• 대한핵의학회지
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• 제25권2호
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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.

• ETRI Journal
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• 제39권5호
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• pp.662-671
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• 2017

Coronary artery disease (CAD) is a major cause of death in the world. As a non-invasive imaging modality, computed tomography angiography (CTA) is now usually used in clinical practice for CAD diagnosis. Precise quantification of coronary stenosis is of great interest for diagnosis and treatment planning. In this paper, a novel cluster method based on a Modified Student's t-Mixture Model is applied to separate the region of vessel lumen from other tissues. Then, the area of the vessel lumen in each slice is computed and the estimated value of it is fitted with a curve. Finally, the location and the level of the most stenoses are captured by comparing the calculated and fitted areas of the vessel. The proposed method has been applied to 17 clinical CTA datasets and the results have been compared with reference standard degrees of stenosis defined by an expert. The results of the experiment indicate that the proposed method can accurately quantify the stenosis of the coronary artery in CTA.

• 기본간호학회지
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• 제17권4호
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• pp.575-587
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• 2010

Purpose: The purpose of this study was to analyze the research on adherence for secondary prevention in patients with coronary artery disease (CAD) in Korea, and to identify the strategies for improvement that should be included in future studies. Methods: Electric literature searches were conducted for Pubmed, CINAHL, RISS4U, KISTI, DBpia, KoreaMed, National Assembly Library, and National Library of Korea. A total of forty two articles published between 1986 and 2009 were selected based on established inclusion criteria. Results: Forty research papers were related to nursing, and there was only one research paper focused 011 elderly people with CAD. There were no papers using concept analysis, qualitative study. or randomized controlled clinical trial. Almost all definitions of adherence were adopted from outdated compliance definitions with the attribute of 'paternalistic obligation', Measurement tools were not based on theoretical framework of adherence but borrowed from tools for measuring self-care, health behavior, or self-efficacy. Overall patient's adherence was analyzed in most studies, except for a few studies which focused on diet and exercise only. Educational strategy was the main strategy used in intervention studies. Conclusions: The concept of adherence and measurement tools need to be clarified, along with development of the specific adherence interventions according to the type of adherence in patients with CAD.

• 대한간호학회지
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• 제41권5호
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• pp.704-714
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• 2011

Purpose: The purpose of this study was to determine whether psychological distress is an independent risk factor for recurrent cardiac events in patients with coronary artery disease (CAD). Methods: A prospective cohort of studies that measured psychological distress and the incidence of recurrent cardiac events in the adult population were included. Three computerized databases were assessed (PubMed, CINAHL, and PSYCINFO). Meta-analysis was conducted using a random-effects model to determine summary estimates of risks of major recurrent cardiac events associated with each psychological distress. Of 506 publications identified, 33 met inclusion criteria, and 24 studies were used to estimate effect size of psychological distress on recurrent cardiac events. Results: Mean number in the research sample was 736 and mean time of follow-up was 4.0 years. Depression, anxiety, anger, and hostility as psychological factors were studied. According to estimation of effect size using random model effect, depression (OR=1.39, 95% CI: 1.22-1.57), anxiety (OR=1.22, 95% CI: 0.96-1.56), and anger/hostility (OR=1.29, 95% CI: 1.07-1.57) CAD patients in significantly increased risk for recurrent cardiac events. Conclusion: Finding suggests that psychological distress in forms of depression, anxiety, anger, and hostility impact unfavorably on recurrent cardiac events in CAD patients.

• Journal of Ginseng Research
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• 제34권3호
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• pp.212-218
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• 2010

Korean red ginseng (KRG) has been shown to enhance endothelium-dependent vasorelaxation in experimental animals; however, little is known about its pharmacological effects on vascular stiffness in patients with coronary artery disease (CAD). This randomized, double-blind, placebo-controlled crossover trial was carried out to determine whether KRG has beneficial effects on arterial stiffness, cardiovascular risk factors such as plasma lipid profiles and blood pressure (BP), and Rho-associated kinase (ROCK) activity. Twenty patients (mean age, 62.5 years) with stable angina pectoris were given KRG (2.7 g/day) and a placebo alternatively for 10 weeks. Blood biochemical analysis and pulse wave velocity (PWV) recording were performed on day 0 and after the completion of each treatment. ROCK activity was assessed based on the level of phospho-$Thr^{853}$ in the myosin-binding subunit of myosin light chain phosphatase, determined by Western blot analysis of peripheral blood mononuclear cells. KRG significantly decreased the systolic BP, brachial ankle PWV, and heart femoral PWV in the patients (all p<0.05), but did not significantly alter the serum lipid profiles, including triglycerides and total, high-density lipoprotein, and low-density lipoprotein cholesterol levels. The ROCK activity tended to decrease (p=0.068) following KRG treatment. The placebo did not significantly alter any of the variables. In conclusion, KRG decreased systolic BP and arterial stiffness, probably via the inhibition of ROCK activity, in patients with CAD, but had a neutral effect on serum lipid profiles. Our data suggest that KRG has a therapeutic effect on CAD.

• 산업융합연구
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• 제20권8호
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• pp.85-96
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• 2022

본 연구는 관상동맥질환 자의 관상동맥질환 중증도 분류에 따른 성별 위험요인 차이를 비교하고자 실시하였으며, 일개 종합병원에 처음 입원하여 관상동맥조영술을 실시한 남성 340명, 여성 221명을 대상으로 간호 정보 조사지와 관상동맥질환 중증도 진단 결과 기록을 2차 분석한 후향적 조사연구이다. 대상자가 진단받은 관상동맥질환 중증도 분류에 따라 남녀의 관상동맥질환의 위험요인 차이를 분석한 결과, 남성의 관상동맥질환 중증도 분류에 따른 위험요인은 나이(p=004), 총콜레스테롤(p=.040), 중성지방(p=.049), 당화혈색소(p<.001), 흡연(p<.001), 음주(p=.002), 동반질환(p=.036)에서 통계적으로 유의한 차이가 있었다. 반면 여성의 위험요인은 나이(p=.002)와 동반질환(p=.018)에서만 유의한 차이가 있었다. 남성의 관상동맥질환 중증도 분류에 영향을 주는 유의한 위험요인은 1개 관상동맥에 질환이 있는 군에서는 총콜레스테롤(OR 0.97, 95% CI 0.96-1.00, p=.014), 2개 관상동맥에 질환이 있는 군은 음주(OR 52.47, 95% CI 2.99-91.95, p=.007), 3개 관상동맥에 질환이 있는 군에서 총콜레스테롤(OR 0.98, 95% CI 0.95-0.98, p=.026)이었다. 여성의 관상동맥질환 중증도 분류에 영향을 주는 유의한 위험요인은 3개 관상동맥에 질환이 있는 군에서 동반질환 (OR 0.30, 95% CI 0.11-0.82, p=.020)이었다. 본 연구 결과를 통해 남성 관상동맥질환 자 위험요인 관리에는 금연과 절주, 혈당 조절, 콜레스테롤 관리 및 동반 질환 관리 등의 간호 중재 필요성과 중요성을 알 수 있었다. 본 연구는 관상동맥 중증도 분류에 따라 성별 위험요인 차이를 비교하여 개별적 맞춤형 간호 중재의 근거를 마련했다고 생각한다.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1081-1092
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• 2023

Objective: To investigate the incidence of microvascular myocardial ischemia in diabetic patients without obstructive coronary artery disease (CAD) and its relationship with angina. Materials and Methods: Diabetic patients and an intermediate-to-high pretest probability of CAD were prospectively enrolled. Non-diabetic patients but with an intermediate-to-high pretest probability of CAD were retrospectively included as controls. The patients underwent dynamic computed tomography-myocardial perfusion imaging (CT-MPI) and coronary computed tomography angiography (CCTA) to quantify coronary stenosis, myocardial blood flow (MBF), and extracellular volume (ECV). The proportion of patients with microvascular myocardial ischemia, defined as any myocardial segment with a mean MBF ≤ of 100 mL/min/100 mL, in patients without obstructive CAD (Coronary Artery Disease-Reporting and Data System [CAD-RADS] grade 0-2 on CCTA) was determined. Various quantitative parameters of the patients with and without diabetes without obstructive CAD were compared. Multivariable analysis was used to determine the association between microvascular myocardial ischemia and angina symptoms in diabetic patients without obstructive CAD. Results: One hundred and fifty-two diabetic patients (mean age: 59.7 ± 10.7; 77 males) and 266 non-diabetic patients (62.0 ± 12.3; 167 males) were enrolled; CCTA revealed 113 and 155 patients without obstructive CAD, respectively. For patients without obstructive CAD, the mean global MBF was significantly lower for those with diabetes than for those without (152.8 mL/min/100 mL vs. 170.4 mL/min/100 mL, P < 0.001). The mean ECV was significantly higher for diabetic patients (27.2% vs. 25.8%, P = 0.009). Among the patients without obstructive CAD, the incidence of microvascular myocardial ischemia (36.3% [41/113] vs. 10.3% [16/155], P < 0.001) and interstitial fibrosis (69.9% [79/113] vs. 33.3% [8/24], P = 0.001) were significantly higher in diabetic patients than in the controls. The presence of microvascular myocardial ischemia was independently associated with angina symptoms (adjusted odds ratio = 3.439, P = 0.037) in diabetic patients but without obstructive CAD. Conclusion: Dynamic CT-MPI + CCTA revealed a high incidence of microvascular myocardial ischemia in diabetic patients without obstructive CAD. Microvascular myocardial ischemia is strongly associated with angina.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1055-1064
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• 2020

Objective: To assess the incremental prognostic value of coronary computed tomography angiography (CCTA) in comparison to a clinical risk model (Framingham risk score, FRS) and coronary artery calcium score (CACS) for future cardiac events in ischemic stroke patients without chest pain. Materials and Methods: This retrospective study included 1418 patients with acute stroke who had no previous cardiac disease and underwent CCTA, including CACS. Stenosis degree and plaque types (high-risk, non-calcified, mixed, or calcified plaques) were assessed as CCTA variables. High-risk plaque was defined when at least two of the following characteristics were observed: low-density plaque, positive remodeling, spotty calcification, or napkin-ring sign. We compared the incremental prognostic value of CCTA for major adverse cardiovascular events (MACE) over CACS and FRS. Results: The prevalence of any plaque and obstructive coronary artery disease (CAD) (stenosis ≥ 50%) were 70.7% and 30.2%, respectively. During the median follow-up period of 48 months, 108 patients (7.6%) experienced MACE. Increasing FRS, CACS, and stenosis degree were positively associated with MACE (all p < 0.05). Patients with high-risk plaque type showed the highest incidence of MACE, followed by non-calcified, mixed, and calcified plaque, respectively (log-rank p < 0.001). Among the prediction models for MACE, adding stenosis degree to FRS showed better discrimination and risk reclassification compared to FRS or the FRS + CACS model (all p < 0.05). Furthermore, incorporating plaque type in the prediction model significantly improved reclassification (integrated discrimination improvement, 0.08; p = 0.023) and showed the highest discrimination index (C-statistics, 0.85). However, the addition of CACS on CCTA with FRS did not add to the prediction ability for MACE (p > 0.05). Conclusion: Assessment of stenosis degree and plaque type using CCTA provided additional prognostic value over CACS and FRS to risk stratify stroke patients without prior history of CAD better.

• 대한지역사회영양학회지
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• 제12권4호
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• pp.396-404
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• 2007

Increased oxidative stress contributes to the progression of atherosclerosis. We measured serum antioxidant mineral concentrations, capacities of serum antioxidant enzymes and fasting lipid profile in 97 male patients with coronary artery disease (CAD) and 21 male controls. Nutrient intake was assessed by the semi-quantitative food frequency method. CAD patients were divided into single-vessel disease (SVD, n=66) and multi-vessel disease (MVD, n = 31) groups on the coronary angiography. The ratio of serum LDL- to HDL-cholesterol elevated with an increasing number of diseased vessels compared to the control (control < SVD < MVD, p < 0.05). Patients with SVD and MVD had higher levels of serum lipoprotein (a) than the control (p < 0.05). The mean intake of carbohydrate, protein and cholesterol was higher in MVD patients and the intakes of vitamins C and E were lower in MVD and SVD patients than in the control (p < 0.05). Serum copper (Cu) and zinc (Zn) levels were higher in MVD and SVD patients than in the control (Cu: control $75.8{\pm}5.07$, SVD $99.2{\pm}2.90$, MVD $100.1{\pm}2.32{\mu}g/dL$, p<0.01; Zn: $76.8{\pm}5.36$, $119.0{\pm}5.95$, $129.1{\pm}2.70{\mu}g/dL$, p < 0.01). And the ratio of Zn to Cu was higher in SVD and MVD patients than in the control (control $0.78{\pm}0.06$, SVD $0.88{\pm}0.05$, MVD $0.99{\pm}0.04$, P < 0.05). The activity of glutathione peroxidase (GSH-Px) was lower in MVD than in SVD and the control (control $35.13{\pm}1.34$, SVD $35.30{\pm}1.01$, MVD $31.00{\pm}1.04 U/mg$ protein, p < 0.05). The ratio of the activities of superoxide dismutase (SOD) to GSH-Px was higher in MVD than in control and SVD (p < 0.05). In groups with CAD, serum Cu and Zn concentrations and their ratio were changed compared to the control. GSH-Px activity was decreased and the ratio of SOD to GSH-Px was increased in the patients with MVD. The balances between the activities of SOD and GSH-Px should also be considered a risk factor in CAD patients.

• Journal of Multimedia Information System
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• 제6권4호
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• pp.317-322
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• 2019

The purpose of this study was to develop a self-management program for patients suffering from coronary artery disease (CAD), based on the self-determination theory and subsequently perform a heuristic evaluation by professionals and a quality assessment by users. The program consisted of 6 main menus and 20 submenus. Heuristic evaluation was conducted using eight principles, and as a result, a score of 1 was assigned by a professional for five principles: consistency and mapping, good ergonomics and minimalist design, flexibility and efficiency, anesthetics, and error management. Two professionals gave the principles of ease of input, screen readability, and glanceability a score of 1. In the quality assessment by the users, the system quality category had the highest score of 4.6 out of 5, and information quality had the lowest score of 3.87 out of 5. The overall average score was 4.08, which indicated the general satisfaction regarding the quality of the application. We have reflected on all the recommendations provided by the professionals based on their heuristic evaluation and incorporated them in the program.