• Title/Summary/Keyword: Angina pectoris, Variant

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Cardiovascular Risk Factors Predicting Endothelial Dysfunction in Patients with Variant Angina (이형협심증 환자의 혈관내피세포 기능저하에 영향을 미치는 심혈관질환 위험인자)

  • Cho, Sook-Hee;Hwang, Seon-Young;Jeong, Myung-Ho
    • Korean Journal of Adult Nursing
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    • v.21 no.5
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    • pp.477-488
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    • 2009
  • Purpose: This study was conducted to identify the clinical characteristics and risk factors on the occurrence of variant angina, and to examine the predicting factors on the vascular endothelial dysfunction of the patients with variant angina. Methods: A total of 134 patients diagnosed with variant angina were recruited from 2006 to 2008. The degrees of endothelial dysfunction were measured and recorded by the researcher using the values of flow-mediated vasodilation of their brachial arteries and Nitroglycerine-mediated dilation. Subjects' demographic data and risk factors were gathered after obtaining informed consent, and their electronic medical records were reviewed to collect laboratory data. Results: The mean age was $54.2{\pm}9.6$ years and 52% was male patients. More than 50% of the male patients were cigarette smokers and had hypercholesterolemia. 84% of the male patients and 70% of the female patients had more than one risk factor of cardiovascular disease. A stepwise multiple regression analysis showed that smoking and hypercholesterolemia predicted the decrease of flow-mediated vasodilation (Adjusted $R^2$ = .204, p < .001). Conclusion: Tailored educational interventions for smoking cessation and cholesterol management are needed to prevent recurrence of angina attack for patients with variant angina and to prevent cardiovascular disease for middle-aged workers.

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Effects of a Smoking Cessation Education on Smoking Cessation, Endothelial Function, and Serum Carboxyhemoglobin in Male Patients with Variant Angina (금연교육이 이형 협심증 남성 흡연 환자의 금연, 혈관내피세포 기능 및 혈청 일산화탄소헤모글로빈에 미치는 효과)

  • Cho, Sook-Hee
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.190-198
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    • 2012
  • Purpose: The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. Methods: A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. Results: Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group ($p$<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. Conclusion: The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.

Variant angina diagnosed on pre-hospital 12-lead electrocardiogram: A case report (병원 전 12-Lead ECG 측정을 통해 진단된 이형성 협심증 1례)

  • Kim, Ji-Won;Ki, Eunyoung
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.243-249
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    • 2021
  • A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.

Method Development of Verapamil in Presence of NSAIDs using RP-HPLC Technique

  • Sultana, Najma;Arayne, M. Saeed;Waheed, Abdul
    • Bulletin of the Korean Chemical Society
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    • v.32 no.7
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    • pp.2274-2278
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    • 2011
  • Verapamil is a calcium channel blocker and is classified as a class IV anti-arrhythmic agent. It is used in the control of supra ventricular tachyarrhythmias, and in the management of classical and variant angina pectoris. It is also used in the treatment of hypertension and used as an important therapeutic agent for angina pectoris, ischemic heart disease, hypertension and hypertrophic cardiomyopathy. Verapamil commonly co-administered with NSAIDs (non-steroidal anti-inflammatory drugs) i.e. diclofenac sodium, flurbiprofen, Ibuprofen, mefanamic acid and meloxicam. A simple and rapid RP-HPLC method for simultaneous determination and quantification of verapamil and NSAIDs was developed and validated. The mobile phase constituted of acetonitrile: water (55:45) whose pH was adjusted at 2.7 and pumped at a flow rate of 2.0 mL $min^{-1}$ at 230 nm. The proposed method is simple, precise, accurate, low cost and least time consuming for the simultaneous determination of verapamil and NSAIDs which can be effectively applied for the analysis of human serum.

Coronary Computed Tomography Angiography for the Diagnosis of Vasospastic Angina: Comparison with Invasive Coronary Angiography and Ergonovine Provocation Test

  • Jiesuck Park;Hyung-Kwan Kim;Eun-Ah Park;Jun-Bean Park;Seung-Pyo Lee;Whal Lee;Yong-Jin Kim;Dae-Won Sohn
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.719-728
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    • 2019
  • Objective: To investigate the diagnostic validity of coronary computed tomography angiography (cCTA) in vasospastic angina (VA) and factors associated with discrepant results between invasive coronary angiography with the ergonovine provocation test (iCAG-EPT) and cCTA. Materials and Methods: Of the 1397 patients diagnosed with VA from 2006 to 2016, 33 patients (75 lesions) with available cCTA data from within 6 months before iCAG-EPT were included. The severity of spasm (% diameter stenosis [%DS]) on iCAGEPT and cCTA was assessed, and the difference in %DS (Δ%DS) was calculated. Δ%DS was compared after classifying the lesions according to pre-cCTA-administered sublingual nitroglycerin (SL-NG) or beta-blockers. The lesions were further categorized with %DS ≥ 50% on iCAG-EPT or cCTA defined as a significant spasm, and the diagnostic performance of cCTA on identifying significant spasm relative to iCAG-EPT was assessed. Results: Compared to lesions without SL-NG treatment, those with SL-NG treatment showed a higher Δ%DS (39.2% vs. 22.1%, p = 0.002). However, there was no difference in Δ%DS with or without beta-blocker treatment (35.1% vs. 32.6%, p = 0.643). The significant difference in Δ%DS associated with SL-NG was more prominent in patients who were aged < 60 years, were male, had body mass index < 25 kg/m2, and had no history of hypertension, diabetes, or dyslipidemia. Based on iCAG-EPT as the reference, the per-lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of cCTA for VA diagnosis were 7.5%, 94.0%, 60.0%, 47.1%, and 48.0%, respectively. Conclusion: For patients with clinically suspected VA, confirmation with iCAG-EPT needs to be considered without completely excluding the diagnosis of VA simply based on cCTA results, although further prospective studies are required for confirmation.