• Title/Summary/Keyword: Coronary

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The Effect of Supportive Nursing Care on the Knowledge Level and Compliance of Sick-Role Behavior in Patients with Coronary Artery Disease after Coronary Angiography (지지간호가 관상동맥조영술을 받은 관상동맥질환자의 질병관련 지식과 환자역할행위 이행에 미치는 효과)

  • Choi, Ok Ja;Cho, Bok Hee
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.47-55
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    • 2007
  • Purpose: The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography (CAG). Methods: A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher. Results: 1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group (t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group (t=4.580, p=.001). Conclusion: The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.

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Altered Delayed Rectifier $K^+$ Current of Rabbit Coronary Arterial Myocytes in Isoproterenol-Induced Hypertrophy

  • Kim, Na-Ri;Han, Jin;Kim, Eui-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.5 no.1
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    • pp.33-40
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    • 2001
  • The aim of present study was to define the cellular mechanisms underlying changes in delayed rectifier $K^+\;(K_{DR})$ channel function in isoproterenol-induced hypertrophy. It has been proposed that $K_{DR}$ channels play a role in regulation of vascular tone by limiting membrane depolarization in arterial smooth muscle cells. The alterations of the properties of coronary $K_{DR}$ channels have not been studied as a possible mechanism for impaired coronary reserve in cardiac hypertrophy. The present study was carried out to compare the properties of coronary $K_{DR}$ channels in normal and hypertrophied hearts. These channels were measured from rabbit coronary smooth muscle cells using a patch clamp technique. The main findings of the study are as follows: (1) the $K_{DR}$ current density was decreased without changes of the channel kinetics in isoproterenol-induced hypertrophy; (2) the sensitivity of coronary $K_{DR}$ channels to 4-AP was increased in isoproterenol-induced hypertrophy. From the above results, we suggest for the first time that the alteration of $K_{DR}$ channels may limit vasodilating responses to several stimuli and may be involved in impaired coronary reserve in isoproterenol-induced hypertrophy.

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Application of Quantitative Assessment of Coronary Atherosclerosis by Coronary Computed Tomographic Angiography

  • Su Nam Lee;Andrew Lin;Damini Dey;Daniel S. Berman;Donghee Han
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.518-539
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    • 2024
  • Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.

A rare type of single coronary artery with right coronary artery originating from the left circumflex artery in a child

  • Kim, Jong Min;Lee, Ok Jeong;Kang, I-Seok;Huh, June;Song, Jinyoung;Kim, Geena
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.37-40
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    • 2015
  • The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular followup.

Altered Electrophysiological Properties of Coronary Artery in Iso-prenaline-Induced Cardiac Hypertrophy

  • Kim, Na-Ri;Han, Jin;Kim, Eui-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.5 no.5
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    • pp.413-421
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    • 2001
  • An impaired smooth muscle cell (SMC) relaxation of coronary artery by alteration of $K^+$ channels would be the most potential explanation for reduced coronary reserve in left ventricular hypertrophy (LVH), however, this possibility has not been investigated. We performed morphometrical analysis of the coronary artery under electron microscopy and measured $Ca^{2+}-activated\;K\;(K_{Ca})$ currents and delayed rectifier K $(K_{dr})$ currents by whole-cell and inside-out patch-clamp technique in single coronary arterial SMCs from rabbits subjected to isoprenaline-induced cardiac hypertrophy. Coronary arterial SMCs underwent significant changes in ultrastructure. The unitary current amplitude and the open-state probability of $K_{Ca}$ channel were significantly reduced in hypertrophy without open-time and closed-time kinetic. The concentration-response curve of $K_{Ca}$ channel to $Ca^{2+}$ is shifted to the right in hypertrophy. The reduction in the mean single channel current and increase in the open channel noise of $K_{Ca}$ channel by TEA were more sensitive in hypertrophy. $K_{dr}$ current density is significantly reduced in hypertrophy without activation and inactivation kinetics. The sensitivity of $K_{dr}$ current on 4-AP is significantly increased in hypertrophy. This is the first study to report evidence for alterations of $K_{Ca}$ channels and $K_{dr}$ channels in coronary SMCs with LVH. The findings may provide some insight into mechanism of the reduced coronary reserve in LVH.

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Coronary Artery Bypass Graft with Coronary Thromboendarterectomy in Coronary Artery Disease (관상동맥질환에 있어서 관상동맥우회술과 내막제거술의 효과)

  • Jeong, Jong-Su;Ji, Haeng-Ok
    • Journal of Chest Surgery
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    • v.22 no.6
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    • pp.1092-1100
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    • 1989
  • Since May 1987 to April 1989, fifteen patients have been subjected to coronary artery bypass graft [CABG] including coronary thromboendarterectomy in 3 patients at Hanyang University Hospital. The correlation between the preoperative coronary angiography, electrocardiography, clinical status, operative finding and postoperative blood flow, complication and degree of clinical improvement were evaluated. 1. Ten patients [67 %] were male and five patients [33 %] were female, Ages ranged from 30 to 68 years. [average 52.2 years] 2. The angina by types of presentation was stable in 3 patients, unstable in 12 patients with resting, postinfarction and progressive angina as the criteria of unstability. 3. The number of involved vessels were single in 6 cases, double in 4 cases, triple in 5 cases including 1 case of left main coronary arterial disease. 4. The distribution of sites of distal anastomosis revealed predilection to left coronary arterial system [83 %], especially left anterior descending arterial system. 5. The author performed 4 cases of single bypass, 4 cases of double bypass, 5 cases of triple bypass and 2 cases of quadruple bypass. Of these 15 patients, 3 patients received coronary thromboendarterectomy, LAD in 2 patients and right coronary artery [RCA] in 1 patient. 6. The distal anastomosis were performed first with using saphenous vein grafts as conduits in all cases except 1 case using Gore-Tex conduit because of deficient in length and narrowed internal mammary artery and sequential bypass methods were employed in last 6 cases. 7. One operative death occurred and therefore, mortality rate was 6.7%. The perioperative myocardial infarction were occurred in 3 cases [20%] and its cause was supposed that they were triple vessel disease and therefore, aortic cross clamping times were relatively long. 8. All survivors were followed for 17.7 months on an average [range 5-28 months] and they have had symptomatic improvement except 1 case having mild degree of angina at 1.5 months after operation.

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An Estimate of Image Quality and Radiation Doses of Coronary Artery in MDCT Using Prospective and Retrospective ECG Gating Scan Mode (MDCT 관상동맥 조영 검사에서 전향적 동조화 및 후향적 동조화 기법의 화질과 선량 관계)

  • Oh, Jong-Kap
    • Journal of radiological science and technology
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    • v.34 no.4
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    • pp.315-321
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    • 2011
  • The goal of this study is to reduce patient exposure dose by providing image quality and radiation dose according to inspection methods. Volume Computed Tomography Dose Index(CTDIvol) and Dose Length Product(DLP) of prospective and retrospective ECG gating snapshot segment of Coronary CT angiography(CTA) were measured each snapshot segment methods. CT number, noise, uniformity, and resolution were also measured using phantom under the same condition of coronary CTA. The results showed that CT number, noise, uniformity and resolution are similar to each other. In terms of CTDIvol and DLP, however, measurement dose of prospective ECG gating snapshot segment was lower than the retrospective case by 37.5% and 40.3%. Therefore, it is highly recommended that in the coronary CTA, prospective ECG gating scan mode should be chosen to reduce patient dose.

Effects of Ginsenoside Rg3 Epimers on Swine Coronary Artery Contractions

  • Kim, Jong-Hoon;Nah, Seung-Yeol
    • Journal of Ginseng Research
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    • v.29 no.3
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    • pp.119-125
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    • 2005
  • The previous reports demonstrated that ginseng saponins, active ingredient of Panax ginseng, inhibited blood vessel contraction induced by various hormones or high $K^+$. Recently, we demonstrated that 20(R)- and 20(S)-ginsenoside $Rg_3$. regulate ion channel activities with differential manners. The aim of this study was to examine whether ginsenoside $Rg_3$ isomers also show differential effects on swine coronary artery contractionresponses induced by high $K^+$, serotonin (5-HT) or acetylcholine. Treatment of 20(S)- but not 20(R)-ginsenoside $Rg_3$ caused a concentration-dependent relaxation of coronary artery contracted by 25mM KCI. 20(S)- and 20(R)-ginsenoside $Rg_3$ induced significant relaxations of coronary artery contraction induced by 5-HT $(3{\mu}M)$ in the presence of endothelium with concentration-dependent manner and, also in the absence of endothelium only 20(S)-ginsenoside $Rg_3$ induced a strong Inhibition of coronary artery contraction induced by 5-HT in a concentration-dependent manner. 20(S)-ginsenoside $Rg_3$ caused relaxation of coronary artery in the absence and presence of endothelium. In contrast, treatment of 20(S)- and 20(R)-ginsenoside $Rg_3\;(100{\mu}M)$ did not show significant inhibition of coronary artery contraction induced by acetylcholine $(0.01\;to\;30{\mu}M)$ in the presence of endothelium, whereas both isomers caused significant inhibition of coronary artery contraction induced by acetylcholine $(0.01\;to\;30{\mu}M)$ in the absence of endothelium in a concentration-dependent manner. These findings indicate that 20(S)-or 20(R)-ginsenoside $Rg_3$ exhibits differential relaxation eff3cts of swine coronary artery contractions caused by high $K^+$, acetylcholine, and 5-HT treatment and that this differential vasorelaxing effects of ginsenoside $Rg_3$ isomers also might be dependent on endothelium.

Outcome and Graft Patency in Coronary Artery Bypass Grafting with Coronary Endarterectomy

  • Nemati, Mohammad Hassan;Astaneh, Behrooz;Khosropanah, Shahdad
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.13-24
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    • 2015
  • Background: Controversy persists regarding the use of coronary endarterectomy (CE) in patients with severe coronary artery disease. We compared the comorbidities and perioperative characteristics of patients undergoing coronary artery bypass grafting (CABG) with and without CE. Methods: This study was performed in two private hospitals in Shiraz, Iran from May 2010 to December 2011 on 967 patients who underwent CABG without CE and 84 patients who underwent CABG with CE (the CE+ group). After follow-up at $9.66{\pm}3.65$ months post-surgery, 28 patients from the CE+ group underwent angiography to evaluate the patency of grafts and native coronary vessels. Results: Patients in the CE+ group had a more prevalent history of diabetes (48% vs. 36%) and number of diseased vessels ($2.88{\pm}0.39$ vs. $2.70{\pm}0.85$). The overall hospital mortality was 1.8%, and no significant difference was observed between the two groups. In the 28 patients who underwent reangiography, 113 vessels were bypassed and 29 endarterectomies were performed, mostly on the left anterior descending artery (12 endarterectomies) and the right coronary artery (8 endarterectomies). In the endarterectomized vessels, a 66% patency rate was found in both the grafts and the native vessels. The native coronary vessels were more likely to be patent when the left internal mammary artery was used as a conduit than when a saphenous vein bypass graft was used. Conclusion: The lack of a significant difference in postoperative complications in patients who underwent CABG with or without CE may indicate that CE does not expose patients to a higher risk of complications. Since most of the endarterectomized vessels were shown to be patent during the follow-up period, we propose that endarterectomy is a viable option for patients with severely diseased vessels.

CT Imaging Findings in Non-Atherosclerotic Coronary Artery Disease (다양한 비죽상경화 관상동맥 질환의 CT 영상 소견)

  • Jongmin Park;Byunggeon Park;Eun-Ju Kang;Jongmin Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.70-83
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    • 2022
  • Acute coronary syndrome (ACS) is mainly caused by atherosclerotic coronary artery disease (CAD); however, it can also occur in patients with non-atherosclerotic CAD. Conventional coronary angiography only shows the lumen of arteries, indicating the presence of stenosis or dilatation. Thus, it has limited value in evaluating the coronary artery wall and offers low specificity for diagnosing CAD. Coronary CT angiography provides additional information, including the depiction of the concerned vessel and the aorta, as well as the pulmonary artery, which permits the diagnosis of non-atherosclerotic CAD and the differentiation of various causes of the disease. In this review, we present the pathophysiology and CT imaging features of non-atherosclerotic CAD.