Shinjeong Song

Kim HL, et al. Korean Circ J. 2025 Apr;55:e79. https://doi.org/10.4070/kcj.2024.0435

Objectives: There is limited knowledge regarding the impact of lifestyle changes on cardiovascular events and mortality among individuals with prehypertension or prediabetes. Methods: This was a serial retrospective cohort study utilizing data from the Korean National Health Insurance Service Health Screening Cohort. The primary outcome considered in the study was major adverse cardiovascular events (MACE). Results: A higher risk of MACE was found in men with prehypertension whose unhealthy lifestyle deteriorated (hazard ratio [HR], 1.13; 95% CI, 1.04–1.23; P=0.004), those who gained weight (HR, 1.15; 95% CI, 1.03–1.28; P=0.010), and those who began smoking (HR, 1.34; 95% CI, 1.17–1.55; P<0.001). Conversely, a reduced risk of MACE was observed in men with prehypertension who improved their unhealthy lifestyle, quit smoking, reduced alcohol consumption, or increased the frequency of physical activity. In men with prediabetes, the risk of MACE was higher in those whose unhealthy lifestyle worsened (HR, 1.23; 95% CI, 1.12–1.35; P<0.001), those who gained weight (HR, 1.19; 95% CI, 1.06–1.33; P=0.003), those who started smoking (HR, 1.41; 95% CI, 1.22–1.64; P<0.001), and those who decreased their physical activity frequency (HR, 1.21; 95% CI, 1.09–1.35; P<0.001). Conclusion: Preventive lifestyle changes reduce cardiovascular events and mortality, particularly in men at risk of developing hypertension or type 2 diabetes.

Aims: Two‐dimensional ultrasound (2D‐US) is the mainstay imaging technique used to evaluate carotid atherosclerosis. An automated single sweep three‐dimensional ultrasound (3D‐US) technique became available. We evaluated the feasibility and accuracy of 3D‐US in the assessment of carotid plaques compared to those of 2D‐US. Carotid computed tomography angiography (CTA) was used as a reference.Methods and results: Among 126 stroke patients who underwent carotid 2D‐US, 73 underwent 3D‐US and carotid CTA. 3D‐US was pursued when there were carotid plaques or when area stenosis was ≥ 20% by 2D‐US. Both 2D‐ and 3D‐US images of the carotid arteries were acquired using a dedicated ultrasound system that was equipped with the single sweep volumetric transducer. In total, 266 arteries from 73 patients were selected for comparison of the detection rate of carotid plaques between 2D‐ and 3D‐US. Among the 73 patients, carotid CTA detected 139 plaques. 3D‐US demonstrated a higher detection rate of carotid plaques than did 2D‐US (108 plaques (77.9%) vs. 70 plaques (50.4%)) when using carotid CTA as a reference standard. Carotid plaque volume (PV) of 133 vessels from 73 patients were quantitatively evaluated using both 3D‐US and carotid CTA. Plaque volume of carotid artery was comparable between 3D‐US and CTA (148.5 ± 133.0 mm³ vs. 154.1 ± 134.6 mm³, P = .998, R: 0.9825, P‐value for r < .001).Conclusion: 3D‐US using a single sweep technique was a feasible and accurate method of detecting arterial plaques and assessing plaque volume.

Song S, et al. J Lipid Atheroscler. 2019 May;8(1):58-66. https://doi.org/10.12997/jla.2019.8.1.58

Epidemiologic data regarding pulmonary arterial hypertension (PAH) have relied on registries from Western countries. We assessed the current status of PAH in the Korean population. The Health Insurance Review and Assessment Service (HIRA) claim database, which comprises nationwide medical insurance data of Koreans from 2008–2016, was assessed to determine the current status of PAH. Overall, 1,307 patients were newly diagnosed with PAH from 2008–2016 (0.0005%, annual incidence: 4.84 patients/1 million people/year). The mean age at diagnosis was 44±13 years (range 18–65) and patients were mostly women (n = 906, 69.3%). Cases of idiopathic PAH (51.6%) accounted for the largest proportion, followed by acquired PAH (APAH) associated with congenital heart disease (25.8%) and APAH with connective tissue disease (17.2%). Overall, 807 (61.7%) patients received a single PAH-specific treatment based on their last prescription, of which bosentan (50.6%) was the most frequently used. Only 240 (18.4%) patients received combination therapy, with the bosentan-beraprost combination (32.9%) being the most common. During the mean follow-up of 1.9 years, the 1-, 2-, 3-, and 5-year estimated survival rates were 85%, 62%, 54%, and 46%, respectively. The prevalence and incidence of PAH in the Korean population is currently comparable with that in previous registries. The 5-year survival rate was slightly higher in the Korean population than previously reported.

Song S, et al. Yonsei Med J. 2017 Nov;58(6):1237-1240. https://doi.org/10.3349/ymj.2017.58.6.1237

A 51-year-old woman was diagnosed with critical aortic stenosis due to a bicuspid aortic valve (AV) and metastatic lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutation at the same time (Panel A). Two weeks after AV replacement with a 21-mm Carpentier-Edwards Perimount pericardial bioprosthesis (Edwards Lifesciences, Irvine, CA, USA), she started gefitinib (Iressa^®) at 250 mg daily, a selective inhibitor of the EGFR signal transduction pathway. Although the gefinitib therapy showed a favourable response, she started having progressive chest pain and dyspnoea at 6 months after the surgery. Serial transthoracic echocardiography showed progressive increases of the maximum and mean pressure gradients across the bioprosthetic AV to 75 and 45 mmHg (Panel B). Transoesophageal echocardiography showed nodular thickening of the leaflets and consequent severe aortic stenosis and mild aortic regurgitation (Panel C, D, E and F; see Supplementary data online, Video S1, S2, S3 ). Serum inflammatory and rheumatologic markers were all negative. There was no evidence of bacterial or fungal endocarditis. Because her symptoms were not relieved, a redo AVR was performed using a mechanical prosthetic valve. The removed bioprosthetic AV revealed multiple nodular lesions and unusual degeneration (Panel G). Histologically, there were vegetative dense fibrinous material deposits on the valve and focal acute inflammatory cell infiltrations (Panel H). In the superficial layers of both sides of the valve, there were large numbers of macrophage deposits (Panel I). This case is the first to show a potential link between EGFR inhibition and AV inflammation and degeneration in humans, although it is highly evident in EGFR-deficient mice.