• Title/Summary/Keyword: 심근 경색증

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Left Ventricular Systolic Function Improvement after Surgical Revascularization in Postinfarction Angina (급성 심근 경색 후 협심증 환자에서의 관상동맥 우회술 후 좌심실 수축 기능의 호전)

  • Yi Gi-Jong;Park Seong-Yong;Hong You-Sun;Yoo Kyung-Jong;Chang Byung-Chul;Lim Sang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.674-680
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    • 2006
  • Background: Acute myocardial infarction (MI) is a life-threatening disease and surgical revascularization plays a major role in selected cases. The purpose of this study is to evaluate the left ventricular contractility improvement by examining the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) in patients who under-went surgical revascularization under diagnosis of acute MI. Material and Method: From January, 2001 to December, 2004, 149 patients who underwent coronary artery bypass surgery within 2 weeks of acute MI were included. We evaluated pre- and postoperative left ventricular contractility by measuring WMSI and LVEF and examined the associating factors. Result: WMSI decreased from $1.54{\pm}4.30\;to\;1.43{\pm}0.40$ (p<0.001) and LVEF increased from $48.1{\pm}12.2%\;to\;49.7{\pm}12.3%$ after surgery (p=0.009). Off-pump technique, non-Q wave, anterior MI, and surgery within 7 days after MI were favorable factors for LVEF improvement (p=0.046, p=0.006, p=0.003, p=0.005, respectively). Conversely, aforementioned factors were irrelevant with WMSI improvement. For triple vessel disease, complete revascularization was favorable factor for WMSI improvement (p<0.001). Conclusion: Coronary artery by-pass surgery can improve WMSI and LVEF in patients with acute MI. In case of anterior MI with non-Q wave, early surgical revascularization within 7 days may be most beneficial in LVEF improvement. Regarding WMSI, complete revascularization may be essential.

Comparison of Emergency Tc-99m Sestamibi Myocardial Perfusion SPECT and ECG in the Diagnosis of Acute Myocardial Infarction (급성심근경색증 환자에서 응급으로 시행한 Tc-99m Sestamibi 심근관류 SPECT와 심전도의 비교)

  • Cho, Ihn-Ho;Lee, Hyoung-Woo;Park, Jong-Sun;Won, Kyu-Chang;Do, Jun-Young;Sin, Dong-Gu;Yoon, Kyung-Woo;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.104-111
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    • 1996
  • We did Tc-99m sestamibi myocardial perfusion SPECT in 36 patients with acute myocardial infarction when they arrived at the emergency room. And we compared myocardial perfusion images with ECG findings. Then we obtained the follows. The myocardial infarction by the obstruction of left coronary descending artery and right coronary artery showed a good concordance in the diagnosis and infarction site between myocardial perfusion images and ECG findings. The 7 patients with myocardial infarction by a left circumflex coronary artery showed a perfusion defect in the lateral wall in myocardial perfusion SPECT images. But 4 patients of them showed ST segment elevation, 2 patients showed ST depression and 1 patient showed normal ECG findings. The diagnostic sensitivity of Tc-99m sestamibi myocardial perfusion SPECT was 100% by a qualified analysis. The perfusion defect site in the myocardial perfusion SPECT were corresponded with the infarct related coronary artery in 31 patients which was diagnosed by coronary angiograpy. The size of perfusion defect in the po1ar map was $31{\pm}18%(M{\pm}SD)$, in the myocardial infarction with left anterior descending coronary arery obstruction, $31{\pm}13% (M{\pm}SD)$ in the myocardial infarction with right coronary artery obstruction and $25{\pm}5.9%(M{\pm}SD)$ in the myocardial infarction with left circumflex coronary artery obstruction. We concluded that emergency myocardial perfusion SPECT images are useful in the diagnose of myocardial infarction and it's very useful when we are difficult to diagnose with ECG like as lateral wall infarction or left bundle branch block.

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Extraction of Myocardial Infarction by Consecutive Image Analysis in B-mode Echocardiogram (B-모드 심초음파도의 연속 영상 분석에 의한 심근경색증 추출)

  • Son, Kweon;Cho, Sung-Mok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.7 no.6
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    • pp.1116-1121
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    • 2006
  • We studied on some techniques which are able to discriminate the difference between normal and infarcted myocardium by consecutive image analysis in B-mode echocardiogram. In order to analyze two-dimensional echocardiogram, we presented inter-frame and intra-frame analysis method throughout the complete heart cycle in closed-chest human and proposed new analysis parameters which are named HGE and LT. The analysis technique using the proposed parameters revealed quantitatively dominant features between normal and infarcted regions. The infarcted areas yield regions of higher intensity throughout the entire cardiac cycle, but normal tissue demonstrates greater variability throughout the entire cardiac cycle. Hence, we could verify that these parameters varying over the entire cardiac cycle are good indicators for the state of myocardium.

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Early Surgical Revascularization for Acute Myocardial Infarction (급성 심근 경색후 관상 동맥 우회술의 조기 적용)

  • 지현근;이원용
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1077-1082
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    • 1997
  • To assess the early results, risk factors and optimal timing for coronary artery bypass graft surgery(CABG) after an acute myocardial infarction(AMI), we reviewed our 19 patients who underwent CABG within 30 days after AMI, between June 1994 and October 1996. This study excluded 1 patient whose diagnosis was AMI with ventricular septal rupture. 14 of the patients were male and 5 were female. Their ages ranged from 41 to 77 years(mean age, 60.6$\pm$ 10.4 years), and the amount of time between AMI and CABG ranged from 8 hours to 24 days(mean time, 10.6$\pm$6.4 days). There were 11 anteroseptal infarctions and 8 inferior wall infarctions. 11 patients had trsnsmural infarctions and 8 had subendocardial infarctions. Indications of operations were p imary revascularization and postinfarction angina. Three patients required preoperative intra-aortic balloon pump(IABP) support, and 4 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.6 $\pm$ 0.6 vessels per patient were bypassed. The early mortality rate for these 19 patients was 5.3% and late mortality rate was 5.5%, 1-year and 2-year actuarial survival rates were 89.5% Univariate analysis of mortality showed that an ejection fraction less than 30% and intraopretative IABP supports were associated with risk factors(p value=0.018 and 0.015 respectively). Age, sex, time to CABG, emergency operations, types and locations of infarctions were not significant. Although our studies have weak p.oints in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.

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Repair of a Post-infarction Ventricular Septal Defect and Left Ventricular Pseudoaneurysm Rupture by the "Sandwich Technique" - A case report - ("Sandwich Technique"을 이용한 심근경색 후 발생한 심실 중격 결손과 가성 좌심실류 파열의 수술 - 1예 보고 -)

  • Kim, Hyung-Tae;Kim, Wook-Sung;Park, Pyo-Won;Lee, Young-Tak;Sung, Ki-Ick;Lee, Mi-Na
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.516-519
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    • 2009
  • Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

Relationship between Handgrip Strength and Cardiopulmonary Fitness in Patients with Myocardial Infarction (심근 경색 환자에서의 손의 근력과 심폐기능의 연관성)

  • Kim, JiHee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.10
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    • pp.506-514
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    • 2018
  • This study was conducted to investigate the relationship between hand grip strength and cardiopulmonary fitness in patients with myocardial infarction. In this retrospective study, 67 patients who experienced myocardial infarction for 10 months were analyzed. Hand grip strength was measured using a handheld dynamometer. Dynapenia was diagnosed based on a dominant hand grip strength of less than 30 kg for males and 20 kg for females. A cardiopulmonary exercise test was performed using a treadmill. Physical activity status was also evaluated. Cardiorespiratory fitness parameters were analyzed using a t-test and a Mann-Whitney test. VO2max, METmax, and exercise time significantly decreased in the dynapenia group compared with the non-dynapenia group. Correlation analysis revealed that dominant handgrip strength was significantly related to cardiorespiratory fitness parameters. Moreover, VO2max, METmax, and exercise time were significantly increased in patients with vigorous activity compared with the sedentary group. These findings indicate that handgrip strength could potentially be used as a marker of cardiorespiratory functions. Accordingly, patients with myocardial infarction should be evaluated for grip strength and physical activity, and we can encourage patients to participate actively in cardiac rehabilitation.