메뉴 건너뛰기




Volumn 100, Issue 3, 2011, Pages 241-247

Heart rate variability and biomarkers of systemic inflammation in patients with stable coronary heart disease: Findings from the Heart and Soul Study

Author keywords

Autonomic nervous system; Biomarkers; Cardiac autonomic function; Cardiovascular disease; Heart rate variability; Inflammation

Indexed keywords

ACETYLSALICYLIC ACID; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BIOLOGICAL MARKER; C REACTIVE PROTEIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; INTERLEUKIN 6; STATIN;

EID: 79954624827     PISSN: 18610684     EISSN: 18610692     Source Type: Journal    
DOI: 10.1007/s00392-010-0236-5     Document Type: Article
Times cited : (56)

References (45)
  • 1
    • 21544467275 scopus 로고    scopus 로고
    • Pathophysiology of coronary artery disease
    • DOI 10.1161/CIRCULATIONAHA.105.537878
    • P Libby P Theroux 2005 Pathophysiology of coronary artery disease Circulation 111 3481 3488 10.1161/CIRCULATIONAHA.105.537878 15983262 (Pubitemid 40923403)
    • (2005) Circulation , vol.111 , Issue.25 , pp. 3481-3488
    • Libby, P.1    Theroux, P.2
  • 5
    • 33748420067 scopus 로고    scopus 로고
    • Biomarkers of outcome from cardiovascular disease
    • DOI 10.1097/01.ccx.0000244119.16377.75, PII 0007519820061000000008
    • N Khuseyinova W Koenig 2006 Biomarkers of outcome from cardiovascular disease Curr Opin Crit Care 12 412 419 10.1097/01.ccx.0000244119.16377.75 16943718 (Pubitemid 44341705)
    • (2006) Current Opinion in Critical Care , vol.12 , Issue.5 , pp. 412-419
    • Khuseyinova, N.1    Koenig, W.2
  • 6
    • 0035954249 scopus 로고    scopus 로고
    • Biological profiles in subjects with recurrent acute coronary events compared with subjects with long-standing stable angina
    • P Bogaty P Poirier S Simard L Boyer S Solymoss GR Dagenais 2001 Biological profiles in subjects with recurrent acute coronary events compared with subjects with long standing stable angina Circulation 103 3062 3068 1:STN:280:DC%2BD3MzmsFSmug%3D%3D 11425769 (Pubitemid 32587852)
    • (2001) Circulation , vol.103 , Issue.25 , pp. 3062-3068
    • Bogaty, P.1    Poirier, P.2    Simard, S.3    Boyer, L.4    Solymoss, S.5    Dagenais, G.R.6
  • 7
    • 0032169240 scopus 로고    scopus 로고
    • Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels
    • PM Ridker N Rifai MA Pfeffer, et al. 1998 Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events (CARE) Investigators Circulation 98 839 844 1:CAS:528:DyaK1cXlvFyhur0%3D 9738637 (Pubitemid 28397432)
    • (1998) Circulation , vol.98 , Issue.9 , pp. 839-844
    • Ridker, P.M.1    Rifai, N.2    Pfeffer, M.A.3    Sacks, F.M.4    Moye, L.A.5    Goldman, S.6    Flaker, G.C.7    Braunwald, E.8
  • 11
    • 56349146348 scopus 로고    scopus 로고
    • The relationship between heart rate variability and inflammatory markers in cardiovascular diseases
    • 1:CAS:528:DC%2BD1cXhsVWhur7O 10.1016/j.psyneuen.2008.08.007 18819754
    • A Haensel PJ Mills RA Nelesen MG Ziegler JE Dimsdale 2008 The relationship between heart rate variability and inflammatory markers in cardiovascular diseases Psychoneuroendocrinology 33 1305 1312 1:CAS:528:DC%2BD1cXhsVWhur7O 10.1016/j.psyneuen.2008.08.007 18819754
    • (2008) Psychoneuroendocrinology , vol.33 , pp. 1305-1312
    • Haensel, A.1    Mills, P.J.2    Nelesen, R.A.3    Ziegler, M.G.4    Dimsdale, J.E.5
  • 12
    • 33846913227 scopus 로고    scopus 로고
    • Association of decreased variation of R-R interval and elevated serum C-reactive protein level in a general population in Japan
    • DOI 10.1536/ihj.47.867
    • H Kon M Nagano F Tanaka K Satoh T Segawa M Nakamura 2006 Association of decreased variation of R-R interval and elevated serum C-reactive protein level in a general population in Japan Int Heart J 47 867 876 1:CAS:528: DC%2BD2sXjvFKqurY%3D 10.1536/ihj.47.867 17268121 (Pubitemid 46231815)
    • (2007) International Heart Journal , vol.47 , Issue.6 , pp. 867-876
    • Kon, H.1    Nagano, M.2    Tanaka, F.3    Satoh, K.4    Segawa, T.5    Nakamura, M.6
  • 13
    • 33344456881 scopus 로고    scopus 로고
    • Lower heart rate variability is associated with higher serum high-sensitivity C-reactive protein concentration in healthy individuals aged 46 years or more
    • DOI 10.1016/j.ijcard.2005.03.044, PII S0167527305005917
    • F Araújo I Antelmi AC Pereira, et al. 2006 Lower heart rate variability is associated with higher serum high-sensitivity C-reactive protein concentration in healthy individuals aged 46 years or more Int J Cardiol 107 333 337 10.1016/j.ijcard.2005.03.044 16503254 (Pubitemid 43287777)
    • (2006) International Journal of Cardiology , vol.107 , Issue.3 , pp. 333-337
    • Araujo, F.1    Antelmi, I.2    Pereira, A.C.3    Latorre, M.D.R.D.O.4    Grupi, C.J.5    Krieger, J.E.6    Mansur, A.J.7
  • 15
    • 34547941468 scopus 로고    scopus 로고
    • The effect of urban air pollution on inflammation, oxidative stress, coagulation, and autonomic dysfunction in young adults
    • DOI 10.1164/rccm.200611-1627OC
    • KJ Chuang CC Chan TC Su CT Lee CS Tang 2007 The effect of urban air pollution on inflammation, oxidative stress, coagulation, and autonomic dysfunction in young adults Am J Respir Crit Care Med 176 370 376 1:CAS:528:DC%2BD2sXhtVajsrjM 10.1164/rccm.200611-1627OC 17463411 (Pubitemid 47267471)
    • (2007) American Journal of Respiratory and Critical Care Medicine , vol.176 , Issue.4 , pp. 370-376
    • Chuang, K.-J.1    Chan, C.-C.2    Su, T.-C.3    Lee, C.-T.4    Tang, C.-S.5
  • 16
    • 53149128792 scopus 로고    scopus 로고
    • Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men
    • Lampert R, Bremner JD, Su S et al (2008) Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men. Am Heart J 156:759.e1-e7
    • (2008) Am Heart J , vol.156
    • Lampert, R.1    Bremner, J.D.2    Su, S.3
  • 17
    • 61849151929 scopus 로고    scopus 로고
    • Heart rate variability, overnight urinary norepinephrine and C-reactive protein: Evidence for the cholinergic anti-inflammatory pathway in healthy human adults
    • 1:CAS:528:DC%2BD1MXkvVGqt78%3D 10.1111/j.1365-2796.2008.02023.x 19019182
    • JF Thayer JE Fischer 2009 Heart rate variability, overnight urinary norepinephrine and C-reactive protein: evidence for the cholinergic anti-inflammatory pathway in healthy human adults J Intern Med 265 439 447 1:CAS:528:DC%2BD1MXkvVGqt78%3D 10.1111/j.1365-2796.2008.02023.x 19019182
    • (2009) J Intern Med , vol.265 , pp. 439-447
    • Thayer, J.F.1    Fischer, J.E.2
  • 18
    • 34250638610 scopus 로고    scopus 로고
    • RR interval variability is inversely related to inflammatory markers: The CARDIA study
    • DOI 10.2119/2006-00112.Sloan
    • RP Sloan H McCreath KJ Tracey S Sidney K Liu T Seeman 2007 RR interval variability is inversely related to inflammatory markers: the CARDIA study Mol Med 13 178 184 17592552 (Pubitemid 46944960)
    • (2007) Molecular Medicine , vol.13 , Issue.3-4 , pp. 178-184
    • Sloan, R.P.1    McCreath, H.2    Tracey, K.J.3    Sidney, S.4    Liu, K.5    Seeman, T.6
  • 19
    • 38549131224 scopus 로고    scopus 로고
    • Higher levels of inflammation factors and greater insulin resistance are independently associated with higher heart rate and lower heart rate variability in normoglycemic older individuals: The cardiovascular health study
    • DOI 10.1111/j.1532-5415.2007.01564.x
    • PK Stein JI Barzilay PH Chaves, et al. 2008 Higher levels of inflammation factors and greater insulin resistance are independently associated with higher heart rate and lower heart rate variability in normoglycemic older individuals: the Cardiovascular Health Study J Am Geriatr Soc 56 315 321 10.1111/j.1532-5415.2007.01564.x 18179502 (Pubitemid 351160704)
    • (2008) Journal of the American Geriatrics Society , vol.56 , Issue.2 , pp. 315-321
    • Stein, P.K.1    Barzilay, J.I.2    Chaves, P.H.M.3    Traber, J.4    Domitrovich, P.P.5    Heckbert, S.R.6    Gottdiener, J.S.7
  • 20
    • 41349104059 scopus 로고    scopus 로고
    • Relationship between heart rate variability, interleukin-6, and soluble tissue factor in healthy subjects
    • DOI 10.1016/j.bbi.2007.09.009, PII S088915910700253X
    • R von Känel RA Nelesen PJ Mills MG Ziegler JE Dimsdale 2008 Relationship between heart rate variability, interleukin-6, and soluble tissue factor in healthy subjects Brain Behav Immun 22 461 468 10.1016/j.bbi.2007.09. 009 (Pubitemid 351451820)
    • (2008) Brain, Behavior, and Immunity , vol.22 , Issue.4 , pp. 461-468
    • Von Kanel, R.1    Nelesen, R.A.2    Mills, P.J.3    Ziegler, M.G.4    Dimsdale, J.E.5
  • 21
    • 64949199123 scopus 로고    scopus 로고
    • Nighttime vagal cardiac control and plasma fibrinogen levels in a population of working men and women
    • 10.1111/j.1542-474X.2009.00293.x
    • R von Känel JF Thayer JE Fischer 2009 Nighttime vagal cardiac control and plasma fibrinogen levels in a population of working men and women Ann Noninvasive Electrocardiol 14 176 184 10.1111/j.1542-474X.2009.00293.x
    • (2009) Ann Noninvasive Electrocardiol , vol.14 , pp. 176-184
    • Von Känel, R.1    Thayer, J.F.2    Fischer, J.E.3
  • 22
    • 33947323766 scopus 로고    scopus 로고
    • Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease
    • DOI 10.1016/j.jpsychores.2006.12.004, PII S0022399906005289
    • RM Carney KE Freedland PK Stein, et al. 2007 Heart rate variability and markers of inflammation and coagulation in depressed patients with coronary heart disease J Psychosom Res 62 463 467 10.1016/j.jpsychores.2006.12.004 17383498 (Pubitemid 46441261)
    • (2007) Journal of Psychosomatic Research , vol.62 , Issue.4 , pp. 463-467
    • Carney, R.M.1    Freedland, K.E.2    Stein, P.K.3    Miller, G.E.4    Steinmeyer, B.5    Rich, M.W.6    Duntley, S.P.7
  • 23
    • 34247136353 scopus 로고    scopus 로고
    • C-reactive protein modulates vagal heart rate control in patients with coronary artery disease
    • DOI 10.1042/CS20060132
    • RP Nolan GJ Reid PH Seidelin HK Lau 2007 C-reactive protein modulates vagal heart rate control in patients with coronary artery disease Clin Sci 112 449 456 1:CAS:528:DC%2BD2sXislehtrw%3D 10.1042/CS20060132 17134377 (Pubitemid 46587460)
    • (2007) Clinical Science , vol.112 , Issue.7-8 , pp. 449-456
    • Nolan, R.P.1    Reid, G.J.2    Seidelin, P.H.3    Lau, H.K.4
  • 26
    • 7244254581 scopus 로고    scopus 로고
    • Inflammatory markers and heart rate variability in women with coronary heart disease
    • DOI 10.1111/j.1365-2796.2004.01403.x
    • I Janszky M Ericson M Lekander, et al. 2004 Inflammatory markers and heart rate variability in women with coronary heart disease J Intern Med 256 421 428 1:CAS:528:DC%2BD2cXhtVektLjF 10.1111/j.1365-2796.2004.01403.x 15485478 (Pubitemid 39434379)
    • (2004) Journal of Internal Medicine , vol.256 , Issue.5 , pp. 421-428
    • Janszky, I.1    Ericson, M.2    Lekander, M.3    Blom, M.4    Buhlin, K.5    Georgiades, A.6    Ahnve, S.7
  • 27
    • 52749099065 scopus 로고    scopus 로고
    • Autonomic function and prothrombotic activity in women after an acute coronary event
    • 10.1089/jwh.2007.0764
    • R von Känel K Orth-Gomér 2008 Autonomic function and prothrombotic activity in women after an acute coronary event J Womens Health 17 1331 1337 10.1089/jwh.2007.0764
    • (2008) J Womens Health , vol.17 , pp. 1331-1337
    • Von Känel, R.1    Orth-Gomér, K.2
  • 28
    • 34447131516 scopus 로고    scopus 로고
    • C-reactive protein is associated with heart rate variability
    • DOI 10.1111/j.1542-474X.2007.00164.x
    • T Madsen JH Christensen E Toft EB Schmidt 2007 C-reactive protein is associated with heart rate variability Ann Noninvasive Electrocardiol 12 216 222 10.1111/j.1542-474X.2007.00164.x 17617066 (Pubitemid 47037950)
    • (2007) Annals of Noninvasive Electrocardiology , vol.12 , Issue.3 , pp. 216-222
    • Madsen, T.1    Christensen, J.H.2    Toft, E.3    Schmidt, E.B.4
  • 30
    • 0032517042 scopus 로고    scopus 로고
    • The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking
    • DOI 10.1001/archinte.158.16.1789
    • K Bush DR Kivlahan MB McDonell SD Fihn KA Bradley 1998 The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test Arch Intern Med 158 1789 1795 1:STN:280: DyaK1cvgvV2rug%3D%3D 10.1001/archinte.158.16.1789 9738608 (Pubitemid 28421422)
    • (1998) Archives of Internal Medicine , vol.158 , Issue.16 , pp. 1789-1795
    • Bush, K.1    Kivlahan, D.R.2    McDonell, M.B.3    Fihn, S.D.4    Bradley, K.A.5
  • 31
    • 0029928495 scopus 로고    scopus 로고
    • Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology
    • (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 93:1043-1065
    • (1996) Circulation , vol.93 , pp. 1043-1065
  • 32
    • 0023100673 scopus 로고
    • Decreased heart rate variability and its association with increased mortality after acute myocardial infarction
    • DOI 10.1016/0002-9149(87)90795-8
    • RE Kleiger JP Miller JT Bigger Jr AJ Moss 1987 Decreased heart rate variability and its association with increased mortality after acute myocardial infarction Am J Cardiol 59 256 262 1:STN:280:DyaL2s7isVGisw%3D%3D 10.1016/0002-9149(87)90795-8 3812275 (Pubitemid 17036947)
    • (1987) American Journal of Cardiology , vol.59 , Issue.4 , pp. 256-262
    • Kleiger, R.E.1    Miller, J.P.2    Bigger Jr., J.T.3
  • 33
    • 20344401326 scopus 로고    scopus 로고
    • Depression and heart rate variability in patients with stable coronary heart disease: Findings from the heart and soul study
    • DOI 10.1001/archpsyc.62.6.661
    • A Gehi D Mangano S Pipkin WS Browner MA Whooley 2005 Depression and heart rate variability in patients with stable coronary heart disease: findings from the Heart and Soul Study Arch Gen Psychiatry 62 661 666 10.1001/archpsyc.62.6. 661 15939843 (Pubitemid 40973441)
    • (2005) Archives of General Psychiatry , vol.62 , Issue.6 , pp. 661-666
    • Gehi, A.1    Mangano, D.2    Pipkin, S.3    Browner, W.S.4    Whooley, M.A.5
  • 34
    • 0037180778 scopus 로고    scopus 로고
    • The inflammatory reflex
    • DOI 10.1038/nature01321
    • KJ Tracey 2002 The inflammatory reflex Nature 420 853 859 1:CAS:528:DC%2BD38XpsFygtLc%3D 10.1038/nature01321 12490958 (Pubitemid 36019638)
    • (2002) Nature , vol.420 , Issue.6917 , pp. 853-859
    • Tracey, K.J.1
  • 35
    • 36049003122 scopus 로고    scopus 로고
    • Vagus-brain communication in atherosclerosis-related inflammation: A neuroimmunomodulation perspective of CAD
    • DOI 10.1016/j.atherosclerosis.2006.10.009, PII S0021915006006162
    • Y Gidron N Kupper M Kwaijtaal J Winter J Denollet 2007 Vagus-brain communication in atherosclerosis-related inflammation: a neuroimmunomodulation perspective of CAD Atherosclerosis 195 e1 e9 1:CAS:528:DC%2BD2sXhtlahtb3K 10.1016/j.atherosclerosis.2006.10.009 17101139 (Pubitemid 350087943)
    • (2007) Atherosclerosis , vol.195 , Issue.2
    • Gidron, Y.1    Kupper, N.2    Kwaijtaal, M.3    Winter, J.4    Denollet, J.5
  • 36
    • 67650745371 scopus 로고    scopus 로고
    • Vagal tone and the inflammatory reflex
    • Thayer JF (2009) Vagal tone and the inflammatory reflex. Cleve Clin J Med 76(Suppl 2):S23-S26
    • (2009) Cleve Clin J Med , vol.76 , Issue.SUPPL. 2
    • Thayer, J.F.1
  • 37
    • 24944492741 scopus 로고    scopus 로고
    • Sometimes higher heart rate variability is not better heart rate variability: Results of graphical and nonlinear analyses
    • 10.1111/j.1540-8167.2005.40788.x 16174015
    • PK Stein PP Domitrovich N Hui P Rautaharju J Gottdiener 2005 Sometimes higher heart rate variability is not better heart rate variability: results of graphical and nonlinear analyses J Cardiovasc Electrophysiol 16 954 959 10.1111/j.1540-8167.2005.40788.x 16174015
    • (2005) J Cardiovasc Electrophysiol , vol.16 , pp. 954-959
    • Stein, P.K.1    Domitrovich, P.P.2    Hui, N.3    Rautaharju, P.4    Gottdiener, J.5
  • 38
    • 33748552726 scopus 로고    scopus 로고
    • C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease
    • DOI 10.1111/j.1365-2796.2006.01701.x
    • A Sajadieh OW Nielsen V Rasmussen HO Hein JF Hansen 2006 C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease J Intern Med 260 377 387 1:CAS:528:DC%2BD28Xht1Wntb7L 10.1111/j.1365-2796.2006.01701.x 16961675 (Pubitemid 44370911)
    • (2006) Journal of Internal Medicine , vol.260 , Issue.4 , pp. 377-387
    • Sajadieh, A.1    Nielsen, O.W.2    Rasmussen, V.3    Hein, H.O.4    Hansen, J.F.5
  • 39
    • 63449127796 scopus 로고    scopus 로고
    • Prognostic value of heart rate variability and ventricular arrhythmias during 13-year follow-up in patients with mild to moderate heart failure
    • 1:CAS:528:DC%2BD1MXjslWrtrs%3D 10.1007/s00392-009-0747-0 19219394
    • TD Smilde DJ van Veldhuisen MP van den Berg 2009 Prognostic value of heart rate variability and ventricular arrhythmias during 13-year follow-up in patients with mild to moderate heart failure Clin Res Cardiol 98 233 239 1:CAS:528:DC%2BD1MXjslWrtrs%3D 10.1007/s00392-009-0747-0 19219394
    • (2009) Clin Res Cardiol , vol.98 , pp. 233-239
    • Smilde, T.D.1    Van Veldhuisen, D.J.2    Van Den Berg, M.P.3
  • 40
    • 77955227797 scopus 로고    scopus 로고
    • Inflammation increases NT-proBNP and the NT-proBNP/BNP ratio
    • 1:CAS:528:DC%2BC3cXosFGjsbY%3D 10.1007/s00392-010-0140-z 20229122
    • J Jensen LP Ma ML Fu D Svaninger PA Lundberg O Hammarsten 2010 Inflammation increases NT-proBNP and the NT-proBNP/BNP ratio Clin Res Cardiol 99 445 452 1:CAS:528:DC%2BC3cXosFGjsbY%3D 10.1007/s00392-010-0140-z 20229122
    • (2010) Clin Res Cardiol , vol.99 , pp. 445-452
    • Jensen, J.1    Ma, L.P.2    Fu, M.L.3    Svaninger, D.4    Lundberg, P.A.5    Hammarsten, O.6
  • 41
    • 33744548144 scopus 로고    scopus 로고
    • Is there more than C-reactive protein and fibrinogen?. The prognostic value of soluble CD40 ligand, interleukin-6 and oxidized low-density lipoprotein with respect to coronary and cerebral vascular disease
    • DOI 10.1016/j.atherosclerosis.2005.11.005, PII S0021915005007318
    • MB Lobbes E Lutgens S Heeneman, et al. 2006 Is there more than C-reactive protein and fibrinogen? The prognostic value of soluble CD40 ligand, interleukin-6 and oxidized low-density lipoprotein with respect to coronary and cerebral vascular disease Atherosclerosis 187 18 25 1:CAS:528: DC%2BD28Xltlentbw%3D 10.1016/j.atherosclerosis.2005.11.005 16360159 (Pubitemid 43817018)
    • (2006) Atherosclerosis , vol.187 , Issue.1 , pp. 18-25
    • Lobbes, M.B.I.1    Lutgens, E.2    Heeneman, S.3    Cleutjens, K.B.J.M.4    Kooi, M.E.5    Van Engelshoven, J.M.A.6    Daemen, M.J.A.P.7    Nelemans, P.J.8
  • 42
    • 0034681920 scopus 로고    scopus 로고
    • Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men
    • PM Ridker N Rifai MJ Stampfer CH Hennekens 2000 Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men Circulation 101 1767 1772 1:CAS:528:DC%2BD3cXjtVOntrg%3D 10769275 (Pubitemid 30213096)
    • (2000) Circulation , vol.101 , Issue.15 , pp. 1767-1772
    • Ridker, P.M.1    Rifai, N.2    Stampfer, M.J.3    Hennekens, C.H.4
  • 43
    • 28944453556 scopus 로고    scopus 로고
    • Markers of inflammation in acute coronary syndromes: Association with increased heart rate and reductions in heart rate variability
    • A Hamaad M Sosin AD Blann J Patel GY Lip RJ MacFadyen 2005 Markers of inflammation in acute coronary syndromes: association with heart rate and reductions in heart rate variability Clin Cardiol 28 570 576 10.1002/clc.4960281207 16405201 (Pubitemid 41785840)
    • (2005) Clinical Cardiology , vol.28 , Issue.12 , pp. 570-576
    • Hamaad, A.1    Sosin, M.2    Blann, A.D.3    Patel, J.4    Lip, G.Y.H.5    MacFadyen, R.J.6


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.