Elevated pulmonary pressure and right ventricular (RV) dysfunction are the hallmarks of pulmonary vascular disease in animal models and human patients with pulmonary arterial hypertension (PAH). Monocrotaline models of PAH are widely used to study the pathophysiology of PAH. The purpose of this study was to evaluate the severity of PAH rat model by tissue Doppler imaging (TDI).

PAH was induced in Sprague-Dawley rats by monocrotaline (M) group. The peak systolic (s'), early diastolic (e'), and late diastolic myocardial velocities (a') were measured using TDI at basal segments. Tricuspid annular plane systolic excursion (TAPSE) was measured in the 4-chamber view. Velocity of a tricuspid regurgitation (TR) jet was measured to estimate the pulmonary artery pressure to assess the severity of PAH.

Decrease in the RV shortening fraction and ejection fraction were observed in the M group compared with the control (C) group. RV e' velocity and s' velocity were significantly lower in the M group compared with the C group. The TAPSE was significantly lower in the M group compared with the C group (1.26±0.22 mm vs. 2.83±0.34 mm). The TR velocity was significantly higher in the M group compared with the C group (4.48±0.34 m/sec vs. 1.23±0.02 m/sec).

TAPSE is an easily obtainable, widely recognized and clinically useful echocardiographic parameter of global RV function in the PAH rat model. We recommend that TDI would be a helpful diagnostic tool to evaluate the RV function in PAH rat model.

Adenovirus infection, which has been known to mimic Kawasaki disease (KD), is one of the most frequent conditions observed during differential diagnosis when considering KD. Accordingly, it is essential to being able to differentiate between these two diseases. Therefore, we performed multiplex reverse transcriptase- polymerase chain reaction and tissue-Doppler echocardiography to distinguish between adenovirus patients and KD patients.

A total of 113 adenoviral infection patients (female 48, male 65) diagnosed from January 2010 to June 2016 were evaluated. We divided adenoviral infection patients into two groups: group 1, which consisted of individuals diagnosed with KD according to the KD American Heart Association criteria (n=62, KD with adenovirus infection); and group 2, which comprised individuals only diagnosed with adenovirus infection (n=51). Laboratory data were obtained from each patient including N-terminal pro-brain natriuretic peptide. Echocardiographic measurements were compared between two groups. In addition, reverse transcriptase-polymerase chain reaction was performed using nasopharyngeal secretions to diagnose adenoviral infection.

Conjunctival injection, cervical lymphadenopathy, polymorphous skin rash, abnormalities of the lip or oral mucosa and abnormalities of extremities were significantly higher in group 1 than group 2. Moreover, group 1 had significantly higher C-reactive protein and alanine aminotransferase levels, as well as lower platelet counts and albumin levels than group 2. Coronary artery diameter was significantly greater in group 1 than group 2.

In patients with adenoviral infection with unexplained prolonged fever, echocardiography and C-reactive protein can be used to differentiate KD with adenoviral infection from adenoviral infection alone.

To determine the predicting factors related to cardiovascular injuries and To suggest a clinical indication for emergency echocardiography in sternal fractures.

A total mumber of 40 patients with sternal fractures a over 5-year period were retrospectively assessed on clinical, echocardiographic and biochemical status. We analyzed the following 4 factors as predicting factors for cardiovascular injuries in sternal fractures : 1) presence of restraint, 2) presence of associated injuries, 3) presence of a past medical history involving cardiovascular system, 4) Revised Trauma Score(RTS).

We, also, assessed the utility of conventional diagnostic methods for cardiovascular injuries, such as ECG, chest X-ray, and enzyme levels. Based on the methods, we tried to infer an indication for emergency echocardiography in sternal fractures.

The presence of a past medical history involving cardiovascular system and abnormal RTS on admission were significant predicting factors. Emergency echocardiography was performed according to the predicting factors and the results from conventional evaluations. These data can suggest that indications for emergency echocardiography in sternal fractures include as 1) if more than two studies reveal abnormality without any significant predicting factors. 2) if more than one study reveal abnormality with any significant predicting factors.

The past medical history involving cardiovascular system and initial vital signs imply the presence of associated cardiovascular injuries in sternal fractures. And if possible, emergency echocardiography is recommended.

An elevated serum lipoprotein(a) level is an independent risk factor for atherosclerotic diseases, and the lipoprotein(a) level is correlated to preclinical atherosclerosis. To evaluate the association between lipoprotein(a) and aortic selerosis, mitral sclerosis, and abdominal aorta thickness, we measured the aortic valve thickness, mitral valve thickness and abdominal aorta thickness. Also, we assessed the relationship between the aortic valve sclerosis, mitral valve sclerosis, abdominal aorta thickness and other coronary risk factors.

We measured serum lipoprotein(a) in 116 patients(52 men, 64 women) with mean age of 58.7±13.9 years. Aortic valve thickness was assessed by parasternal long and short axis two dimensional echocardiography, mitral valve thickness was measured by apical 4 chamber view. The abdominal aorta thickness was measured by the subcostal view.

The level of lipoprotein(a) was significantly correlated with the aortic valve thickness, but not with the miral valve thickness and the abdominal aorta thickness. lipoprotein(a) level was higher in smoking patients(p<0.05), and not related to other ariables such as blood pressure, age, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Coronary angiography was performed in 18 paitents, and there was a tendency of the coronary artery disease with high level of the lipoprotein(a)(p<0.005). There was no significant difference in the thickness of aortic valve in terms of sex, blood pressure, total cholesterol, high density lipoprotein, triglyceride or blodo sugar.

We conclude that increased serum levels of lipoprotein(a) are closely related to aortic valve sclerosis and may be a risk factor for coronary artery disease.