• Journal of Cardiovascular Imaging
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• 제30권1호
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• pp.1-24
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• 2022

The Coronary Artery Disease Reporting and Data System (CAD-RADS) is a standardized reporting method for coronary computed tomography angiography (CCTA). It summarizes the findings of CCTA in 6 categories ranging from CAD-RADS 0 (complete absence of coronary artery disease) to CAD-RADS 5 (total occlusion of at least one vessel). It is applied on per patient basis for the highest grade of the stenotic lesion. The CAD-RADS also provides categoryspecific treatment recommendations, helping patient management. The main objectives of the CAD-RADS are to improve the consistency in reporting, facilitate the communication between interpreting and referring clinicians, recommend the best course of patient management, and produce consistent data for quality improvement, research and education. However, CAD-RADS has many limitations, resulting into the misclassification of the observed findings, misinterpretation of the final category, and misguidance for the treatment based upon the single score. In this review, the authors discuss the CAD-RADS categories and modifiers, along with the strengths and limitations of this new classification system.

• 중환자간호학회지
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• 제4권1호
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• pp.1-10
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• 2011

Purpose: The study was conducted to find out clinical characteristics for coronary artery disease patients with diabetes mellitus. Methods: We retrospectively reviewed the electronic medical records which included the data of 6,792 patients, who had been diagnosed coronary artery disease (CAD) such as angina or acute myocardial infarction and admitted to a university hospital in Seoul from January, 2005 to November, 2010. Results: Of the 6,792 patients, 43% had been diagnosed diabetes as comorbidity. The CAD patients with diabetes had lower left ventricular ejection fraction, stayed longer at hospital, and spent on more time from the first symptom to hospital visit than those without diabetes. In addition, they were more likely to have multi vessel coronary artery disease. Conclusion: The CAD patients with diabetes lay on the various factors which can make more worsen condition. Hence, we need to pay attention to specialized nursing care and patient education for the CAD patients with diabetes.

• 대한영상의학회지
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• 제83권1호
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• pp.70-83
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• 2022

급성 관동맥 증후군(acute coronary syndrome)은 대부분 죽상경화 관상동맥 질환(atherosclerotic coronary artery disease)에 의해 발생하지만, 비죽상경화 관상동맥 질환에서도 발생할 수 있다. 고식적 관상동맥 혈관조영술은 동맥 내강의 협착이나 확장 등의 형상에 대한 정보만을 제공하고, 동맥경화반이나 동맥벽에 대한 평가가 어려워 관상동맥 이상의 원인 질환의 진단에 낮은 특이도를 보인다. 반면, 관상동맥 전산화단층촬영 혈관조영술은 혈관경화반의 특징, 혈관벽의 조영증강뿐 아니라 연접한 대동맥이나 폐동맥의 변화 등도 함께 관찰할 수 있어, 비죽상경화 관상상동맥질환의 진단 및 다양한 원인 감별에 도움이 된다. 따라서 이종설에서는 다양한 비죽상경화 관상동맥 질환들을 소개하고, 이의 병태생리 및 대표적인 관상동맥 전산화단층촬영 혈관조영술의 영상 소견에 대해 설명하고자 한다.

• 대한영상의학회지
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• 제85권2호
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• pp.297-307
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• 2024

관상동맥 질환은 죽상동맥경화(atherosclerosis)로 인해 혈관의 내강이 좁아지면서 심근허혈 또는 경색까지 유발할 수 있는 질병이다. 이런 관상동맥 질환은 조기에 진단해서 치료하면 그만큼 예후가 좋기에 정확한 진단이 환자 관리에서 매우 중요하다. 전산화단층촬영 혈관조영술(CT angiography; 이하 CTA)은 높은 해상도와 대조도를 통해 혈관의 구조 및 협착 정도를 세밀하게 평가할 수 있는 비침습적 영상 진단법이다. 여러 임상시험들이 관상동맥 질환에 대한 조기 진단과 평가에 있어 관상동맥 CTA의 유용성을 보고하였다. 최근에 관상동맥 질환이 의심되는 환자들에 대한 보다 효과적인 처치를 위해 CTA에 기반한 관상동맥 질환 진단 분류 체계인 관상동맥 질환 판독과 자료 체계(coronary artery disease-reporting and data system; 이하 CAD-RADS)가 만들어졌다. 이런 CAD-RADS는 관상동맥 CTA를 기반으로 하지만 CAD-RADS는 CTA 결과만으로 관상동맥의 정확한 상태를 해석하는 것이 어려운 경계선 범주를 포함하고 있다. 본 종설은 침습적 관상동맥 조영술 진행 여부를 결정하기에 앞서 추가검사가 필요한 경계선상 CAD-RADS범주들의 CTA의 소견과 이들에 대한 대처를 논하고자 한다.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1749-1763
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• 2021

Coronary computed tomography angiography (CCTA) is routinely used for anatomical assessment of coronary artery disease (CAD). However, invasive measurement of fractional flow reserve (FFR) is the current gold standard for the diagnosis of hemodynamically significant CAD. CT-derived FFRCT and CT perfusion are two emerging techniques that can provide a functional assessment of CAD for risk stratification and clinical decision making. Several clinical studies have shown that the diagnostic performance of concomitant CCTA and functional CT assessment for detecting hemodynamically significant CAD is at least non-inferior to that of other routinely used imaging modalities. This article aims to review the current clinical evidence and recent developments in functional CT techniques.

• 대한핵의학회지
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• 제39권2호
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• pp.87-93
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• 2005

Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary Intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCI. In the management of patients with 57 segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but mote complete. Recently published evidences in the pharmacologic therapy including antiplatelet and stalin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

• BMB Reports
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• 제38권4호
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• pp.486-490
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• 2005

Genetic factors are important in the pathogenesis of coronary artery disease (CAD). Angiotensin converting enzyme (ACE) gene insertion(I)/deletion(D) polymorphism is one of the genetic factor found to be related with CAD. We investigated the association between I/D polymorphism of the ACE gene and the presence of CAD. Threehundred and seven patients (187 males and 120 females, aged between 35-80, mean $54.3{\pm}9.8$ years) who underwent diagnostic coronary angiography were included in the study. ACE I/D polymorphism was detected by polymerase chain reaction. Of the 307, 176 had CAD. The most frequently observed genotype in all subjects was ID (47.9 %). However, in patients with CAD the frequency of II genotype was lower whereas DD genotype was higher compared to the controls (p < 0.05). The number of D allele carrying subjects were also higher (p < 0.05) in CAD patients. The logistic regression analysis indicated that the ACE D allele is an independent risk factor (odds ratio = 1.48, 95% CI = 1.01-2.18, p < 0.05). In conclusion, the I/D polymorphism of ACE gene (carrying D allele) is an independent risk factor for CAD in the studied Turkish population.

• 성인간호학회지
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• 제27권1호
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• pp.21-28
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• 2015

Purpose: This study was aimed to explore and describe the experiences of mindfulness meditation (mindfulness- based stress reduction, MBSR) among patients with coronary artery disease (CAD) as a method of cardiac rehabilitation. Methods: In-depth interviews was conducted with 7 participants with CAD post percutaneous coronary intervention. Main question was 'what is your experiences with MBSR?' Colaizzi's seven steps of phenomenological analysis was used for eliciting embedded meanings. Results: Five theme clusters were found; rediscovery of mindfulness meditation, obtaining self-control for stress management, self-worth, feeling of happiness, and looking into myself. Conclusion: This study provides a profound picture on the experiences of mindfulness meditation among participants with coronary artery disease. MBSR can help patients with CAD in reducing stress and to enhance their cardiac rehabilitations. It is hoped that mindfulness meditation can be used in clinical setting as a part of cardiac rehabilitation program.

• Journal of Nutrition and Health
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• 제30권8호
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• pp.976-986
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• 1997

Coronary artery disease (CAD) such as angina pectoris and myocardial infarction(MI) have been considered the major cause of death for decaddes . THeir incidence and prevalence are still increasing . Numerous studies have been done on the risk factor analysis of CAD in Western countries. Since the diet in Western countries is different from that in Korea it is difficult to assume that the Korean diet has the same effects as its western counterpeart on the development of CAD . THus the gudidelines for the Western CAD patients can no totally be applied to Koreans. This study was conducted to investigate the relationship between diet and CAD in Koreans. Subjects were comprised of patients admitted to the hospital for chest pain with poxxilbe CAD (men 129, women 65) . They were divided into the following three groups according to angiographic results ; angiogrphically normal coronary artery group (control), single vessel disease group(SVD) and multiple vessel disease group (MVD) . Intakes of dietary fatty acids and other nutrients were assessed by the semiquantitative food frequency method. Blood was also obtained from subjects for serum lipid analysis. Serum lipid profiles of men were clearly different form those of women. For men, serum choesterol levels (or LDL or LDL/HDL) seemed to be higher in the MVD group compared to the control and SVD groups, while TG level was significantly higher in the MVD group for women. Both men and women showed significantly higher caloric , fiber and vitamins C and A intakes in the MVD group than in the other two groups. Higher caloric intakes was due to higher intakes of carbohydrate and protein rather than fat intake. In terms of fatty acids intake, there were no significant differences among the three groups . Smoking seemed to have great effect on eating patterns in CAD patients. Smokers and ex-smokers showed significantly higher intakes of most nutrients including individual fatty acids that non-smokers. The results of stepwise regression showed that moderate alcohol intake decreases LDL levels and increases HDL levels and smoking seems to lowe HDL levels in CAD patients.

• International Journal of Vascular Biomedical Engineering
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• 제3권2호
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• pp.10-16
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• 2005

Because patients with coronary artery disease (CAD) have depressed vagal modulation and the mortality risk from acute myocardial infarction is lower in patients with higher vagal modulation, methods that can increase vagal modulation are desirable in patients with CAD. We intended to inspect the effect of recumbent posture on vagal modulation. By using angiography, 33 patients with abnormal (CAD group) and 33 patients with normal coronary arteries (control group) were studied. The nonlinear as well as the linear characteristics of heart rate variability (HRV) were analyzed on these patients in three recumbent postures: namely, the supine, right lateral decubitus, and left lateral decubitus postures. The lower the normalized high-frequency power (nHF) in the supine or left lateral decubitus posture, the higher the increase in the nHF when the posture was changed from supine or left lateral decubitus to right lateral decubitus in both groups of patients. Right lateral decubitus posture can lead to the highest vagal modulation and the lowest sympathetic modulation among the three recumbent postures in both normal and patients with CAD. Therefore, the right lateral decubitus posture can be used as an effective physiologic vagal enhancer in patients with CAD.