• Journal of Chest Surgery
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• 제39권1호
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• pp.42-47
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• 2006

배경: 새로 나온 다절편 전산화흥부단층촬영(Multidetector Computed Tomography: MDCT)은 관상동맥 영상화에 유용하다. 본 교실에서는 관상동맥우회로 술을 시행한 환자에서 술 후 관상동맥 이식편의 평가를 위하여 비침습적 MDCT와 기존의 침습적 관상동맥조영 술의 유용성을 비교하였다. 대상 및 방법: 2003년 11월부터 2004년 11월까지 관상동맥우회로 술을 시행한 후 16 Channel MDCT와 관상동맥조영 술 모두에 동의한 15명을 대상으로 52개의 이식편의 개존성을 분석하였다. MDCT를 이용하여 3차원으로 재조합된 영상과 관상동맥조영술을 통해 얻은 영상을 비교하여 민감도, 특이도, 양성 예측치, 음성 예측치 등을 계산하였다 결과: 환자당 평균 3.4$\pm$0.8개의 도관을 사용하였다. MDCT 도중 환자들의 평균 심박동수는 86회/분(범위, 60$\∼$110회/분)이어서 베타차단제는 사용하지 않았다. 모든 환자들이 필요한 시간만큼 호흡을 참을 수 있었다. 관상동맥조영 술을 통해 얻은 전체 이식편 개존율은 96.2$\%$였다. MDCT의 진단력은 민감도 100$\%$,특이도 98.0$\%$, 양성 예측치 100$\%$,음성 예측치 66$\%$였다. 결론: 관상동맥우회로 술 후 16 Channel MDCT는 기존의 관상동맥조영 술과 비교하여 이식편의 개존상태와 혈류 정도 파악에 신뢰할 수 있는 수준이며, 비침습적이며 저렴하므로 관상동맥조영 술을 대체할 수 있을 것이다.

• 동서간호학연구지
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• 제21권1호
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• pp.69-77
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• 2015

Purpose: The purpose of this study was to investigate the variance of sleep quality and factors affecting sleep disturbance among patients with percutaneous coronary angiography in a general hospital. Methods: The subjects of this study was comprised of 101 patients with percutaneous coronary angiography in a general hospital located in B city. Data were collected by a structured questionnaire from November to December 2013. The data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The levels of the participants' sleep quality and sleep disturbance were 4.35 and 5.91 in order of each out of the total score, 10. There was no significant difference in the quality of sleep between intensive care unit and internal medicine unit. Factors influencing sleep quality were 'uncomfortable bed, gown and pillow'(${\beta}=-.279$, p=.003), 'living alone'(${\beta}=-.273$, p=.003), and 'toilet problem' (${\beta}=-.222$, p=.016), which explained 21.5% of the variance (F=10.03, p<.001). Conclusion: The results of this study will provide a basis for improving the sleep quality of patients with percutaneous coronary angiography.

• 한국방사선학회논문지
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• 제17권4호
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• pp.589-595
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• 2023

관상동맥 경련 유발로 혈관 완전 폐색이 발생할 경우 악성 부정맥 출현으로 사망까지 이를 수 있으므로 관상동맥 경축 협심증 조기 검사는 반드시 필요한 검사이다. 검사 방법 중 관상동맥 조영술을 통한 약물 주입 검사가 일반적으로 시행되고 있다. 따라서 관상동맥 조영 검사 중 경축 협심증 검사의 시술 시간과 조영제 사용량, 방사선 피폭 영향과의 연관성 등을 방사선학적 관점으로 이형성 협심증 조영 검사의 이점을 평가하고자 한다. 2021년 09월부터 2023년 02월까지 관상동맥 조영술과 변이형 협심증 검사를 시행한 142명 환자의 후행적 데이터를 이용하였다. 관상동맥 조영술과 변이형 협심증 검사 비교 분석 결과 체질량 지수를 제외하고 조영제 사용량 67.47 ± 21.81 cc, 흡수선량 15.98 ± 13.8 uGy/m², 공기 중 입사선량 236.73 ± 135.91 mGy, 촬영 시리즈 수 13 장, 검사 시간 1573.6 ± 428.77 s로 관상동맥 조영술만 시행했을 때의 조영제 사용량 49.1 ± 7.73 cc, 흡수선량 9.93 ± 7.81 uGy/m², 공기 중 입사선량 140.6 ± 79.76 mGy, 촬영 시리즈 수 6 장, 검사 시간 544.48 ± 185.76 s보다 통계적으로 유의할 만큼 높은 차이를 나타냈다. (p<0.001) 결론적으로 관상동맥 조영술 외 추가적인 변이형 협심증 검사가 방사선학적 관점에서 더 부정적일 수 있어 과도한 변이형 협심증 검사는 지양하는 것이 좋을 것으로 생각된다. 결론적으로 관상동맥 조영술 외 추가적인 변이형 협심증 검사가 방사선학적 관점에서 더 부정적일 수 있어 과도한 변이형 협심증 검사는 지양하는 것이 좋을 것으로 생각된다. 그럼에도 불구하고 변이형 협심증 검사를 진행해야 할 경우 검사 시간이 길어 질수록 투시 시간과 조영제 사용량도 증가하게 되므로 가능한 빠른 검사 또는 단축 검사를 진행해야 환자의 방사선학적 관점의 부정적인 측면도 해소할 수 있을 것으로 사료된다.

• Journal of Korean Biological Nursing Science
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• 제23권4호
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• pp.308-317
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• 2021

Purpose: The purpose of this study was to elucidate the relationship between readiness to quit smoking and smoking cessation, and identify factors associated with smoking cessation in smokers with ischemic heart disease post-coronary angiography (CAG). Methods: This descriptive study was conducted between December 1, 2020 and May 14, 2021 at a P hospital, Busan. A total of 164 subjects completed the questionnaire including general characteristics, coronary artery disease characteristics, readiness to quit smoking, and smoking cession behavior during hospitalization and 4 weeks after discharge. Results: The success rate of smoking cessation after coronary angiography in patients with ischemic heart disease was 49.4% (n = 81). In addition, 48.2% of smokers (n = 83) attempted smoking cessation after CAG, while 39.8% showed changes in smoking behavior. The readiness to quit smoking was significantly associated with smoking cessation (OR= 2.23, p< .005). Conclusion: Readiness to quit smoking was identified as an important factor associated with smoking cessation in patients with cardiovascular disease in this study. In order to increase the smoking cessation rate, it is necessary to strengthen the readiness to quit smoking, followed by a tailored program for smoking cessation in patients with ischemic heart disease.

• 대한영상의학회지
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• 제85권2호
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• pp.270-296
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• 2024

관상동맥 CT 조영술은 높은 정확도로 유의한 관상동맥 협착을 발견할 수 있어 관상동맥 질환이 의심되는 환자들에서 침습적 관상동맥 조영술의 문지기로서의 역할을 인정받고 있다. 그러나 관상동맥에 과도한 석회화 경화반이 있으면 내강을 시각화하기 어려워 영상의 해석에 오류를 초래할 수 있다. 이는 주로 CT 스캐너의 제한적인 공간 해상도로 인해 석회화 경화반에 의한 번짐허상이 발생하기 때문이다. 그럼에도 불구하고, 높은 칼슘 점수를 보이는 CT 영상에서 관상동맥 협착을 평가해야 하는 상황을 종종 마주한다. 이러한 한계를 극복하기 위한 기술적인 방법으로 고해상도 CT 스캐너의 도입, 새로운 재구성 기법 및 후처리 기술의 개발, 감산기법 등이 있으며, 판독에 도움이 되는 방법으로 적절한 창너비 및 창높이의 설정, 혈관의 단면 영상에서 석회화 경화반의 범위 및 내강의 잔류 가시성 평가 등이 권고된다.

• 한국임상약학회지
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• 제22권2호
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• pp.103-112
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• 2012

Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

• Journal of Chest Surgery
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• 제28권4호
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• pp.409-411
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• 1995

One patient developing left main coronary stenosis following double valve replacement is reviewed. Angina pectoris developed 5 months postoperatively. Coronary perfusion with a balloon tip perfusion catheter was performed during previous operation and was considered technically satisfactory. Coronary angiography confirmed stenosis of the left main coronary artery. There was no further coronary arterial disease. An anterior approach between the aorta and pulmonary artery to expose the left main coronary artery was used and patch angioplasty was done. Repeat coronary angiography showed a widely patent left main coronary artery with excellent runoff. A careful search for coronary arterial injury should be made in all symptomatic patients following aortic valve replacement.

• 대한영상의학회지
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• 제83권1호
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• pp.3-27
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• 2022

심장 전산화단층촬영은 비약적인 기술발전과 다양한 연구 결과를 바탕으로 심혈관위험 계층화와 치료 결정을 위한 관상동맥 질환의 진단과 예후 평가성능이 입증되었다. 전산화단층촬영 관상동맥조영술은 폐쇄성 관상동맥 질환에 대한 음성 예측도가 높아서 침습적 혈관조영술의 빈도를 줄일 수 있는 관상동맥 질환 관련 검사의 관문으로 부상했지만, 진단특이도가 상대적으로 낮다. 하지만 심장 전산화단층촬영을 이용한 분획혈류예비력과 심근관류를 분석하여 관상동맥 질환의 혈역학적 유의성을 확인하는 기능적 평가를 통해 그 한계를 극복할 수 있다. 최근에는 이를 보다 객관적이고 재현 가능하도록 인공지능을 접목하는 연구들이 활발히 진행되고 있다. 본 종설에서는 심장 전산화단층촬영의 기능적 영상화 기법들에 대해 알아보고자 한다.

• Korean Journal of Radiology
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• 제25권6호
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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.

• Journal of Chest Surgery
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• 제26권9호
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• pp.710-713
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• 1993

Congenital coronary fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common than those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber, followed by the right atrium and the pulmonary artery. We report a case of congenital coronary artery fistula of the right coronary artery to the left ventricle with significant shunt in a 20 - year old female. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. The fistula opening was closed with 6-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia [ 28 oC ]. Postoperative course was uneventful and the patient was discharged without specific problem.