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JKM > Volume 39(1); 2018 > Article
Moon, Jung, Kwon, Cho, Park, Jung, Park, Ko, and Cho: The Effect of Geopungchunghyul-dan on Circumferential Strain of Carotid Artery: A Case Series



This study is aimed to examine the effect of Geopungchunghyul-dan on circumferential strain of carotid artery in outpatients of Kyung Hee University hospital of Korean Medicine.


Retrospective chart review is used from June 2016 to August 2017 for outpatients of Kyung Hee University hospital of Korean Medicine. 14 patients taking Geopungchunghyul-dan over 1 month were speculated. Data of circumferential strain and intima-media thickness was taken from carotid ultrasonography and processed by Wilcoxon signed-rank test.


Geopungchunghyul-dan lowered circumferential strain of both carotid arteries after 1 month of administration (p<0.05). Intima-media thickness of both carotid arteries did not changed significantly.


Geopungchunghyul-dan may ameliorate arterial stiffness.

Fig. 1
Change of left circumferential strain for 1 month of treatment.
Fig. 2
Change of right circumferential strain for 1 month of treatment.
Fig. 3
Change of left circumferential strain for 2 months of treatment
Fig. 4
Change of right circumferential strain for 2 months of treatment
Fig. 5
Change of both circumferential strain for 3 months of treatment
Table 1
Clinical Characteristics of Patients. (n=14)
Number of patients (%)
Main impression Small vessel disease 5 (35.71)
Tension type headache 2 (14.29)
Transient ischemic attack 2 (14.29)
Vestibular neuritis 2 (14.29)
Cervicalgia 1 (7.14)
Vasovagal syncope 1 (7.14)
Facial myokymia 1 (7.14)

Chief complain Headache 4 (28.57)
Dysarthria 4 (28.57)
One side weakness 3 (21.43)
Facial palsy 3 (21.43)
Dizziness 3 (21.43)
General weakness 3 (21.43)
One side numbness 2 (14.29)
Motor aphasia 1 (7.14)
Aphthous ulcer 1 (7.14)
Tinnitus 1 (7.14)
Facial myokymia 1 (7.14)

CVD risk factor Hypertension 11 (78.57)
Diabetes mellitus 9 (64.29)
Dyslipidemia 8 (57.14)
Social history Smoke 2 (14.29)
Alcohol 4 (28.57)
Table 2
Mean Value and Standard Deviation of Circumferential Strain and Intima-Media Thickness of each Common Carotid Artery at Start(Baseline) and 1 Month of Treatment.
Baseline 1 month p value
CS (Left) 1.76±0.75 2.09±0.81 0.003*
CS (Right) 1.80±0.56 2.16±0.75 0.013*
IMT (Left) 0.76±0.10 0.79±0.11 0.054
IMT (Right) 0.79±0.11 0.80±0.10 0.726

CS, circumferential strain; IMT, intima-media thickness.

Wilcoxon signed-rank tests were used for comparison between start and 1 month of treatment.

* Statistically significant at p<0.05

Table 3
Rate of Change in Circumferential Strain for 1 Month of Treatment
Patient Rate of change in CS (%)

Left Right
#1 22.97 −5.81
#2 63.64 45.26
#3 1.44 4.76
#4 6.27 21.26
#5 20.23 6.54
#6 13.13 39.7
#7 22.08 39.87
#8 34.1 3.4
#9 −2.8 6.99
#10 6.62 23.68
#11 28.21 34.45
#12 72.46 100
#13 −6.8 −25.19
#14 44.12 6.57

mean 23.26 21.53
SD 22.94 28.98

CS, circumferential strain; SD, standard deviation


1. Cohn JN, Duprez DA, Grandits GA. Arterial elasticity as part of a comprehensive assessment of cardiovascular risk and drug treatment. Hypertension. 2005; 46:1. 217–220.

2. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002; 39:1. 10–15.

3. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001; 37:5. 1236–1241.

4. Bjällmark A, Lind B, Peolsson M, Shahgaldi K, Brodin LA, Nowak J. Ultrasonographic strain imaging is superior to conventional non-invasive measures of vascular stiffness in the detection of age-dependent differences in the mechanical properties of the common carotid artery. Eur J Echocardiogr. 2010; 11:630–636.

5. Saji N, Toba K, Sakurai T. Cerebral small vessel disease and arterial stiffness: tsunami effect in the brain. Pulse. 2016; 3:3–4. 182–189.

6. Jung WS, Kwon S, Cho SY, Park SU, Moon SK, Park JM, et al. The Effects of Chunghyul-Dan (A Korean Medicine Herbal Complex) on Cardiovascular and Cerebrovascular Diseases: A Narrative Review. Evid Based Complement Alternat Med. 2016; 2016:2601740
pmid pmc

7. Park HE, Cho GY, Kim HK, Kim YJ, Sohn DW. Validation of circumferential carotid artery strain as a screening tool for subclinical atherosclerosis. J Atheroscler Thromb. 2012; 19:4. 349–56.

8. Catalano M, Lamberti-Castronuovo A, Catalano A, Filocamo D, Zimbalatti C. Two-dimensional speckle-tracking strain imaging in the assessment of mechanical properties of carotid arteries: feasibility and comparison with conventional markers of subclinical atherosclerosis. Eur J Echocardiogr. 2011; Jul. 12:7. 528–535.

9. Yuda S, Kaneko R, Muranaka A, Hashimoto A, Tsuchihashi K, Miura T, et al. Quantitative measurement of circumferential carotid arterial strain by two-dimensional speckle tracking imaging in healthy subjects. Echocardiography. 2011; Sep. 28:8. 899–906.

10. Yang EY, Dokainish H, Virani SS, Misra A, Pritchett AM, Lakkis N, et al. Segmental analysis of carotid arterial strain using speckle -tracking. J Am Soc Echocardiogr. 2011; Nov. 24:11. 1276–1284.

11. Saito M, Okayama H, Inoue K, Yoshii T, Hiasa G, Sumimoto T, et al. Carotid arterial circumferential strain by two-dimensional speckle tracking: a novel parameter of arterial elasticity. Hypertens Res. 2012; Sep. 35:9. 897–902.

12. Wierzbowska-Drabik K, Cygulska K, Cieślik-Guerra U, Uznańska-Loch B, Rechciński T, Trzos E, et al. Circumferential strain of carotid arteries does not differ between patients with advanced coronary artery disease and group without coronary stenoses. Adv Med Sci. 2016; Sep. 61:2. 203–206.

13. Boutouyrie P. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’ The Reference Values for Arterial Stiffness’ Collaboration. European Heart Journal. 2010; 31:2338–2350.

14. Park TH. Neuroprotective effect of Geopungchunghyul-dan on in vitro oxygen-glucose deprivation and in vivo permanent middle cerebral artery occlusion model[Dissertation]. Seoul: Kyunghee Univ;2015.

15. Park SU, Jung WS, Moon SK, Ko CN, Cho KH, Kim YS, et al. Chunghyul-dan(Qingxie-dan) improves arterial stiffness in patients with increased baPWV. Am J Chin Med. 2006; 34:4. 553–563.

16. Min KD. The Effects of Cardiotonic Pills® on Common Carotid Artery Elasticity in Healthy Subjects [Dissertation]. Seoul: Kyunghee Univ;2016.

17. Park SU. Effect of Chunghyul-dan on Arterial stiffness: Clinical and Molecular Study [Dissertation]. Seoul: Kyunghee Univ;2005.

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