Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Vessel Disease and Gensini Score according to Ankle-Brachial Index in Patients with Cardiovascular Disease

심혈관 질환자의 발목-상완 지수에 따른 Vessel disease 및 Gensini score 비교 융복합 연구

  • 최숙경 (서울아산병원 심장내과) ;
  • 최혜란 (울산대학교 임상전문간호학)
  • Received : 2016.10.06
  • Accepted : 2017.01.20
  • Published : 2017.01.28
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to evaluate the clinical availability of ankle-brachial index(ABI) according to severity of cardiovascular disease. The subjects of this study were the patients who had ABI in a general hospital. In this study, total 441 patients were enrolled for analysis. Electric medical records were reviewed to investigate the result of ABI and severity of cardiovascular disease measured vessel disease and Gensini score. Collected data were analyzed using SPSS 21.0 program. Subjects with $ABI{\leq}0.90$ and > 0.90 were classified as having abnormal and normal ABI. There were significant differences in vessel disease categorization($x^2=4.731$, p=.030) and Gensini score(t=2.351, p=.019) between two groups. Therefore, ABI is an effective and non-invasive tool for the diagnosis of cardiovascular disease with high severity. ABI is a valuable predictive index of ischemic heart disease.

본 연구는 심혈관 질환자의 발목-상완 지수(ankle-brachial index, ABI)에 따른 심혈관 질환 중증도를 분석하여 ABI의 임상적 유용성을 확인하기 위함이다. 연구 대상자는 일개 종합병원의 ABI를 측정한 심장내과 환자 441명 이었으며, 전자 의무 기록을 통해 ABI와 심혈관 질환 중증도를 나타내는 vessel disease 및 Gensini score를 조사하였다. 수집된 자료는 SPSS 21.0을 이용하여 분석하였다. ABI 0.90 이하인 비정상군과 0.90 초과인 정상군으로 나누어 비교하였을 때, vessel disease 분포 비율의 차이가 있었다($x^2=4.731$, p=.030). ABI 두 군과 Gensini score에 대한 비교분석에서 비정상군 $39.1{\pm}32.7$점, 정상군 $27.4{\pm}27.4$점으로 유의한 차이가 있었다(t=2.351, p=.019). 본 연구의 결과에서 ABI 비정상군이 중증도 높은 심혈관 질환자들의 분포가 많았으며, 평균 Gensini score도 높은 것을 확인할 수 있었다. 따라서 ABI를 시행하는 것은 비침습적인 방법으로 중증도 높은 심혈관 질환자를 예측하는데 도움이 되어 허혈성 심장 질환의 조기 발견에 유용하게 활용 가능할 것으로 기대된다.

Keywords

References

  1. Korean Statistical Office, Cause of death statistics 2012. Retrieved November 27, 2013, from http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&aSeq=308559
  2. H. M. Dalal, A. Zawada, K. Jolly, T. Moxham, R. S. Taylor, "Home based versus centre based cardiac rehabilitation : Cochrane systematic review and meta-analysis", British Medical Journal, Vol. 340, pp. b5631, 2010. https://doi.org/10.1136/bmj.b5631
  3. Y. S. Choi, "Comparison in nursing needs of heart disease patient depending on whether or not readmitted", Journal of Digital Convergence, Vol. 12, No. 6, pp. 519-526, 2014. https://doi.org/10.14400/JDC.2014.12.6.519
  4. T. Thom, N. Haase, W. Rosamond, V. J. Howard, J. Rumsfeld, T. Manolio, Z. J. Zheng, K. Flegal, C. O'Donnell, S. Kittner, D. Lloyd-Jones, D. C. Goff, Jr, Y. Hong, R. Adams, G. Friday, K. Furie, P. Gorelick, B. Kissela, J. Marler, J. Meigs, V. Roger, S. Sidney, P. Sorlie, J. Steinberger, S. Wasserthiel-Smoller, M. Wilson, P. Wolf, "Heart disease and stroke statistics-2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee", Circulation, Vol. 113, No. 6, pp. e85-e151, 2006. https://doi.org/10.1161/CIRCULATIONAHA.105.171600
  5. S. Nakata, Y. Yokoi, R. Matsumoto, N. Shirai, R. Otsuka, K. Sugioka, H. Yoshitani, S. Ehara, T. Kataoka, M. Yoshiyama, "Long-term cardiovascular outcomes following ischemic heart disease in patients with and without peripheral vascular disease", Osaka City Medical Journal, Vol. 54, No. 1, pp. 21-30, 2008.
  6. V. Aboyans, M. H. Criqui, P. Abraham, M. A. Allison, M. A. Creager, C. Diehm, F. G. Fowkes, W. R. Hiatt, B. Jönsson, P. Lacroix, B. Marin, M. M. McDermott, L. Norgren, R. L. Pande, P. M. Preux, H. E. Stoffers, D. Treat-Jacobson, "Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association", Circulation, Vol. 126, No. 24, pp. 2890-2909, 2012. https://doi.org/10.1161/CIR.0b013e318276fbcb
  7. C. Formosa, A. Gatt, N. Chockalingam, "Screening for peripheral vascular disease in patients with type 2 diabetes in Malta in a primary care setting", Quality in Primary Care, Vol. 20, No. 6, pp. 409-414, 2012.
  8. M. Sebastianski, S. Narasimhan, M. M. Graham, O. Toleva, J. Shavadia, S. Abualnaja, R. T. Tsuyuki, M. S. McMurtry, "Usefulness of the ankle-brachial index to predict high coronary SYNTAX scores, myocardium at risk, and incomplete coronary revascularization", The American Journal of Cardiology, Vol. 114, No. 11, pp. 1745-1749, 2014. https://doi.org/10.1016/j.amjcard.2014.09.010
  9. M. H. Criqui, R. L. McClelland, M. M. McDermott, M. A. Allison, R. S. Blumenthal, V. Aboyans, J. H. Ix, G. L. Burke, K. Liu, S. Shea, "The ankle-brachial index and incident cardiovascular events in the MESA(Multi-Ethnic Study of Atherosclerosis)", Journal of the American College of Cardiology, Vol. 56, No. 18, pp. 1506-1512, 2010. https://doi.org/10.1016/j.jacc.2010.04.060
  10. S. G. Ahn, H. S. Lim, D. Y. Joe, S. J. Kang, B. J. Choi, S. Y. Choi, M. H. Yoon, G. S. Hwang, S. J. Tahk, J. H. Shin, "Relationship of epicardial adipose tissue by echocardiography to coronary artery disease", Heart, Vol. 94, No. 3, pp. 1-6, 2008. https://doi.org/10.1136/hrt.2007.138040
  11. C. Sinning, L. Lillpopp, S. Appelbaum, F. Ojeda, T. Zeller, R. Schnabel, E. Lubos, A. Jagodzinski, T. Keller, T. Munzel, C. Bickel, S. Blankenberg, "Angiographic score assessment improves cardiovascular risk prediction: the clinical value of SYNTAX and Gensini application", Clinical Research in Cardiology, Vol. 102, No. 7, pp. 495-503, 2013. https://doi.org/10.1007/s00392-013-0555-4
  12. G. G. Gensini, "A more meaningful scoring system for determining the severity of coronary heart disease", The American Journal of Cardiology, Vol. 51, No. 3, pp. 606, 1983. https://doi.org/10.1016/S0002-9149(83)80105-2
  13. I. J. Neeland, R. S. Patel, P. Eshtehardi, S. Dhawan, M. C. McDaniel, S. T. Rab, V. Vaccarino, A. M. Zafari, H. Samady, A. A. Quyyumi, "Coronary angiographic scoring systems: An evaluation of their equivalence and validity", American Heart Journal, Vol. 164, No. 4, pp. 547-552, 2012. https://doi.org/10.1016/j.ahj.2012.07.007
  14. C. Lahoz, J. M. Mostaza, "Ankle-brachial index: a useful tool for stratifying cardiovascular risk", Revista Espanola de Cardiología, Vol. 59, No. 7, pp. 647-649, 2006. https://doi.org/10.1157/13091364
  15. O. S. Lee, M. G. Kim, S. H. Ha, "Interactive image segmentation for ultrasound vascular imaging", Journal of the Korea Convergence Society, Vol. 3, No. 4, pp. 15-21, 2012.
  16. A. Enoch, A. Ijeoma, "The role of ankle-brachial index as a screening test for coronary artery disease in the Hispanic population", Southern Medical Journal, Vol. 101, No. 11, pp. 1117-1120, 2008. https://doi.org/10.1097/SMJ.0b013e318189aabc
  17. C. M. Papamichael, J. P. Lekakis, K. S. Stamatelopoulos, T. G. Papaioannou, M. K. Alevizaki, A. T. Cimponeriu, J. E. Kanakakis, A. Papapanagiotou, A. T. Kalofoutis, S. F. Stamatelopoulos, "Ankle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease", The American Journal of Cardiology, Vol. 86, No. 6, pp. 615-618, 2000. https://doi.org/10.1016/S0002-9149(00)01038-9
  18. B. R. Koh, Y. K. Kim, S. M. Ahn, K. E. Song, S. H. Jung, H. J. Kim, D. J. Kim, Y-S. Chung, K. W. Lee, "Relationship between diabetic peripheral vascular disease and ankle-brachial index", Journal of Korean Society of Endocrinology, Vol. 21, No. 5, pp. 382-388, 2006. https://doi.org/10.3803/jkes.2006.21.5.382
  19. S. S. Kweon, M. H. Shin, K. S. Park, H. S. Nam, S. K. Jeong, S. Y. Ryu, E. K. Chung, J. S. Choi, "Distribution of the ankle-brachial index and associated cardiovascular risk factors in a population of middle-aged and elderly Koreans", Journal of Korean Medicine Science, Vol. 20, No. 3, pp. 373-378, 2005. https://doi.org/10.3346/jkms.2005.20.3.373
  20. H. J. Kim, "Utility of brachial-ankle pulse wave velocity, ABI, AI as independent predictor of cardiovascular disease in Korean type2 DM patients", Unpublished master's thesis, Yonsei university, 2005.
  21. Y. J. Lee, S. J. Lee, C. G. Kim, "Korean adolescents' weight control behaviors by BMI(body mass index) and body shape perception-Korea Youth Risk Behavior web-based Survey from 2010", Journal of Digital Convergence, Vol. 10, No. 3, pp. 227-232, 2012. https://doi.org/10.14400/JDPM.2012.10.3.227
  22. S. Tanaka, K. Kamiya, T. Masuda, N. Hamazaki, R. Matsuzawa, K. Nozaki, E. Maekawa, C. Noda, M. Yamaoka-Tojo, A. Matsunaga, J. Ako, "Low ankle brachial index is associated with the magnitude of impaired walking endurance in patients with heart failure", International Journal of Cardiology, Vol. 224, pp. 400-405, 2016. https://doi.org/10.1016/j.ijcard.2016.09.060
  23. P. J. Scanlon, D. P. Faxon, A. Audet, B. Carabello, G. J. Dehmer, K. A. Eagle, R. D. Legako, D. F. Leon, J. A. Murray, S. E. Nissen, C. J. Pepine, R. M. Watson, J. L. Ritchie, R. L. Gibbons, M. D. Cheitlin, T. J. Gardner, A. Garson, Jr, R. O. Russell, Jr, T. J. Ryan, S. C. Smith, Jr, "ACC/AHA guidelines for coronary angiography", Journal of the American College of Cardiology, Vol. 33, No. 6, pp. 1756-1824, 1999. https://doi.org/10.1016/S0735-1097(99)00126-6
  24. L. Y. He, J. F. Zhao, J. L. Han, S. S. Shen, X. J. Chen, "Correlation between serum free fatty acids levels and Gensini score in elderly patients with coronary heart disease", Journal of Geriatric Cardiology, Vol. 11, No. 1, pp. 57-62, 2014.
  25. T. P. Murphy, R. Dhangana, M. J. Pencina, R. B. D'Agostino, "Ankle-brachial index and cardiovascular risk prediction: An analysis of 11,594 individuals with 10-year follow-up", Atherosclerosis, Vol. 220, No. 1, pp. 160-167, 2012. https://doi.org/10.1016/j.atherosclerosis.2011.10.037
  26. C. Espinola-Klein, H. J. Rupprecht, C. Bickel, K. Lackner, S. Savvidis, C. M. Messow, T. Munzel, S. Blankenberg, "Different calculations of ankle-brachial index and their impact on cardiovascular risk prediction", Circulation, Vol. 118, No. 9, pp. 961-967, 2008. https://doi.org/10.1161/CIRCULATIONAHA.107.763227
  27. Y. Igarashi, T. Chikamori, S. Hida, H. Tanaka, C. Shiba, Y. Usui, T. Hatano, A. Yamashina, "Importance of the ankle-brachial pressure index in the diagnosis of coronary artery disease in women with diabetes without anginal pain", Circulation Journal, Vol. 75, No. 9, pp. 2006-2212, 2011.
  28. H. M. Su, W. C. Voon, T. H. Lin, K. T. Lee, C. S. Chu, M. Y. Lee, S. H. Sheu, W. T. Lai, "Ankle-brachial pressure index measured using an automated oscillometric method as a predictor of the severity of coronary atherosclerosis in patients with coronary artery disease", Kaohsiung Journal of Medical Sciences, Vol. 20, No. 6, pp. 268-272, 2004. https://doi.org/10.1016/S1607-551X(09)70117-2
  29. J. H. Kim, M. Y. Rhee, Y. S. Kim, J. H. Bae, D. Y. Nah, Y. K. Kim, M. M. Lee, C. Lim, C. J. Kim, "Brachial-ankle pulse wave velocity for the prediction of the presence and severity of coronary artery disease", Clinical and Experimental Hypertension, Vol. 36, No. 6, pp. 404-409, 2014. https://doi.org/10.3109/10641963.2013.846354
  30. M. Bosevski, I. Peovska, "Clinical usefulness of assessment of ankle-brachial index and carotid stenosis in type 2 diabetic population-three-year cohort follow-up of mortality", Angiology, Vol. 64, No. 1, pp. 64-68, 2013. https://doi.org/10.1177/0003319711435936
  31. Y. Ueki, T. Miura, Y. Miyashita, H. Motoki, K. Shimada, M. Kobayashi, H. Nakajima, H. Kimura, H. Akanuma, E. Mawatari, T. Sato, S. Hotta, Y. Kamiyoshi, T. Maruyama, N. Watanabe, T. Eisawa, S. Aso, S. Uchikawa, N. Hashizume, N. Sekimura, T. Morita, S. Ebisawa, A. A. Izawa, J. Koyama, U. Ikeda, "Predictive value of combining the anklebrachial index and SYNTAX score for the prediction of outcome after percutaneous coronary intervention(from the SHINANO Registry)", The American Journal of Cardiology, Vol. 117, No. 2, pp. 179-185, 2016. https://doi.org/10.1016/j.amjcard.2015.10.042
  32. H. Y. Lee, "The Analysis of Pulse Wave Velocity of Jeju female divers", Journal of Digital Convergence, Vol. 13, No. 9, pp. 515-521, 2015. https://doi.org/10.14400/JDC.2015.13.9.515