• Title/Summary/Keyword: Coronary artery disease(CAD)

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Hepatic Lipase C514T Polymorphism and its Relationship with Plasma HDL-C Levels and Coronary Artery Disease in Koreans

  • Park, Kyung-Woo;Choi, Jin-Ho;Chae, In-Ho;Cho, Hyun-Jai;Oh, Se-Il;Kim, Hyo-Soo;Lee, Myoung-Mook;Park, Young-Bae;Choi, Yun-Shik
    • BMB Reports
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    • v.36 no.2
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    • pp.237-242
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    • 2003
  • Hepatic lipase is a key enzyme that is involved in HDL-C metabolism. The goal of this study was to find out the frequency of the hepatic lipase C514T polymorphism, and evaluate its relationship with plasma HDL-C levels and coronary artery disease (CAD) in Koreans. Two hundred and twenty four subjects with no previous history of lipid-lowering therapy, 118 patients with significant CAD, and 106 controls were examined with respect to their genotypes, lipid profiles, and other risk factors for CAD. The frequency of the -514T allele was 0.37 in men and 0.35 in women, which were higher than the frequency that was reported in Caucasians, but lower than the frequency that was reported in African-Americans. The -514T allele was associated with significantly higher HDL-C levels in women. After controlling for age, gender, BMI, DM, and smoking, the non-CC genotype was significantly associated with HDL-C levels, and explained 6% of the HDL-C variation in this study. When the genotypes-distribution was compared between the CAD and non-CAD patients, the hepatic lipase C-514T polymorphism was not associated with the presence of CAD. Koreans have a higher frequency of the hepatic lipase gene 514T allele than Caucasians, and the -514T allele is associated with higher plasma HDL-C levels in Korean women, and perhaps non-smoking men. However, our data does not suggest an association between the polymorphism and an increased risk of CAD.

Heart Rate Variability in Patients with Coronary Artery Disease (관상동맥질환 환자의 심박동변이도)

  • Kim Wuon-Shik;Bae Jang-Ho;Choi Hyoung-Min;Lee Sang-Tae
    • Science of Emotion and Sensibility
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    • v.8 no.2
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    • pp.95-101
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    • 2005
  • This study is based on previous information regarding reduced cardiac vagal activity in patients with coronary artery disease(CAD), on reduced variance(SDNN : standard deviation of all normal RR intervals), low-frequency power(LF), and the complexity of heart rate variability(HRV) in patients with chronic heart failure(CHF), and on the normalized high-frequency power of HRV is the highest in the right lateral decubitus position among 3 recumbent postures in patients with CAD, However, nothing is known about the nonlinear dynamics of HRV for the 3 recumbent postures in patients with CAD. To investigate the linear and non-linear characteristics of HRV in patients with CAD, 29 patients as CAD group and 23 patients as control group were studied. Electrocardiogram(ECG) with lead II channel was measured on these patients for 3 recumbent postures in random order. The HRV from ECG was analyzed with linear method(for time and frequency domains) and nonlinear method. The lower the high-frequency power in normalized unit(nHF) in the supine or left lateral decubitous position, the higher the increase in nHF when the position was changed from supine or left lateral decubitous to right lateral decubitous. Among the 3 recumbent postures in patients with severe CAD, the right lateral decubitus position was observed to induce the highest vagal modulation, the lowest sympathetic modulation, and the highest complexity of human physiology system.

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Cancer Risk from Medical Radiation Procedures for Coronary Artery Disease: A Nationwide Population-based Cohort Study

  • Hung, Mao-Chin;Hwang, Jeng-Jong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2783-2787
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    • 2013
  • To assess the risk of cancer incidence after medical radiation exposure for coronary artery disease (CAD), a retrospective cohort study was conducted based on Taiwan's National Health Insurance Research Database (NHIRD). Patients with CAD were identified according to the International Classification of Diseases code, 9th Revision, Clinical Modification (ICD-9-CM), and their records of medical radiation procedures were collected from 1997 to 2010. A total of 18,697 subjects with radiation exposure from cardiac imaging or therapeutic procedures for CAD were enrolled, and 19,109 subjects receiving cardiac diagnostic procedures without radiation were adopted as the control group. The distributions of age and gender were similar between the two populations. Cancer risks were evaluated by age-adjusted incidence rate ratio (aIRR) and association with cumulative exposure were further evaluated with relative risks by Poisson regression analysis. A total of 954 and 885 subjects with various types of cancers in both cohorts after following up for over 10 years were found, with incidences of 409.8 and 388.0 per 100,000 person-years, respectively. The risk of breast cancer (aIRR=1.85, 95% confidence interval: 1.14-3.00) was significantly elevated in the exposed female subjects, but no significant cancer risk was found in the exposed males. In addition, cancer risks of the breast and lung were increased with the exposure level. The study suggests that radiation exposure from cardiac imaging or therapeutic procedures for CAD may be associated with the increased risk of breast and lung cancers in CAD patients.

Post-Traumatic Stress Disorder Symptoms and Quality of Life of Patients with Coronary Artery Disease (관상동맥질환자의 외상 후 스트레스장애 증상과 삶의 질)

  • Lee, Seung Ah;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.82-93
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    • 2019
  • Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (${\beta}=-.25$, p =.003), recurrence of CAD (${\beta}=.21$, p =.008), and PTSD symptoms (${\beta}=-.33$, p <.001). The mental component of health-related QoL was influenced by religion (${\beta}=-.17$, p =.044), body mass index (${\beta}=.17$, p =.033), and PTSD symptoms (${\beta}=-.37$, p <.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.

Practical Approach for Angina and Non-Obstructive Coronary Arteries: A State-of-the-Art Review

  • Coen K.M. Boerhout;Marcel A.M. Beijk;Peter Damman;Jan J. Piek;Tim P. van de Hoef
    • Korean Circulation Journal
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    • v.53 no.8
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    • pp.519-534
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    • 2023
  • Anginal symptoms are frequently encountered in patients without the presence of significant obstructive coronary artery disease (CAD). It is increasingly recognized that vasomotor disorders, such as an abnormal vasodilatory capacity of the coronary microcirculation or coronary vasospasm, are the dominant pathophysiological substrate in these patients. Although the evidence with respect to angina in patients with non-obstructive coronary arteries is accumulating, the diagnosis and treatment of these patients remains challenging. In this review, we aimed to provide a comprehensive overview regarding the pathophysiological origins of angina with non-obstructive coronary arteries disorders and its diagnostic and therapeutic considerations. Hereby, we provide a practical approach for the management of patents with angina and non-obstructive CAD.

Smoking History and Quality of Life in the Patients with Coronary Artery Disease (관상동맥질환자의 흡연력과 삶의 질)

  • Son Haeng-Mi;Lee Dong-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.3
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    • pp.276-282
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    • 2003
  • Purpose: The purpose of this study was to investigate smoking history and quality of life in the patients with coronary artery disease (CAD). Method: Data were collected from 157 men who quit smoking or attempted to quit smoking. Quality of life was measured with the SCQoL(smoking cessation quality of life) scale which was developed by Olufade et al. (19?19), and includes 5 factors; social interactions, cognitive functioning, self control, anxiety, and sleep. Result: The patients usually smoking in their twenties (61.8%), continued to smoke for over 30 years (70.7%), and smoked 20-29 cigarettes a day (50.3%). The total mean scores for the SCQoL was $50.48{\pm}7.11$. Of the 5 factors, self control had the highest mean score ($17.00{\pm}3.79$). Patients who began smoking in their twenties had a higher SCQoL. However, there were no significantly differences in the SCQoL according to duration of smoking or amount of smoking per day. Conclusion: Age when smoking is begun is an important variable to explain SCQoL in patients with CAD. But, further study is needed to identify the influence of other variables such as duration and amount of smoking.

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Assessment of Prognosis and Risk Stratification in Coronary Artery Disease (관상동맥질환의 예후 및 위험도 평가)

  • Lim, Seok-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.222-228
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    • 2009
  • Risk stratification and assessment of prognosis in patients with known or suspected CAD is of crucial important for the practice of contemporary medicine. Noninvasive testing such as myocardial perfusion scintigraphy, coronary artery calcium scoring or CT coronary angiography is increasingly being used to determine the need for aggressive medical therapy and to select patients for catheterization. The integrated anatomic and functional information may provide more additional information for the cardiologist or other clinician by the improved risk stratification and diagnostic accuracy of integrated techniques. The development of SPECT/CT or PET/CT hybrid systems is therefore of important value for the nuclear cardiology.

Classification of magnetocardiographic maps in coronary artery disease diagnosis (관상동맥질환 진단을 위한 심자도맵의 분류 방법)

  • Kwon H.;Kim K.;Kim J. M.;Lee Y. H.;Kim T. E.;Lim H. K.;Ko Y. G.;Chung N.
    • Progress in Superconductivity
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    • v.7 no.1
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    • pp.41-45
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    • 2005
  • The diagnostic management of patients with chest pain remains a clinical challenge. Magnetocardiography (MCG) has been proposed as a new non-invasive method for detection of myocardial ischemia. To date, however, MCG technique is not intensively introduced for clinical use. One of the main reasons might be the absence of statistically valid and diagnostically clean criteria, which can determine the presence of certain heart disease. In this work, we suggested a new method to classify the diagnostic value of MCG for the detection of coronary artery disease (CAD) in patients with chest pain. MCG was recorded for three groups (healthy subjects and patients without and with CAD) by means of the 64 channel SQUID gradiometer system installed at a hospital. Using four parameters, which were found to be significantly different between groups, we evaluated a probability, in which parameters can be classified into each group based on the distribution function of the parameter in each group. For all parameters, sum of probabilities was compared between groups to determine the presence of CAD. Our classification method shows that the MCG can be a useful tool to predict the presence of CAD with sensitivity and specificity of higher than $80\%$ each.

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Role of Magnetocardiography in Emergency Room (응급실에서 심자도의 역할)

  • Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
    • Progress in Superconductivity
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    • v.8 no.1
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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Lung/Heart Uptake Ratio in Dipyridamole $^{99m}Tc-MIBI$ Myocardial Perfusion Scan in Coronary Artery Disease (관상동맥질환에서 디피리다몰 부하 $^{99m}Tc-MIBI$ 심근스캔의 폐/심장 섭취율)

  • Kang, Keon-Wook;Lee, Dong-Soo;Choi, Chang-Woon;Lee, Kyung-Han;Chung, June-Key;Lee, Myung-Chul;Seo, Jung-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.218-222
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    • 1993
  • Lung/heart uptake ratio (L/H R) in $^{201}Tl$ myocardial perfusion scan is a reliable marker for long-term prognosis in patients with coronary artery disease. However, the value of L/H R in $^{99m}Tc-MIBI$ myocardial perfusion scan is controversial in determining the prognosis and severity of the coronary artery disease. The purpose of this study was to determine the clinical implications of L/H R in $^{99m}Tc-MIBI$ myocardial perfusion scan. Forty five patients who received $^{99m}Tc-MIBI$ myocardial perfusion scan were divided into control group and coronary artery disease (CAD) group by their clinical findings, EKGs, and $^{99m}Tc-MIBI$ myocardial perfusion scans. Twenty five patients in CAD group were divided into ischemic group and infarct group according to their results from $^{99m}Tc-MIBI$ myocardial perfusion scan. L/H R was calculated on the anterior planar view, 60 minutes after infusion of dipyridamole. Two regions of interest (ROI) were placed on the left lung area 8 pixel above the left ventricle and on the myocardial area which had the highest radioactivity. In the control group, there were no significant differences of L/H R according to sex and age. No significant difference of L/H R was found between the control and CAD group ($0.26{\pm}0.06,\;0.29{\pm}0.05$, p>0.05). In the CAD group, there was also no significant difference of L/H R between the ischemic group and infarct group ($0.29{\pm}0.07,\;0.30{\pm}0.04$, p>0.05). L/H R in CAD group did not show correlations with the defect area of stress polar map (r=0.18, p >0.05) and with the sum of severity weighted extent score or reversibility score which represent severity and extent of myocardial perfusion defect area in stress (r=0.18, p>0.05). We conclude that it is difficult to use L/H R as a marker for severity of CAD in dipyridamole $^{99m}Tc-MIBI$ myocardial perfusion scan.

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