• Title/Summary/Keyword: 경색심근

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고지혈증의 원인과 치료 - 당뇨병환자에게 처방되는 고지혈증약

  • Jo, Jeong-Gu
    • The Monthly Diabetes
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    • s.285
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    • pp.23-29
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    • 2013
  • 당뇨병은 심근 경색의 재발 위험이나 심혈관 질환에 의한 사망 위험이 높다는 것은 잘 알려진 사실로 당뇨병 자체로도 관상동맥질환이 있는 것과 같이 대등한 위험인자로 취급하도록 권고되고 있다. 이러한 당뇨병에 이상지질혈증, 고혈압, 복부비만이 동반되어 있는 경우를 대사증후군으로 명명하기도 하며 심혈관질환 위험이 훨씬 증가한다.

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Defect of $^{18}F-FDG$ Uptake Observed in Infarcted Myocardium Showing Reverse Redistribution on Rest / 24-Hour Delayed $^{201}Tl$ Myocardial SPEG after Acute Myocardial Infarction (급성 심근경색 후 휴식 / 24시간 지연 $^{201}Tl$ 심근 SPECT 상 역재분포를 보인 경색심근에서 관찰된 $^{18}F-FDG$ 섭취 결손)

  • Lee, Ho-Young;Paeng, Jin-Chul;Oh, So-Won;Kim, Ji-Yeong;Chung, Woo-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.478-481
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    • 2008
  • Reverse redistribution is frequently observed after revascularization in acute myocardial infarction, and usually regarded as a predictor of viable myocardium on stress/rest and 2- to 4-hour redistribution $^{201}Tl$ SPECT. However, there is not enough report of reverse redistribution in case of 24-hour delayed SPECT, which is commonly used for viability assessment. In this report, a case of reverse redistribution on rest and 24-hour delayed $^{201}Tl$ SPECT is reported with use of automatic segmental quantitative analysis. The myocardium of reverse redistribution was dysfunctional on gated SPECT, and diagnosed as non-viable on $^{18}F-FDG$ PET.

골수단핵세포 이식에 의한 심장근육 조직 재생

  • Ryu, Ju-Hui;Kim, Il-Gwon;Jo, Seung-U;Im, Sang-Hyeon;Yu, Gyeong-Jong;Hong, Yu-Seon;Choe, Cha-Yong;Kim, Byeong-Su
    • 한국생물공학회:학술대회논문집
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    • 2003.04a
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    • pp.95-97
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    • 2003
  • Despite recent advances in the treatment of acute myocardial infarction, the ability to repair extensive myocardial damage is limited. To develop a new therapy for myocardial infarction, we examined the possibility of regenerating myocardium by implanting bone marrow-derived mononuclear cells(BM-MNC) . Histological and immunohistochemical examination showed myocardium regeneration and angiogenesis in the cell transplantation site. Isolated perfused (Langendorff) heart experiments revealed enhanced functions of heart. These results suggest that BM-MNC transplantation induce cardiac muscle regeneration and that this approach could be applied as a possible treatment for myocardial infarction.

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Analysis of Aggravated Perfusion in Myocardial SPECT after Coronary Artery Bypass Surgery (관동맥우회로술 후에 심근 SPECT에 나타난 관류의 악화 분석)

  • Lee, Won-Woo;Yoon, Seok-Nam;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.36-42
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    • 1997
  • Though myocardial perfusion was usually expected to improve after coronary artery bypass graft(CABG) surgery, some myocardial segments were aggravated after operation, as we compared perfusion changes on postoperative SPECT with preoperative ones. In this study, we evaluated perfusion changes after operation in rest and stress myocardial SPECT in 44 patients (M:F=25:19, age 57.1 $year{\pm}8.2$) who had CABG before and 3 months after operation. We tried to find out possible causes for perfusion aggravation with multivariate logistic regression analysis regarding whether bypass graft was artery or vein and which coronary artery territory was operated. Among 616 myocardial segments which were operated, 89(14.4%) aggravated after operation. In the univariate analysis, myocardial segments in the left circumflex arteries(LCx) aggravated more often(p<0.01) than others and segments having operative angioplasty did less often(p<0.01). Multivariate logistic regression revealed that LCx was risk factor for perfusion aggravation [odds ratio=2.54 (95% confidence interval : 1.53-4.22, p<0.01)]. However, this was not the case when we analysed in terms of arterial territories. Among 106 coronary arterial territories which were operated, 27(25.5%) aggravated. The territories having aggravated had similar characteristics regarding whether they received arterial or venous grafts, angioplasty and whether the operated territories were left anterior descending, right coronary or left circumflex arteries. In conclusion, myocardial segments in the left circumflex artery tended to aggravate more often after bypass surgery than the others. In short-term comparison of perfusion after surgery, we could not find any tendency that arterial or venous graft was associated with more frequency of the aggravation of perfusion after operation.

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Diagnosis of Coronary Artery Disease using Myocardial Perfusion SPECT in Patients with Diabetes Mellitus: Analysis of Risk Factors (당뇨병 환자에서 심근관류 SPECT을 이용한 관동맥질환의 진단: 위험인자 분석)

  • Seo, Ji-Hyoung;Kang, Seong-Min;Bae, Jin-Ho;Jeong, Shin-Young;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.155-162
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    • 2006
  • Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

Regional Myocardial Blood Flow Estimation Using Rubidium-82 Dynamic Positron Emission Tomography and Dual Integration Method (Rubidium-82 심근 Dynamic PET 영상과 이중적분법을 이용한 국소 심근 혈류 예측의 기본 모델 연구)

  • 곽철은;정재민
    • Journal of Biomedical Engineering Research
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    • v.16 no.2
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    • pp.223-230
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    • 1995
  • This study investigates a combined mathematical model for the quantitative estimation of regional myocardial blood flow in experimental canine coronary artery occlusion and in patients with ischemic myocardial diseases using Rb-82 dynamic myocardial positron emission tomography. The coronary thrombosis was induced using the new catheter technique by narrowing the lumen of coronary vessel gradually, which finally led to partial obstruction of coronary artery. Thirty four Rb-82 dynamic myocardial PET scans were performed sequentially for each experiment using our 5, 10 and 20 second acquisition protocol, respectively, and six to seven regions of interest were drawn on each transaxial slices, one on left ventricular chamber for input function and the others on normal and decreased perfusion myocardial segments for the flow estimation in those regions. Two compartment model and graphical analysis method have been applied to the measured sets of regional PET data, and the rate constants of influx to myocardial tissue were calculated for regional myocardial flow estimates with the two parameter fits of raw data by the Levenberg-Marquardt method. The results showed that, (I) two compartment model suggested by Kety-Schmidt, with proper modification of the measured data and volume of distribution, could be used for the simple estimation of regional myocardial blood flow, (2) the calculated regional myocardial blood flow estimates were dependent on the selection of input function, which reflected partial volume effect and left ventricular wall motion in previously used graphical analysis, and (3) mathematically fitted input and tissue time activity curves were more suitable than the direct application of the measured data in terms of convergence.

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ST Segment Shape Classification Algorithm for Making Diagnosis of Myocardial Ischemia (심근허혈 진단을 위한 ST세그먼트 형태 분류 알고리즘)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.15 no.10
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    • pp.2223-2230
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    • 2011
  • ECG is used to diagnose heart diseases such as myocardial ischemia, arrhythmia and myocardial infarction. Particularly, myocardial ischemia causes the shape change of the ST segment, this change is transient and may occur without symptoms. So it is important to detect the transient change of ST segment through long term monitoring. ST segment classification algorithm for making diagnosis myocardial ischemia is presented in this paper. The first step in the ST segment shape classification process is to detect R wave point and feature points based adaptive threshold and window. And then, the suggested algorithm detects the ST level change, To classify the ST segment shape, the suggested algorithm uses the slope values of the four points between the S and T wave. The ECG data in the European ST-T database were used to verify the performance of the developed algorithm. The best correct rate was 99.40% and the worst correct rate was 68.48%.

Surgery for Myocardial Bridging - A report of two cases - (심근교(Myocardial Bridging)에 대한 수술적 치료 -2예 보고)

  • Kim, Jae-Hyun;Oh, Sam-Sae;Yie, Kil-Soo;Jeong, In-Seok;Youn, Hyo-Chul;Kim, In-Sub;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.629-632
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    • 2007
  • Most myocardial bridgings are found incidentally without symptoms, but myocardial bridging may induce symptoms such as angina, myocardial infarction, and ventricular arrythmia. In a patient who has symptoms despite of proper medication, stent insertion, supra-arterial myotomy or coronary artery bypass grafting have been applied without a definite guideline of treatment. We report two surgical cases of myocardial bridging with a review of the literature.