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

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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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Diagnosis of Coronary Artery Disease in Patients with Chest Pain by Means of Magnetocardiography (흉통환자에서 심자도를 이용한 관상동맥질환의 진단)

  • 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.46-53
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    • 2006
  • Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool for the detection of cardiac electrical abnormality associated with myocardial ischemia. In our previous study, we have proposed a new classification method of MCG parameters, based on the different populations of the parameters between coronary artery disease(CAD) patients, symptomatic patients and healthy volunteers. We used four parameters, representing the directional changes of the electrical activity in the period of an R-ST-T interval. In patients with chest pain and without ST-segment elevation, who were selected consecutively from all patients admitted to the hospital in 2004, the patients with CAD could be classified with a higher sensitivity than conventional methods, showing that the proposed method can be useful for the diagnosis of CAD with MCG. In this study, we examined the validity of the algorithm with the prior probability distribution in diagnosis of new patients admitted to the hospital in 2005. In the results, presence of CAD could be found with sensitivity and specificity of 81.3% and 71.4%, respectively, in patients with chest pain and non-diagnostic ECG findings.

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Factors Associated with Sleep Quality in Patients with Coronary Artery Disease (관상동맥질환자의 수면의 질과 관련요인)

  • Lee, Su-Jin;Hwang, Sun-Kyung
    • Journal of Korean Critical Care Nursing
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    • v.16 no.2
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    • pp.15-27
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    • 2023
  • Purpose : This study aimed to examine the relationship between sleep quality and its influencing factors in patients with coronary artery disease (CAD). Methods : This descriptive correlational study included 130 patients with CAD admitted to the cardiology department of a general hospital in B City between September 2019 and February 2020. Data were collected using structured questionnaires and research instruments to measure sleep quality, anxiety, depression, chronotype, and daytime sleepiness. Results : The mean scores for sleep quality, daytime sleepiness, anxiety, and depression were 7.59±3.45, 6.45±3.46, 6.58±3.88, and 7.74±4.05, respectively. In terms of chronotypes, 10.8%, 48.5%, and 40.7% of the participants had evening-, intermediate-, and morning-type patterns, respectively. Sleep quality was significantly correlated with anxiety (r=0.38, p<.001), depression (r=.37, p<.001), and daytime sleepiness (r=.26, p =.002). Factors associated with sleep quality in patients with CAD included anxiety (β=.29), heart failure (β=.22), daytime sleepiness(β=.21), and sleeping alone (β=.19). Collectively, these factors had an explanatory power of 23.1% for sleep quality variance. Conclusion: Patients with CAD often experience poor sleep quality owing to various factors such as anxiety, daytime sleepiness, heart failure, and sleeping alone. It is recommended that healthcare providers objectively evaluate sleep and identify factors that influence sleep quality. This will enable the development of effective methods for sleep management as part of nursing care.

Development and Evaluation of Motivational Enhancement Therapy for Patients with Coronary Artery Disease (관상동맥질환자를 위한 동기증진 교육·상담 프로그램이 건강행위변화에 미치는 효과)

  • Kang, Kyung Ja;Song, Mi Soon
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.2
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    • pp.5-16
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    • 2010
  • Purpose: The purpose of this study was to develop a motivational enhancement therapy (MET) for coronary artery disease (CAD) patients in early stages of health behavior change and evaluate its effects on health motivation, the stages of change, health behaviors, and cardiovascular risk factors. Methods: Using a non-equivalent control pre-post design, the study was conducted on 42 CAD patients who underwent medical treatment or percutaneous coronary interventions in a hospital. The intervention group (n=21) received the MET (MET 1 during admission, MET 2 after discharge via telephone). The control group (n=21) received a standard care. Data were analyzed using descriptive statistics, ${\chi}^2-test$ and t-test with the SPSS 12.0 program. Results: Participants in the intervention group reported significantly increased scores of health motivation (t=-2.093, p=.043), the stages of change (t=-5.682, p<.001), and health behaviors (t=-3.069, p=.004) and significantly decreased scores of cardiovascular risk factors (t=2.131, p=.039) compared to those of the control group. Conclusion: The findings indicate that the MET is an effective intervention in improving health behaviors and decreasing cardiovascular risk factors for CAD patients.

Lung/Heart Uptake Ratio and Transient Dilation Ratio of the Left Ventricle During Thallium-201 Imaging with Dipyridamole (Dipyridamole 부하를 T1-201 심근스캔에서 폐/심장 섭취율과 일과성 좌심실 확장율에 관한 연구)

  • Lee, Jae-Tae;Chung, Byung-Chun;Kim, Sang-Hyun;Lee, Kyu-Bo;Chae, Sung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.177-185
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    • 1991
  • Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

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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.

Comparison of Diagnostic Accuracy for Detecting Coronary Artery Disease of Dipyridamole $^{99m}Tc$-MIBI Myocardial SPECT and It's Defect Map between Men and Women (디피리다몰 부하 $^{99m}Tc$-MIBI 심근 SPECT 극성결손지도를 이용한 관동맥질환 진단의 남녀 비교)

  • Bae, Sang-Kyun;Lee, Dong-Soo;Oh, Byung-Hee;Chung, June-Key;Lee, Myoung-Mook;Park, Young-Bae;Lee, Myung-Chul;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.59-64
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    • 1993
  • To evaluate the usefulness and differences in diagnosing coronary artery disease (CAD) between men and women of intravenous dipyridamole $^{99m}Tc$-MIBI myocardial SPECT, we obtained $^{99m}Tc$-MIBI myocardial SPECT and compared with the findings of coronary angiographies. Ninety eight male and 37 female patients who underwent dipyridamole $^{99m}Tc$-MIBI myocardial imaging within one month of cardiac catheterization were studied. Scans were considered abnormal if perfusion defect was detected and the defect size was more than 12% for left anterior descending artery (LAD) and circumflex (LCX) and 8% for right coronary artery (RCA) territories. Lesions${\geqq}$50% luminal diameter narrowing were considered significant CAD. Overall sensitivity for detection of CAD was 94.3% in men and 96.4% in women; specificity was 70% in men and 52.6% in women (P=not significant, ns). Vessel-matched sensitivity was 75.3% in men and 72.7% in women (P=ns): specificity was 84.6% in men and 67.9% in women (P < 0.025). For individual coronary artery, the sensitivity in men and women was 87.7%, 81.8% for LAD; 78%, 83.3% for RCA and 52.2%, 46.7% for LCX (P=ns): the specificity was 80%, 40% for LAD (P<0.01), 82.5%, 68.4% for RCA, 88.9%, 86.4% for LCX (P=ns). The hemodynamic parameter after intravenous dipyridamole in men and women were significantly changed; the heart rate was increased and systolic, diastolic blood pressure was decreased. Adverse effects were reported in 58.8% of men and 72.7% in women (P=ns). The incidence of chest pain and headache were higher in women. There was no significant difference in the incidences of nausea, abdominal pain, dizziness, facial flushing, dyspnea. In conclusion, dipyridamole $^{99m}Tc$-MIBI myocardial SPECT is a safe, noninvasive test for evaluation of CAD. There was no gender difference to detect CAD, but more false-positive rate in women especially in the territory of LAD.

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Quantitative Analysis of Thallium-201 Myocardial Tomograms (Thallium-201 심근 단층영상의 정량적 분석)

  • Kim, Sang-Eun;Nam, Gi-Byoung;Choi, Chang-Woon;Choi, Kee-Joon;Lee, Dong-Soo;Sohn, Dae-Won;Ahn, Cu-Rie;Chung, June-Key;Lee, Myoung-Mook;Lee, Myung-Chul;Park, Young-Bae;Choi, Yun-Shik;Seo, Jung-Don
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.165-176
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    • 1991
  • The purpose of this study was to assess the ability of quantitative Tl-201 tomography to identify and localize coronary artery disease (CAD). The study population consisted of 41 patients (31 males, 10 females; mean age $55{\pm}7$ yr) including 14 with prior myocardial infarction who underwent both exercise Tl-201 myocardium SPECT and coronary angiography for the evaluation of chest pain. From the short axis and vertical long axis tomograms, stress extent polar maps were generated by Cedars-Sinai Medical Center program, and the % stress defect extent (SDE) was quantified for each coronary artery territory. For the purpose of this study, the coronary circulation was divided into 6 arterial segments, and the "myocardial ischemic score" (MIS) was calculated from the coronary angiogram. Sensitivity for the detection of CAD ($\geq50%$ coronary stenosis by angiography) by angiography) by stress extent polar map was 95% in single vessel disease, and 100% in double and triple vessel deseases. Overall sensitivity was 97%. Sensitivity and specificity for the detection of individual diseased vessels were, respectively, 87% and 90% for the left anterior descending artery (LAD), 36% and 93% for the left circumflex artery (LCX), and 71% and 70% for the right coronary artery (RCA). Concordance for the detection of individual diseased vessels between the coronary angiography and stress polar map was fair for the LAD (kappa=0.70), and RCA (kappa=0.41) lesions, whereas it was poor for the LCX lesions (kappa : 0.32). There were siginificant correlations between the MIS and SDE in LAD (rs=0.56, p=0.0027), and RCA territory (rs=0.60, p=0.0094). No significant correlation was found in LCX territory. When total vascular territories were combined, there was a significant correlation between the MIS and SDE (rs=0.42, p=0.0116). In conclusion, the quantitative analysis of Tl-201 tomograms appears to be accurate for determining the presence and location of CAD.

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