Ji-Hung Wang

Tzu Chi University, Hua-lien, Taiwan, Taiwan

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Publications (51)133.21 Total impact

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    ABSTRACT: Anomalous origin of the left main coronary artery from the right sinus of Valsalva is extremely rare and can lead to sudden cardiac death. We report a case in which an 18-year-old college student collapsed immediately after a long-distance run of 10 km. After cardiopulmonary resuscitation and electrical shock for ventricular fibrillation, she experienced a return of spontaneous circulation. Cardiac catheterization and cardiac computed tomographic angiography revealed an unusually long intramural course of the left main coronary artery from the right sinus of Valsalva. The young woman underwent a successful unroofing operation for coronary artery correction. She remained asymptomatic upon exercise during 2.5 years of follow-up.
    No preview · Article · Dec 2015 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
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    Gen-Min Lin · Yi-Hwei Li · Cha-Po Lai · Chin-Lon Lin · Ji-Hung Wang
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    ABSTRACT: Background: The body mass index (BMI)-mortality paradox has been well known in patients with obstructive coronary artery disease (CAD). However, this phenomenon has rarely been described among elderly patients over a 5-year follow-up. Methods: We studied a cohort of 722 elderly patients (age ≥ 65 years) with angiographic CAD from the ET-CHD registry during 1997-2003 in eastern Taiwan. To evaluate the BMI effect on mortality, the elderly subjects were categorized into 5 groups by BMI (kg/m2): underweight and normal-low weight (< 21), normal-high weight (21-23.9), overweight (24-26.9), mild obesity (27-29.9) and moderate/severe obesity (≥ 30). At a maximal 10-year follow-up, cardiac and all-cause deaths were the primary end points. Results: After multivariate analysis, patients from the category of underweight and normal-low weight in reference to those from the normal-high weight category had a significantly higher risk of cardiac and all-cause mortality (hazard ratio (HR): 1.68 (95% CI: 1.04-2.70) and 2.02 (95% CI: 1.42-2.87), respectively) following a median of 5.4 years. Obese elderly patients tended to have the lowest risk of all-cause death across all the study BMI categories in the early stage. However, after 5 years, mortality increased in the obese patients surviving beyond 5 years, and was higher than that in overweight patients. Conclusions: The obesity-mortality paradox was present in elderly patients with angiographic CAD in Taiwan and the risk of death was significantly higher in those with a BMI < 21 kg/m2. However, a J-shaped relationship between mortality and BMI developed after 5 years of follow-up.
    Full-text · Article · Aug 2015 · Acta cardiologica
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    ABSTRACT: Background: Adipocyte fatty acid binding protein (A-FABP) is a novel fat-derived circulating protein, which is independently and positively associated with atherosclerosis. The present study evaluated the relationship between fasting serum A-FABP and central arterial stiffness in geriatric adults. Methods: Fasting blood samples were obtained from 87 geriatric patients and the serum A-FABP levels were measured using an enzyme immunoassay. Carotid-femoral pulse wave velocity (cfPWV) was determined using the SphygmoCor system. cfPWV values of >10 m/s represented the high arterial stiffness group, while values ≤10 m/s defined the low arterial stiffness group. Results: High arterial stiffness group comprised of 42 geriatric adults (48.3%). When compared to those in the low arterial stiffness group, the high arterial stiffness group had a higher rate of diabetes mellitus (P = 0.044) and hypertension (P = 0.043). Body weight (P = 0.027), waist circumference (P = 0.035), body mass index (P = 0.001), systolic blood pressure (P = 0.005), diastolic blood pressure (P = 0.045), pulse pressure (P = 0.038), and serum A-FABP level (P < 0.001) were also higher in the high arterial stiffness group than in the low arterial stiffness group. Multivariate logistic regression analysis of the factors significantly associated with arterial stiffness revealed that A-FABP (odds ratio: 1.833, 95% confidence interval 1.123-2.993, P = 0.015) was an independent predictor of arterial stiffness in geriatric adults. Conclusions: Serum A-FABP levels constitute a major risk factor in the development of central arterial stiffness in the geriatric population.
    Preview · Article · Jul 2015 · BMC Geriatrics
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    ABSTRACT: Aim: Arterial stiffness is recognized to be an independent risk factor for cardiovascular morbidity and mortality. Recent studies have found that osteoprotegerin (OPG) is associated with increased pulse wave velocity and may reflect endothelial dysfunction. The aim of this study was to evaluate the relationship between the serum OPG level and arterial stiffness in hypertensive patients using the cardio-ankle vascular index (CAVI). Methods: Fasting blood samples were obtained from 115 hypertensive patients and 52 healthy participants. The CAVI value was derived using the waveform device (CAVI-VaSera VS-1000). The serum OPG levels were measured using a commercially available enzyme-linked immunosorbent assay. A CAVI value of ≥9 defined the high arterial stiffness group. Results: Sixty-five hypertensive patients (56.5%) were included in the high arterial stiffness group. Diabetes (p=0.032), smoking (p=0.044), age (p<0.001), systolic blood pressure (p=0.001), diastolic blood pressure (p=0.024), pulse pressure (p=0.046) and the creatinine (p=0.013) and serum OPG (p<0.001) levels were higher in the high arterial stiffness group than in the low arterial stiffness group, while the glomerular filtration rate (p=0.003) was lower in the high arterial stiffness group than in the low arterial stiffness group among the hypertensive patients. The results of the Spearman’s rank correlation coefficient test also indicated a strong positive correlation between the OPG and CAVI values (r=0.484, p<0.001) in the hypertensive patients. In addition, a multivariate logistic regression analysis showed that age (odds ratio: 1.162, 95% confidence interval (CI): 1.070-1.263, p<0.001), diastolic blood pressure (odds ratio: 1.109, 95% CI: 1.033-1.190, p=0.004), and serum OPG level (odds ratio: 1.275, 95% CI: 1.030-1.580, p=0.026) were independent predictors of arterial stiffness in hypertensive patients. Conclusions: The serum OPG level is positively associated with arterial stiffness in hypertensive patients.
    Full-text · Article · Oct 2014 · Journal of atherosclerosis and thrombosis
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    ABSTRACT: [Purpose] To investigate the effects of Phase II cardiac exercise therapy (CET) on exercise capacity and changes in coronary risk factors (CRFs) of patients with acute myocardial infarction (AMI). [Subjects] Thirty male subjects with AMI were divided into an experimental group (EG) and a control group (CG). Another 30 age-matched subjects with patent coronary arteries served as a normal-control group (NCG). [Methods] Subjects in EG (n=20) trained using a stationary bicycle for 30 min at their target heart rate twice a week for 8 weeks. Exercise capacity was defined as the maximal metabolic equivalents (METs) that subjects reached during the symptom-limited maximal exercise test. HR, BP and RPP were recorded. Subjects in EG and CG received exercise tests and screening for CRFs at the beginning of, end of, and 3 months after Phase II CET, while subjects in NCG participated only in the 1st test. [Results] METs of CG did not improve until the 3rd test, while RPP at the 2nd test showed a significant increase. However, EG showed increased METs at the 2nd test without increase of RPP, and increased their high density lipoprotein cholesterol (HDL-C) during the follow-up period between the 2nd and 3rd tests. [Conclusion] Phase II CET shortens the recovery time of exercise capacity, helps to maintain the gained exercise capacity and increases HDL-C in phase III.
    Full-text · Article · Sep 2014 · Journal of Physical Therapy Science
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    ABSTRACT: Osteopontin (OPN) is involved in the regulation of vascular calcification processes. The aim of this study was to evaluate the relationship between fasting serum OPN concentration and carotid-femoral pulse wave velocity (cfPWV) in geriatric persons. Fasting blood samples were obtained from 93 geriatric persons. cfPWV were performed by SphygmoCor system. Serum OPN levels were measured using a commercially available enzyme-linked immunosorbent assay. Geriatric adults who had diabetes (P = 0.007) or dyslipidemia (P = 0.029) had higher cfPWV levels than those without diabetes or dyslipidemia. The univariable linear regression analysis showed that age (P = 0.002), waist circumference (P = 0.048), body mass index (P = 0.004), systolic blood pressure (P = 0.001), diastolic blood pressure (P = 0.036), pulse pressure (P = 0.017), creatinine (P = 0.002), and log-OPN level (P = 0.001) were positively correlated with cfPWV levels, while the high-density lipoprotein cholesterol (HDL-cholesterol) level (P = 0.007) and glomerular filtration rate (P = 0.001) were negatively correlated with cfPWV levels among the geriatric adults. Multivariable forward stepwise linear regression analysis of the significant variables also showed that log-OPN (β = 0.233, R (2) = 0.123, regression coefficient: 1.868, P = 0.011) was still an independent predictor of cfPWV levels in geriatric persons.
    Full-text · Article · Jul 2014 · BioMed Research International
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    ABSTRACT: It has been shown that metabolic syndrome is associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. However, there is no study about the association between Nt-proBNP and metabolic syndrome in hypertensive patients. AIM:: To elucidate the relationship between Nt-proBNP and components of metabolic syndrome in hypertensive patients. Fasting blood samples were obtained from 74 hypertensive patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation. Forty-four hypertensive patients met the criteria for metabolic syndrome. We found that plasma Nt-proBNP levels were lower in hypertensive patients with metabolic syndrome attributable to inverse relationships between Nt-proBNP and albumin, triglyceride, insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and pancreatic β-cell function (HOMA-β). We further performed a multivariable linear regression analysis. The result showed that HOMA-IR is the independent predictor of plasma Nt-proBNP levels in hypertensive patients. Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in hypertensive patients. HOMA-IR is the independent predictor of Nt-proBNP in hypertensive patients.
    Full-text · Article · Apr 2014 · The American Journal of the Medical Sciences
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    Mei-Ling Chen · Sing-Kai Chuo · Ji-Hung Wang

    Preview · Article · Apr 2014 · Journal of the American College of Cardiology
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    ABSTRACT: Osteoprotegerin (OPG) has been implicated in the process of vascular stiffness. The aim of this study was to evaluate the relationship between fasting serum OPG concentration and carotid-femoral pulse wave velocity (c-f PWV) in hypertensive patients. Fasting blood samples were obtained from 184 participants with or without hypertension. c-f PWV were performed by SphygmoCor system. Serum OPG levels were measured using a commercially available enzyme-linked immunosorbent assay. Hypertensive patients who had diabetes had higher c-f PWV levels than those without diabetes (P=.031). The univariable linear regression analysis showed that age (P<.001), systolic blood pressure (P=.003), pulse pressure (r=0.287; P=.003), log-BUN (P=.011), Cre (P<.001), and log-OPG concentration (P<.001) were positively correlated with c-f PWV levels, while the glomerular filtration rate (P=.005) and HDL-C level (P=.024) was negatively correlated with c-f PWV levels among the hypertensive patients. Multivariable forward stepwise linear regression analysis of the significant variables also showed that log-OPG (β=0.312, regression coefficient: 1.736; 95% confidence interval, 0.809-2.663; P<.001) was still an independent predictor of c-f PWV levels in hypertensive patients. Serum OPG levels positively associated with c-f PWV levels in hypertensive patients.
    Full-text · Article · Mar 2014 · Journal of Clinical Hypertension
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    ABSTRACT: Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) was lower in the general population with metabolic syndrome (MetS). The aim of this study was to evaluate the relationship between MetS and fasting serum NT-proBNP concentration in elderly persons. Fasting blood samples were obtained from 84 elderly volunteers aged 65 years or older. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. Thirty-eight elderly persons (45.2%) had MetS. Fasting NT-proBNP level was negatively correlated with MetS among elderly patients (p = 0.001). Univariate linear regression analysis showed that age (r = 0.338; p = 0.002) was positively correlated with fasting serum log-NT-proBNP levels, while height (r = -0.253; p = 0.020), body weight (r = -0.238; p = 0.029), waist circumference (r = -0.270; p = 0.013), body fat mass (r = -0.356; p = 0.002) and triglyceride (r = -0.291; p = 0.007) were negatively correlated with fasting serum log-NT-proBNP levels among the elderly persons. Multivariate forward stepwise linear regression analysis of the significant variables showed that age (R2 change = 0.114, p = 0.011), triglyceride (R2 change = 0.118, p < 0.001), body fat mass (R2 change = 0.084, p < 0.001), and height (R2 change = 0.101, p < 0.001) were the independent predictor of fasting serum log-NT-proBNP levels in elderly persons. NT-proBNP level is significantly reduced in elderly persons affected by MetS, and is significantly positively related to age, while negatively related to triglyceride, body fat mass, height in these subjects.
    Full-text · Article · Feb 2014 · Diabetology and Metabolic Syndrome
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    ABSTRACT: Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF). Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation. Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients. Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.
    Full-text · Article · Nov 2013 · PLoS ONE
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    ABSTRACT: [Purpose] To investigate the effects of cardiac exercise therapy (CET) on exercise capacity and coronary risk factors (CRFs) of patients with acute myocardial infarction (AMI). [Methods] Patients who participated in an 8-week supervised, hospital-based phase II and 6-month home-based phase III CET with monthly telephone and/or home visits were defined as the exercise group (EG) (n=20), while those who did not receive phase II or phase III CET were defined as the no-exercise group (NEG) (n=10). CRFs were evaluated pre- and post-phase II and eight months after discharge. One and two-way repeated measures ANOVA were used to perform intra- and inter-group comparisons. [Results] Thirty men with AMI aged 49.3 ± 8.3 years were studied. EG increased their exercise capacity (METs) (6.8 ± 1.6 vs.10.0 ± 1.9) after phase II CET and was able to maintain it at 8-month follow-up. Both groups had significantly fewer persons who kept on smoking compared to the first examination. High density lipoprotein cholesterol (HDL-C) increased from 38.1 ± 11.0 to 43.7 ± 8.7 mg/dl at follow-up in EG while no significant difference was noted in NEG. [Conclusion] After phase III CET subjects had maintained the therapeutic effects of smoking cessation, and increasing exercise capacity obtained in phase II CET. HDL-C in EG continued to improve during phase III CET.
    Preview · Article · Nov 2013 · Journal of Physical Therapy Science
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    Gen-Min Lin · Yi-Hwei Li · Chin-Lon Lin · Ji-Hung Wang · Chih-Lu Han

    Full-text · Article · Sep 2013 · Journal of Cardiology
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    ABSTRACT: Atrial natriuretic peptide (ANP) is a potent lipolytic agent that acts in adipose tissue. Low levels of ANP might lead to reduced lipolysis and excessive weight gain, which could be one of the biological alterations that contribute to the development of obesity. The aim of the present study was to evaluate the relationship between metabolic syndrome and fasting serum ANP concentrations in older adults. Fasting blood samples were obtained from 90 older adults. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation. A total of 40 older adults (44.4%) had metabolic syndrome. Fasting ANP level was negatively correlated with metabolic syndrome (P = 0.015). Univariate linear regression analysis showed that high-density lipoprotein cholesterol (P < 0.001) was positively correlated with serum logANP levels, whereas waist circumference (P = 0.001) and body fat mass (P = 0.002) were negatively correlated with fasting serum logANP levels. Multivariate forward stepwise linear regression analysis of the significant variables showed that high-density lipoprotein cholesterol (β = 0.419, R(2) = 0.268, P < 0.001) and body fat mass (β = -0.396, R(2) = 0.154, P = 0.002) were independent predictors of fasting serum logANP levels in geriatric persons. Serum ANP levels were reduced in geriatric persons affected by metabolic syndrome. Body fat mass and high-density lipoprotein cholesterol were independent predictors of fasting serum ANP levels in older adults. Geriatr Gerontol Int 2013; ●●: ●●-●●.
    Full-text · Article · Sep 2013 · Geriatrics & Gerontology International
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    ABSTRACT: Coronary artery fistulae that drain into the left ventricle are extremely rare, and even fewer cases of fistulae involving all three of the coronary arteries have so far been reported. We herein report a 64-year-old woman with a unique pattern of coronary artery-left ventricular fistulae that involved all three of the coronary arteries. The multiple fistulae presented in a diffuse plexus-like arrangement. The fistulae resulted in a diastolic volume overload of the left ventricle (left-to-left shunt), as well as "coronary steal" with the shunting of blood away from the myocardium since the fistulae represented the path of least resistance.
    No preview · Article · Sep 2013 · Internal Medicine
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    Gen-Min Lin · Yi-Hwei Li · Chin-Lon Lin · Ji-Hung Wang · Chih-Lu Han

    Full-text · Article · Jul 2013 · International journal of cardiology
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    Gen-Min Lin · Yi-Hwei Li · Chin-Lon Lin · Ji-Hung Wang · Chih-Lu Han

    Full-text · Article · Jul 2013 · International journal of cardiology
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    Yi-Hwei Li · Gen-Min Lin · Cha-Po Lai · Chin-Lou Lin · Ji-Hung Wang

    Full-text · Article · Jul 2013 · International journal of cardiology
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    Yi-Hwei Li · Gen-Min Lin · Cha-Po Lai · Chin-Lon Lin · Ji-Hung Wang

    Full-text · Article · Jul 2013 · International journal of cardiology
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    ABSTRACT: Hyperuricemia is associated with a higher risk of death in patients with coronary artery disease (CAD). In contrast, overweight or obesity was associated with survival benefits in this population. However, the relation of body mass index (BMI) and serum uric acid (SUA) to mortality has not been clarified in this population. We studied a cohort of 1202 patients with angiographic CAD from the ET-CHD registry during 1997-2003 in Taiwan. To evaluate the relation of BMI and SUA on mortality, the subjects were categorized into 4 groups by BMI≧25kg/m(2) (overweight or obesity) or BMI<25kg/m(2) (normal- or under-weight), and SUA levels higher or lower than the median of 6.6mg/dl. At a median follow-up of 5.4 years, cardiac and all-cause deaths were the primary end points. Multivariate analyses demonstrated that high SUA group had a significantly higher cardiac mortality [hazard ratio (HR): 1.79, 95% confidence interval (CI): 1.14-2.82, p=0.023] and overall mortality (HR: 1.68, 95% CI: 1.19-2.36, p=0.003) than low SUA group only in overweight or obese patients. Additionally, high BMI was associated with a significantly lower cardiac mortality (HR: 0.58, 95% CI: 0.38-0.99, p=0.023) and overall mortality (HR: 0.62, 95% CI: 0.41-0.82, p=0.003) than low BMI in patients with low SUA levels. Furthermore, normal-low weight and underweight patients (BMI<21kg/m(2)) were found to have a higher risk of mortality regardless of SUA levels. Among patients with established CAD, SUA may be a potent predictor to mortality in overweight or obese patients. Moreover, the obesity-mortality paradox phenomenon was mainly driven by higher mortality risk in underweight patients and lower mortality risk in overweight and obese patients with low SUA.
    Full-text · Article · Jul 2013 · Journal of Cardiology

Publication Stats

242 Citations
133.21 Total Impact Points

Institutions

  • 2010-2015
    • Tzu Chi University
      • Department of Medicine
      Hua-lien, Taiwan, Taiwan
  • 2002-2015
    • Buddhist Tzu Chi General Hospital
      • Department of Urology
      T’ai-pei, Taipei, Taiwan
  • 1998
    • Chang Gung Memorial Hospital
      T’ai-pei, Taipei, Taiwan