging
December 2024
Aims: Determining elevated left atrial (LA) pressure is crucial in patients with atrial fibrillation (AF), yet non-invasive estimation using echocardiography remains unclear. This study aimed to identify useful echocardiographic indices for identifying elevated LA pressure in patients with AF.
Methods And Results: Patients with paroxysmal or persistent AF referred for catheter ablation at two tertiary hospitals were prospectively enrolled.
Background: In patients with tricuspid regurgitation (TR), delayed surgical intervention is associated with poor outcomes, particularly in advanced stages. This study aimed to assess whether earlier tricuspid valve (TV) surgery provides a survival benefit in patients with moderate to severe TR who are considered at low to intermediate risk of adverse clinical or surgical outcomes.
Methods: This retrospective cohort study included 10 016 patients diagnosed with moderate to severe TR between 2008 and 2020.
Article Synopsis
- - This study examined the diagnosis and treatment of valvular heart disease (VHD) in Korea, focusing on adult patients with moderate to severe cases through echocardiography in 45 hospitals.
- - Out of 4,094 patients, about 1,482 had severe VHD, with varied rates of intervention depending on the type of valve issue, highlighting significant in-hospital mortality, especially for secondary severe mitral regurgitation (9.0%).
- - The findings reveal a 5.4% overall in-hospital mortality rate, with lower mortality in patients who underwent surgical or transcatheter interventions compared to those receiving conservative treatment, suggesting the need for improved VHD management strategies in the future.
Incremental Prognostic Value of Left Ventricular and Left Atrial Strain in Moderate Aortic Stenosis.
Eur Heart J Cardiovasc Imaging
November 2024
Aims: Patients with moderate aortic stenosis (AS) show a poor prognosis if they have high-risk features. We investigated the incremental prognostic value of left ventricular (LV) and left atrial (LA) strain in patients with moderate AS.
Methods And Results: In a cohort of 923 patients with moderate AS (median age 74 years, men 55%, aortic valve area 1.
Article Synopsis
- Surgical occlusion of the left atrial appendage (LAA) during mitral valve surgery in patients with atrial fibrillation reduces the risk of thromboembolic events and all-cause death compared to preserving the LAA.
- A study analyzed 237 patients with severe mitral regurgitation and found that those who had their LAA occluded experienced significantly fewer adverse outcomes over a follow-up of about 37 months.
- Multivariate analysis confirmed that LAA occlusion linked to better outcomes, with significant improvements in reducing primary outcomes and thromboembolic events, suggesting it may be beneficial for AF patients undergoing mitral valve surgery.
Article Synopsis
- The study explored whether evogliptin, a dipeptidyl peptidase-4 inhibitor, could slow the progression of aortic stenosis (AS) in 228 patients over 96 weeks, measuring changes in aortic valve calcium volume (AVCV).
- Results showed no significant reduction in AVCV for either dosage of evogliptin compared to placebo; however, evogliptin groups had significantly lower active calcification volume at 48 weeks using F-sodium fluoride PET.
- Although evogliptin did not appear to protect against AV calcification, the study suggests the potential for longer-term benefits, indicating a need for larger trials to confirm these findings.
Article Synopsis
- The Korean Society of Echocardiography outlines its official stance on valvular heart diseases, emphasizing clinical management.
- The paper references recent guidelines from major cardiac organizations, including the American College of Cardiology and the European Society of Cardiology.
- Part I of the article specifically focuses on aortic valve disease and its current situation in Korea, incorporating new research findings and Korean data.
Article Synopsis
- This manuscript outlines the official stance of the Korean Society of Echocardiography on valvular heart diseases, focusing on their diagnosis and management.
- It references recent guidelines from major cardiac organizations like the American College of Cardiology and the European Society of Cardiology.
- The paper includes a systematic review of national data and plans to provide specific recommendations for mitral and tricuspid valve disease in a subsequent section.
Background: Echocardiography is widely used to evaluate left ventricular (LV) diastolic function in patients suspected of heart failure. For patients in sinus rhythm, a combination of several echocardiographic parameters can differentiate between normal and elevated LV filling pressure with good accuracy. However, there is no established echocardiographic approach for the evaluation of LV filling pressure in patients with atrial fibrillation.
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- South Korea's economic growth over the past two decades has affected the clinical profile of patients with rheumatic mitral stenosis (MS), leading to older patients with more severe conditions and comorbidities like hypertension and atrial fibrillation.
- Analysis of data from 2,337 patients showed that while the rate of mitral interventions increased, the overall clinical outcomes worsened, indicating a need for improved treatment strategies.
- Despite stable stroke incidence due to better anticoagulation therapy, the findings emphasize the challenges faced as the healthcare landscape transitions with the country’s development.
Background: TRI-SCORE was recently developed in Europe as a risk model for predicting in-hospital death after isolated tricuspid valve surgery. We aimed to validate TRI-SCORE in an Asian population and investigate its value for predicting long-term outcomes.
Methods And Results: The TRI-SCORE was calculated for 202 patients (65±11 years, 61% women, 81% functional tricuspid regurgitation) who underwent isolated tricuspid valve surgery for severe tricuspid regurgitation at 2 Korean centers and was based on 8 parameters: age, New York Heart Association class, right-sided heart failure signs, furosemide daily dose, glomerular filtration rate, bilirubin, left ventricular ejection fraction, and moderate/severe right ventricular dysfunction.
Article Synopsis
- Percutaneous mitral valvuloplasty (PMV) is an effective treatment for patients with severe rheumatic mitral stenosis (RMS), but the impact of changes in mitral valve area (∆MVA) during the procedure is not well understood.
- A study analyzed 308 patients from the MASTER registry, focusing on those undergoing their first PMV, and found that a ∆MVA greater than 0.5 cm² correlated with better long-term health outcomes.
- The research indicates that not only achieving optimal post-procedure results but also aiming for a significant increase in ∆MVA could improve patient prognosis in PMV surgeries.
Article Synopsis
- Malignant pericardial effusion (MPE) in cancer patients has a poor prognosis, and this study compares the effectiveness of two drainage methods: pericardiocentesis and pericardial window formation.
- The study analyzed 765 cancer patients who underwent pericardial drainage from 2003 to 2022, finding no significant difference in overall mortality between the two methods, but noted a lower recurrence rate of MPE with pericardial window formation (6.3% vs. 18.0%).
- Ultimately, the findings suggest that while both methods have similar mortality outcomes, pericardial window formation is more effective in reducing MPE recurrence, especially in recent years.
Article Synopsis
- This study compared the effectiveness of percutaneous mitral valvuloplasty (PMV) and mitral valve replacement (MVR) in treating severe mitral stenosis (MS) defined as mitral valve area (MVA) ≤ 1.5 cm, using data from the MASTER registry involving 3140 patients.
- The analysis focused on 442 patients, revealing that while primary outcomes like cardiovascular death and heart failure hospitalization were similar for both treatment options, MVR resulted in fewer secondary outcomes, particularly in very severe MS (VS-MS) cases.
- The study concluded that although neither treatment significantly impacted mortality or hospitalization rates, MVR may be preferred over PMV for VS-MS patients due to a higher need for redo interventions
Risk Factors and Outcomes With Progressive Mitral Annular Calcification.
J Am Heart Assoc
September 2023
Article Synopsis
- - The study investigated the progression of mitral annular calcification (MAC) in 138 patients, finding that 31.2% experienced significant worsening of their condition within 18-36 months.
- - Factors like higher systolic blood pressure, elevated MAC angle, and changes in left ventricular function were linked to MAC progression, indicating that hemodynamic stress contributes to the condition.
- - Patients with progressive MAC faced worse clinical outcomes, including higher rates of mortality and hospitalizations, compared to those with stable MAC.
Article Synopsis
- Aortic valve replacement (AVR) is crucial for treating symptomatic patients with severe aortic stenosis (AS), but there's limited data on early AVR benefits for those with normal-flow, low-gradient (NFLG) AS.
- In a study of 281 symptomatic NFLG AS patients, 121 underwent early AVR while the other 121 received conservative care; results indicated that early AVR significantly reduced the combined risk of death and heart failure (HF) hospitalization.
- The early AVR group experienced lower HF hospitalizations and had promising findings that warrant further investigation in randomized studies to confirm these benefits.
Article Synopsis
- - This study explored how periodontitis, caused by the bacterial pathogen Porphyromonas gingivalis (PG), affects gut bacteria and contributes to atherosclerosis in mice, particularly focusing on the impact of oral PG infection.
- - Mice were fed different diets and received oral PG to analyze changes in atherosclerotic lesions, blood lipid levels, and liver metabolism, with results indicating increased atherosclerosis and altered gut microbiota due to PG infection.
- - Key findings showed a 1.7-fold rise in atherosclerotic lesions in PG-infected mice, reduced HDL levels, and significant shifts in gut microbiome diversity, highlighting the interconnectedness of oral infections and cardiovascular health.
Article Synopsis
- A study examined the outcomes of different diagnostic tests in over 27,000 patients suspected of having coronary syndromes, using data from South Korea between 2006 and 2014.
- The research found that single-photon emission computed tomography (SPECT) was linked to higher risks of cardiac death and myocardial infarction, while treadmill tests showed lower risks when compared to coronary computed tomography angiography (CCTA).
- Ultimately, the study concluded that starting with CCTA did not lead to fewer instances of cardiac death or myocardial infarction than functional tests in these patients.
Phenotyping heart failure by echocardiography: imaging of ventricular function and haemodynamics at rest and exercise.
Eur Heart J Cardiovasc Imaging
September 2023
Traditionally, congestive heart failure (HF) was phenotyped by echocardiography or other imaging techniques according to left ventricular (LV) ejection fraction (LVEF). The more recent echocardiographic modality speckle tracking strain is complementary to LVEF, as it is more sensitive to diagnose mild systolic dysfunction. Furthermore, when LV systolic dysfunction is associated with a small, hypertrophic ventricle, EF is often normal or supernormal, whereas LV global longitudinal strain can reveal reduced contractility.
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- The study investigates the effect of septal reduction therapy on the mechanical function of the left atrium (LA) and left ventricle (LV) in patients with obstructive hypertrophic cardiomyopathy (HCM).
- Among 44 patients analyzed post-surgery, there was a significant decrease in LA volume and improvement in LA strain, indicating better mechanical function.
- However, LV function worsened, with a decrease in ejection fraction and global longitudinal strain, highlighting that while LA function improved, LV function deteriorated following the surgery.
Article Synopsis
- The study explored how left ventricular global longitudinal strain (LV GLS) in patients with end-stage renal disease changes after kidney transplantation (KT).
- A total of 488 patients were analyzed, considering their LV GLS values before and within three years after KT, revealing notable variations in heart structure and function based on initial LV GLS levels.
- Results showed that patients with severely impaired pre-KT LV GLS experienced the most significant improvements in heart function after KT, demonstrating positive overall changes in LV structure across all pre-KT LV GLS categories.
Article Synopsis
- - The study investigated the progression of moderate aortic stenosis (AS) using data from 686 patients and identified two groups based on how their heart condition progressed: slow (44.6%) and rapid (55.4%).
- - The rapid progression group exhibited higher initial systolic mean pressure gradient (MPG) readings and had a significantly greater rate of aortic valve replacement (AVR), while the prevalence of atrial fibrillation was more common in the slow progression group.
- - The findings suggest that a higher initial MPG (≥ 24 mmHg) can predict faster AS progression and increased AVR rates, providing important insights for managing moderate AS in patients.