• Korean Journal of Radiology
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• v.20 no.5
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• pp.719-728
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• 2019

Objective: To investigate the diagnostic validity of coronary computed tomography angiography (cCTA) in vasospastic angina (VA) and factors associated with discrepant results between invasive coronary angiography with the ergonovine provocation test (iCAG-EPT) and cCTA. Materials and Methods: Of the 1397 patients diagnosed with VA from 2006 to 2016, 33 patients (75 lesions) with available cCTA data from within 6 months before iCAG-EPT were included. The severity of spasm (% diameter stenosis [%DS]) on iCAGEPT and cCTA was assessed, and the difference in %DS (Δ%DS) was calculated. Δ%DS was compared after classifying the lesions according to pre-cCTA-administered sublingual nitroglycerin (SL-NG) or beta-blockers. The lesions were further categorized with %DS ≥ 50% on iCAG-EPT or cCTA defined as a significant spasm, and the diagnostic performance of cCTA on identifying significant spasm relative to iCAG-EPT was assessed. Results: Compared to lesions without SL-NG treatment, those with SL-NG treatment showed a higher Δ%DS (39.2% vs. 22.1%, p = 0.002). However, there was no difference in Δ%DS with or without beta-blocker treatment (35.1% vs. 32.6%, p = 0.643). The significant difference in Δ%DS associated with SL-NG was more prominent in patients who were aged < 60 years, were male, had body mass index < 25 kg/m², and had no history of hypertension, diabetes, or dyslipidemia. Based on iCAG-EPT as the reference, the per-lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of cCTA for VA diagnosis were 7.5%, 94.0%, 60.0%, 47.1%, and 48.0%, respectively. Conclusion: For patients with clinically suspected VA, confirmation with iCAG-EPT needs to be considered without completely excluding the diagnosis of VA simply based on cCTA results, although further prospective studies are required for confirmation.

• Korean Journal of Veterinary Research
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• v.36 no.1
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• pp.83-91
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• 1996

Activation of $K^+$ channels induces relaxation of smooth muscles by reducing electrical excitability and cytosolic free $Ca^{2+}$ level. ${\beta}$-adrenergic agonist isoproterenol is known to induce relaxation of the uterine smooth muscle by membrane hyperpolarization and $K^+$ efflux. Recently it is suggested that the activity of $Ca^{2+}$-activated $K^+$ channel was increased by isoproterenol in the uterine myocytes isolated from myometrium of the pregnant rat. However, the type of $K^+$ channel mediating the relaxant effect of isopreterenol in the tissue level has not yet studied. In this work, we investigated the type of $K^+$ channels involved in the isoproterenol-induced relaxation of uterine smooth muscle by measuring the integrated insometric tension of the estrogen-treated isolated nonpregnant rat uterus. Contraction of uterine tissue was induced by oxytocin (0.2nM, 2~3 contractions/min) or high KCl(20~80mM). The result are as follows : 1. Isoproterenol($10^{-10}{\sim}10^{-4}M$) inhibited oxytocin-induced contraction of isolated rat uterus($EC_{50}=1.17{\times}10^{-10}M$). 2. Isoproterenol($10^{-10}{\sim}10^{-4}M$) effectively inhibited uterine contraction induced by low KCl(20~40mM) but little those induced by high KCl(60~80mM). 3. Relaxant effect of isoproterenol($10^{-10}{\sim}10^{-4}M$) on 0.2nM oxytocin-induced contraction was effectively reduced by 4-aminopyridine(3, 10mM) but little by TEA(10~30mM), $Ba^{2+}$($1{\sim}30{\mu}M$) and glibenclamide($100{\mu}M$). Our data suggest that the relaxant effect of isoproterenol is mediated by the $K^+$ channel(s) which can be blocked by 4-aminopyridine.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.407-413
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• 2007

Background: The brain natriuretic peptide (BNP) level has been reported in some studies to be associated with the occurrence of atrial fbrillation (AF). The aim of this study is to evaluate the potential usefulness of the BNP level as a predictor of the occurrence of postoperative (postop) AF and to assess the relationship of the BNP level with the onset of AF and the restoration of sinus rhythm. Material and Method: From January 1, 2005 to February 28, 2006, 82 patients without a history of atrial arrhythmia that had undergone cardiac surgery were enrolled in the study. Blood samples for plasma BNP were drawn daily for all these patients from the preoperative (preop) day to the 7th postop day. The patient records were reviewed and postop EKGs were checked daily for AF until the time of discharge. Result: Patients were divided into two groups based on development of postop AF. Postoperative AF developed in 26 patients (31.7%). There was no significant statistical difference in age, sex distribution, preop left ventricle ejection fraction, hypertension, left ventricular hypertrophy, or the use of beta blockers between the non-postop AF and postop AF group. More patients in the AF group had undergone valve surgery (39.3% versus 76.9%, p=0.002). The preop left atrium size was significantly larger in the AF patients ($43.8{\pm}10.3 mm$ versus $49.8{\pm}11.5 mm$, p=0.029). The preop plasma BNP levels were higher in the postop AF patients ($144.1{\pm}20.8 pg/mL$ versus $267.5{\pm}68 pg/mL$, p=0.034). In the postop AF group, the plasma BNP level was the highest on the 3rd postop day. Postop AF developed in most patients by the 3rd postop day; restored sinus rhythm developed by the 7th postop day. Conclusion: Elevated plasma BNP levels may lead to the occurrence of postop AF in patients undergoing cardiac surgery. Patients who have a high risk of postop AF should be considered for aggressive prophylactic antiarrhythmic therapy.