• Korean Circulation Journal
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• v.54 no.4
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• pp.165-171
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• 2024

Beta blockers are one of the commonest prescription drugs in medicine and they have been thought to revolutionize the treatment of heart failure (HF) with reduced ejection fraction (HFrEF) in the last century. In addition to HFrEF, they are prescribed for a variety of diseases in cardiology from hypertension to HF, angina, and stable coronary artery disease (CAD). The increased prescription of beta blockers in conditions like HF with preserved ejection fraction (HFpEF), and stable CAD may be doing more harm than good as per the data we have so far. The available data shows that beta blockers are associated with increased stroke risk and atrial fibrillation (AF) in hypertension and in patients with HFpEF, they have been associated with decreased exercise capacity. In patients with stable CAD and patients with myocardial infarction with normal systolic functions, beta blockers don't offer any mortality benefit. In this article, we critically review the common indications and the uses of beta blockers in patients with HFpEF, CAD, hypertension and AF and we propose that beta blockers are overprescribed under the shadow of their beneficial effects in patients with HFrEF.

• The Journal of the Korea Contents Association
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• v.12 no.10
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• pp.349-356
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• 2012

In the diagnosis of coronary artery atheromatous plaque, Cardiac computed tomography (Cardiac Computed Tomographic Angiography: CCTA) compared with IVUS(Intravascular Ultrasound: IVUS) investigate the diagnostic accuracy, Interested in CCTA atheromatous plaque in computed tomography values (Hounsfield Unit: HU) try to find out. From April 2006 to August 2008 among coronary artery disease(Coronary Artery Disease: CAD) patients with confirmed or suspicious of CAD by CCTA performed atherosclerotic plaques and found 200 patients who underwent IVUS were enrolled. 200 patients who underwent CCTA and IVUS results from the 476 plaque was found, IVUS results of the soft plaque(n; 84), fibrous plaque(n; 63), mixed plaque (n; 97), calcific plaque(n; 232). The results are classified according to the IVUS plaque in HU in the soft plaque : $53.8{\pm}10.5$, fibrous plaque : $108.1{\pm}20.0$, mixed plaque : $371.2{\pm}113.1$, and calcific plaque : $731.0{\pm}160.4$. CCTA had sensitivity of 97% and confidence interval of 95.0-98.3. This study that is the diagnosis of coronary atheromatous plaque for using CCTA, we confirm the high sensitivity and the confidence interval Based on IVUS results CCTA atheromatous plaque with HU in the analysis could be classified to characterize in the treatment of patients with CAD is expected to help.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.