Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Pathophysiology and Role of Coronary CT Angiography in Stable Angina

안정형 협심증의 병태생리 및 관상동맥 CT 혈관조영술의 역할

  • Jong Eun Lee (Department of Radiology, Chonnam National University Hospital) ;
  • Hye Mi Park (Department of Radiology, Chonnam National University Hospital) ;
  • Yongwhan Lim (Department of Cardiovascular Medicine, Chonnam National University Hospital) ;
  • Won Gi Jeong (Department of Radiology, Chonnam National University Hwasun Hospital) ;
  • Yun-Hyeon Kim (Department of Radiology, Chonnam National University Hospital)
  • 이종은 (전남대학교병원 영상의학과) ;
  • 박혜미 (전남대학교병원 영상의학과) ;
  • 임용환 (전남대학교병원 순환기내과) ;
  • 정원기 (화순전남대학교병원 영상의학과) ;
  • 김윤현 (전남대학교병원 영상의학과)
  • Received : 2021.10.25
  • Accepted : 2021.12.24
  • Published : 2022.01.01
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Abstract

The clinical concept of coronary artery disease (CAD) has seen a paradigm shift over the last decade. CAD is mostly a progressive disease, and patients with CAD can develop acute coronary syndromes at any point in disease progression. In this clinical context, a new term, "chronic coronary syndrome," was published in the 2019 European Society of Cardiology guidelines, reflecting the importance of early diagnosis and active management. Recent advances have been made in the evaluation of CAD using coronary CT angiography (CCTA). The clinical usefulness of CCTA in patients with stable angina or chronic coronary syndrome begins with the detection of early asymptomatic CAD. The characterization of atherosclerotic plaque and its role in determining treatment strategies for CAD have been demonstrated for all stages of the disease. This review describes the pathophysiology of stable angina to aid in the understanding of the clinical applications of CCTA.

관상동맥질환의 임상적인 개념은 지난 10년 동안 패러다임의 변화를 보여왔다. 관상동맥질환은 대부분 진행성 질환이며, 관상동맥질환 환자는 질병 진행의 어느 시점에서도 급성 관상동맥 증후군에 직면할 수 있다. 이러한 임상적 맥락에서 2019년 유럽심장학회 가이드라인에서는 조기 진단과 꾸준한 관리가 필요한 관상동맥질환의 임상적인 중요성을 반영하여 "만성관상동맥증후군"이라는 용어의 사용을 발표하였다. 최근 관상동맥 전산화단층촬영 혈관조영술을 이용한 관상동맥질환의 평가는 많은 발전을 이루었고, 안정형 협심증 또는 만성 관상동맥증후군 환자에서 관상동맥 전산화단층촬영 혈관조영술의 임상적 유용성은 초기 무증상 관상동맥질환의 발견에서부터 죽상경화판의 특성 분석 및 관상동맥질환의 치료 전략 결정에 도움을 주는 역할까지 관상동맥질환의 다양한 단계에 걸쳐 입증되고 있다. 이 종설에서는 안정형 협심증 환자의 이해를 돕는 병태생리를 설명하고 이에 대한 관상동맥 전산화단층촬영의 임상적 적용과 역할에 대해 알아보고자 한다.

Keywords

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