• 제목/요약/키워드: Coronary

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종합검진 수검자의 관상동맥 전산화단층 혈관조영술 검사에서 관상동맥질환의 위험요인과 관련성 분석 (A Study on the Analysis of Risk Factors and Correlations of Coronary Artery Disease of the Examinee taking Coronary Computed Tomography Angiography in a Comprehensive Health Improvement Center)

  • 최민경;곽종혁;김광;이삼열
    • 한국방사선학회논문지
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    • 제13권7호
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    • pp.1005-1014
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    • 2019
  • 본 연구는 건강검진 목적으로 시행된 관상동맥 CT에서의 성별, 연령에 따른 관상동맥질환 발견율에 대한 유용성과 글루코스, 총 콜레스테롤, 내장지방, 체질량지수, 중성지방, 고밀도지단백질(HDL), 저밀도지단백질(LDL) 각각의 인자들과 관상동맥질환과의 관련성에 대해 알아보았다. 총 299명의 수검자를 대상으로 후향적 분석을 실시 한 결과 관상동맥질환 발견율에 대해서는 남성, 50세 이상에서의 유병율이 높은 것으로 나타났으며, 통계적으로 유의성을 보였다. 특히 남성의 유병율(37.9%)은 여성의 유병율(17.0%) 보다 약 2배가 높은 것으로 확인되었다. 또한 관상동맥질환과 관계되는 혈액학적 요인으로는 글루코스와 고밀도지단백질(HDL)이 통계적으로 유의성을 보였다. 관상동맥질환의 예방 및 관리를 위해서는 글루코스와 고밀도지단백질(HDL)의 조절이 필요할 것으로 보이며, 다른 혈액학적 인자들과는 통계적으로 유의성은 낮았지만, 관상동맥질환에 대한 관리의 필요성이 확인되었다. 주요 결과로서 선별검사 목적으로 관상동맥 CT의 사용은 방사선 피폭 등의 문제점으로 인해 수검자의 성별, 나이를 고려하여 시행하는 것이 좋을 것으로 생각되며, 관상동맥 CT 시행 이전에 비침습적인 방법들의 선행검사를 통한 관상동맥 질환 검사가 필요함을 제안한다.

Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

  • Kang, Joonkyu;Song, Hyun;Lee, Seok In;Moon, Mi Hyung;Kim, Hwan Wook;Jo, Gyun Hyun
    • Journal of Chest Surgery
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    • 제47권2호
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    • pp.106-110
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    • 2014
  • Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

관상동맥질환 환자들에서 스트레스와 관상동맥 협착 간의 관계 (The Relationhip between Stress and Coronary Artery Stenosis in Patients with Coronary Artery Diseases)

  • 노규식;고경봉
    • 정신신체의학
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    • 제6권2호
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    • pp.126-135
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    • 1998
  • The object of this study was to investigate the relationship between stress and the extent of coronary artery stenosis in 101 patients with coronary artery diseases. Global assessment of recent stress(GARS) scale and perceived stress response inventory were used to measure perception for stressors and stress responses. Biological variables such as the extent of coronary artery stenosis, the number of the affected lesions on coronary angiography, serum Low Density Lipoprotein(LDL)-cholesterol, High Density Lipoprotein(HDL)-cholesterol, and total cholesterol were measured in all the subjects. Scores of perceived stress related to changes in relationship and overall global scores on GARS scale had significantly positive correlation with the extent of coronary artery stenosis. On the other hand, scores of percieved stress related to changes in relationship and changes or no changes in routine had significantly positive correlation with the number of the lesions. Scores of perceived stress related to change or no change in routine also positively correlated with serum level of LDL-cholesterol and total cholesterol. In contrast, general somatic symptoms negatively correlated with the extent of coronary artery stenosis. Impulsive-aggressive behavior negatively correlated with the number of the lesions. However, impulsive-aggressive thinking positively correlated with LDL-cholesterol. The above results suggest that perception for stressors may negatively affect the extent of coronary artery stenosis, the number of the lesions, serum LDL-cholesterol and total cholesterol. However, some stress responses showed inconsistent effect on the above biological variables. Thus, strategies designed to modify perception for stressors and some stress responses are likely to help the patients minimize the extent of coronary artery stenosis and prevent the diseases.

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건강검진 수검자에서 비만 지표들과 관상동맥협착증과의 관련성 (Relationship between Some Obesity Indices and Coronary Artery Stenosis in Health-Screen Examinees)

  • 어재은;신새론
    • 대한통합의학회지
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    • 제8권1호
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    • pp.125-135
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    • 2020
  • Purpose : Obesity indices are major predictive markers for coronary artery stenosis, but there are few studies about the relationship between obesity indices and coronary artery stenosis in the Korean population. Therefore, we analyzed the association between obesity indices and coronary artery stenosis among health-screen examinees. Methods : This study included 99 males and females who visited a health-examination center. The obesity indices included body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT), visceral adipose tissue/subcutaneous adipose tissue ratio (V/S ratio). All subjects had their degree of coronary artery stenosis measured using coronary computed tomography angiography (CCTA). A multiple logistic regression test was conducted to analyze the association between obesity indices and coronary artery stenosis. Results : This study was taken by multiple logistic regression test adjusted by age, sex, smoking status, frequency of alcohol drinking/week and frequency of exercise/week. The adjusted odds ratio for the presence of coronary artery stenosis for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥ 90 cm in males; ≥ 85 cm in females) was 6.263 (95 % confidence interval (CI) 1.974-19.869), for subjects with visceral obesity by visceral adipose tissue (visceral obesity defined as a visceral adipose tissue ≥ 100) was 11.430 (95 % CI 3.044-42.928). Conclusion : In this study of adults, WC and VAT were independent predictors of coronary artery stenosis. These results suggest that WC and VAT may be useful markers of coronary artery stenosis.

심장 관상동맥 외과 (The Clinical Summary of the Coronary Bypass Surgery)

  • 정황규
    • Journal of Chest Surgery
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    • 제13권3호
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Analysis of Semantic Relations Between Multimodal Medical Images Based on Coronary Anatomy for Acute Myocardial Infarction

  • Park, Yeseul;Lee, Meeyeon;Kim, Myung-Hee;Lee, Jung-Won
    • Journal of Information Processing Systems
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    • 제12권1호
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    • pp.129-148
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    • 2016
  • Acute myocardial infarction (AMI) is one of the three emergency diseases that require urgent diagnosis and treatment in the golden hour. It is important to identify the status of the coronary artery in AMI due to the nature of disease. Therefore, multi-modal medical images, which can effectively show the status of the coronary artery, have been widely used to diagnose AMI. However, the legacy system has provided multi-modal medical images with flat and unstructured data. It has a lack of semantic information between multi-modal images, which are distributed and stored individually. If we can see the status of the coronary artery all at once by integrating the core information extracted from multi-modal medical images, the time for diagnosis and treatment will be reduced. In this paper, we analyze semantic relations between multi-modal medical images based on coronary anatomy for AMI. First, we selected a coronary arteriogram, coronary angiography, and echocardiography as the representative medical images for AMI and extracted semantic features from them, respectively. We then analyzed the semantic relations between them and defined the convergence data model for AMI. As a result, we show that the data model can present core information from multi-modal medical images and enable to diagnose through the united view of AMI intuitively.

한국인 성인심장의 좌관상동맥 근위부에 대한 형태학적 연구 (The Morphologic Study of the Proximal Part of the Left Coronary Artery in Korean Adult Hearts)

  • 오중환
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.214-219
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    • 1985
  • It is well known that the morphologic feature of coronary artery is variant as finger print. Left coronary artery is divided into the left anterior descending artery and circumflex artery and supplies almost left atrium, left ventricle and interventricular septum. Clinically, the morphologic features of number of branches and the length of the left main coronary artery are important. In Korea, there are few reports about morphologic study of the coronary artery, and the coronary angiogram and open heart surgery are common. Now the author studied the morphology of the proximal part of the left coronary artery in Korean 50 Adult cadavers and obtained the following results: 1. The length of the left main coronary artery is from 5 mm to 16 mm [mean 9.7 mm]. 2. The diameter of the proximal part of the left coronary artery is from 3.2 mm to 7.7 mm [mean 5.3]. 3. The features of the branching are bifurcation [58%] trifurcation [38%] and quadrifurcation [4%]. 4. The diameter of the left anterior descending artery is from 2.7 mm to 8.1 mm [mean 4.5] and circumflex artery from 2.1 mm to 6.2 mm [mean 3.9].

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Simple Anastomotic Techniques for Coronary Artery Bypass Surgery in Patients with Small Coronary Arteries or a Marked Size Discrepancy Between the Coronary Artery and Graft

  • Lee, Mi Kyung;Song, Joon Young;Kim, Tae Youn;Kim, Jong Hun;Choi, Jong Bum;Kuh, Ja Hong
    • Journal of Chest Surgery
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    • 제49권6호
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    • pp.485-488
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    • 2016
  • Different suture techniques have been used for anastomosis in coronary artery bypass graft surgery. Bypass surgery may be difficult for patients who have small coronary arteries or marked size discrepancies between target coronary arteries and grafts. For proximal and distal anastomoses, three continuous stitches are first placed in the heel and toe of the small coronary arteries; for sequential anastomosis, an interrupted eight-stitch technique is used. We applied these anastomotic suture techniques in patients requiring coronary artery bypass graft surgery, achieving an early angiographic patency rate of 100%.

관상동맥 협착부에 각이진 스텐트 시술시 혈류역학적 특성변화 (Changes of Hemodynamic Characteristics during Angulated Stenting in the Stenosed Coronary)

  • 서상호;조민태;권혁문;이병권
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2002년도 학술대회지
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    • pp.717-720
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    • 2002
  • The present study is to evaluate the performances of flow velocity and wall shear stress in the stenosed coronary artery using human in vivo hemodynamic Parameters and computer simulation. Initial and follow-up coronary angiographics in the patients with angulated coronary stenosis are performed. Follow-up coronary angiogram demonstrated significant difference in the percent of diameter in the stenosed coronary between two groups ($Group\;1:\;40.3{\%},\;Group\;2:\;25.5{\%}$). Flow-velocity wave obtained from in vivo intracoronary Doppler ultrasound data is used for the boundary condition for the computer simulation. Spatial and temporal variations of flow velocity vector and recirculation area are drawn throughout the selected segment of coronary models. The WSS of pre- and post-intracoronary stenting are calculated from three-dimensional computer simulation. Then negative shear stresses area on 3D simulation we noted on the inner wall of the post-stenotic area before stenting. The negative WSS is disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2. The present study suggest that hemodynamic forces exerted by pulsatile coronary circulation termed WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. The local recirculation area which has low or negative WSS, might lead to progression of atherosclerosis.

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Coronary three vessel disease: hydrodynamic simulations including the time-dependence of the microvascular resistances

  • Harmouche, Majid;Anselmi, Amedeo;Maasrani, Mahmoud;Mariano, Chiara;Corbineau, Herve;Verhoye, Jean-Philippe;Drochon, Agnes
    • Advances in biomechanics and applications
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    • 제1권4호
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    • pp.279-292
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    • 2014
  • This paper presents some simulations of fluxes and pressures in the coronary network, in the case of very severe coronary disease (several stenoses on the left branches and total occlusion of the right coronary artery). In that case, coronary artery bypass graft surgery is the commonly performed procedure. However, the success of the intervention depends on many factors. Modeling of the coronary circulation is thus important since it can help to understand the influence of all these factors on the coronary haemodynamics. We previously developed an analog electrical model that includes the eventual presence of collateral flows, and can describe the different revascularization strategies (two grafts, three grafts, ...). The aim of the present work is to introduce in our simulations the time-dependence of the coronary microvascular resistances, in order to better represent the effect of the systolic ventricular contraction (which induces an elevation of the resistances because the vessels are squeezed).