• Journal of the Korean Society of Radiology
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• v.85 no.2
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• pp.297-307
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• 2024

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.865-867
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• 2004

Development of intraoperative aortic dissection during coronary artery bypass surgery is extremely rare with catastrophic outcomes resulting in high rates of morbidity and mortality. The prognosis is highly dependant upon prompt diagnosis and emergent treatment. We report our experience on a 72 year old female patient who successfully received ascending aortic graft replacement for acute intraoperative aortic dissection during coronary artery bypass procedure.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.3-27
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• 2022

Cardiac CT has been proven to provide diagnostic and prognostic evaluation of coronary artery disease for cardiovascular risk stratification and treatment decision-making based on rapid technological development and various research evidence. Coronary CT angiography has emerged as a gateway test for coronary artery disease that can reduce invasive angiography due to its high negative predictive value, but the diagnostic specificity is relatively low. However, coronary CT angiography is likely to overcome its limitations through functional evaluation to identify the hemodynamic significance of coronary artery disease by analyzing myocardial perfusion and fractional flow reserve through cardiac CT. Recently, studies have been actively conducted to incorporate artificial intelligence to make this more objective and reproducible. In this review, functional imaging techniques of cardiac computerized tomography are explored.

• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.153-161
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• 2003

Purpose: Recently the occurrence of dipyridamole stress-induced short term stunning was proven and it is reported that Bland Altman analysis by repeated acquisition Tl-201 gated myocardial SPECT (gSPECT) revealed the 95% limit of agreement for LVEF was 10.3 %. The purpose of this study was to investigate the clinical value of dipyridamole induced transient LV dysfunction on Tl-201 gSPECT. Materials and Methods: Total 93 patients were included and coronary angiography was peformed in all patients less than 2 month from gSPECT. The patients with myocardial infarction were excluded. All patients underwent both dipyridamole stress and 4-h redistribution Tl-201 gSPECT. Forty nine patients of total 93 showed normal coronary arteries (Group 1) and the remaining 44 patients had coronary artery disease (Group 2). We compared LV EF, EDV and ESV during post-stress and 4-h redistribution period calculated by gSPECT using quantitative gated SPECT software and the incidence of dipyridamole induced transient LV dysfunction between group 1 and 2. The criteria for transient LV dysfunction was defined more decrease ${\geq}11%$ of LVEF during post-stress than 4-h redistribution according to previous reported Bland Altman analysis. Results: During post-stress and 4-h redistribution average of 3.1% increment in LVEF, 6.6% increment in LVEDV and 0.7% decrement in LVESV were shown after stress in Group 1, whereas 4.1% decrement, 9.7% increment and 7.2% increment in Group 2 respectively. Dipyridamole induced transient LV dysfunction was only detected in group 2 (18.2%) and not in group 1. It was more frequently observed in triple vessel disease and left main disease (31.8%, N=22) than one and two vessel disease (4.5%, N=22). Conclusion: As with Tc-99m myocardial agent post-stress LV dysfunction was observed in dipyridamole Tl-201 gSPECT. It was only detected in CAD and more frequently occurred in multivessel disease. Thus this finding seems to provide additional information in the diagnosis of coronary artery disease and prediction of prognosis.

• The Monthly Diabetes
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• s.134
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• pp.72-73
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• 2001

당뇨병 환자에서 고혈압의 빈도는 일반인에 비해 2배 이상 높고, 대개 환자의 약 40$\~$60$\%$에서 고혈압을 동반한다. 고혈압이 당뇨병과 같이 있는 경우는 대혈관 및 미세혈관 질환의 위험인자로서 작용하여 심장사, 관상동맥 질환, 울혈성 심부전, 뇌혈관질환, 그리고 말초혈관 질환의 발생 위험을 높여 당뇨병 환자 사망원인의 대부분을 차지하며, 고혈압이 동반되어 있지 않을 경우에는 장기생존률이 높다. 또한 당뇨병에서 확장기 및 수축기 혈압은 당뇨병성 신증과 망막증의 발생 및 경과 악화에도 영향을 미친다. 당뇨병에서 고혈압이 예후에 중대한 영향을 미치는 만큼, 고혈압을 동반한 당뇨병 환자에서, 혈당의 조절뿐 아니라 죽상경화증의 예방 및 고혈압의 치료가 당뇨병에 의한 혈관 합병증의 발생과 진행을 지연시키고 사망률을 감소시키는데 결정적이라 할 수 있다.

• Proceedings of the KSCN Conference
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• 2003.05a
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• pp.138-138
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• 2003

흡연은 각종 암의 발병율을 높이고 동맥경화증, 혈전증과 같은 관상심장질환의 주요 발병요인이 되는 것으로 알려져 있다. 흡연자에게 보여지는 지질과산화작용에 의한 LDL의 산화는 구리나 철과 같은 항산과 관련 무기질에 의해 촉진되며, 특히 구리는 매우 연관성이 높은 물질로 보고되었다. 따라서 흡연자의 혈중 무기질 함량의 측정은 항산화 능력과 심혈관계 질병의 진단 및 예후 판정에 민감한 지표로 사용할 수 있을 것으로 사료된다. (중략)

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.386-394
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• 2009

Purpose: We aimed to assess the myocardial velocity on gated myocardial perfusion SPECT (gated MPS), to compare myocardial velocity between patients without coronary artery disease (CAD) and CAD patients and to assess the correlation of myocardial velocity and perfusion and wall thickening on CAD group. Materials and Methods: Seventeen patients without CAD (M:F=9:8, mean age $61.8{\pm}11.1$ yrs: group A) and thirty-nine patients with CAD (M:F=18:21, mean age $66.9{\pm}8.1$ yrs : group B) had undergone one-day adenosine stress gated MPS. In twenty segment model, 12 segments (except apical and basal segments) of each patient were included. We obtained systolic and diastolic gate ratio in left ventricular volume curve by eight frames per cardiac cycle on gated MPS. Using the systolic and diastolic gate ratio and R-R time of each patient, we obtained systolic and diastolic time ratio. The myocardial velocity was defined as wall thickening over systolic or diastolic time. Results: We presented normal range of myocardial velocities according segments and territories of coronary artery. The myocardial velocity of group B was significantly lower than group A (p=0.00). There was no significant difference between the myocardial velocity of group B with preserved EF and group A. The stress systolic velocity significantly correlated with regional myocardial perfusion in group B with preserved EF (p=0.00) as well as decreased EF (p=0.01). In group B, stress perfusion of segments which had decreased wall thickening and decreased myocardial velocity was significantly lower than segments which had decreased wall thickening and preserved myocardial velocity (p=0.01). Conclusion: The new functional index of velocity will be used as an useful of gated MPS.

• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1370-1377
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• 2005

Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C($33.64{\pm}7.49mg/dL$ vs $50.43{\pm}14.41mg/dL$, P<0.01) and apo A1($99.75{\pm}6.39mg/dL$ vs $113.34{\pm}11.35mg/dL$, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself.

• Journal of Korean Academy of Nursing
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• v.41 no.5
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• pp.704-714
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• 2011

Purpose: The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD). Methods: A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events. Results: Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events. Conclusion: Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.340-343
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• 1997

We experienced a female patient with intramural hematoma of the aorta. This patient had a severe anterior chest pain radiating to interscapular area with choking sensation. CT revealed a intramural hematoma of the thoracic aorta and a part of the abdominal aorta but there was no evidence of intimal tearing. We did the eme gency operation under hypothermic circulatory arrest and retrograde cerebral perfusion. Ascending aorta was replaced and coronary artery bypass graft was done because of intimal tearing of the ostium of right coronary artery. She was discharged without any significant complication. We reported this case with consideration about necessity of emergency operation for intramural hematoma of the thoracic aorta.