• Korean Journal of Radiology
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• 제20권5호
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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.

• 대한수의학회지
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• 제36권1호
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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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• 제40권6호
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• pp.407-413
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• 2007

배경: 혈중 BNP 농도가 심방세동 발생과 관련 있다는 여러 보고가 있다. 본 연구의 목적은 혈중 BNP 농도가 술 후 심방세동의 발생에 유용한 예견인자인지 알아보고 술 후 BNP 수치의 변화와 심방세동 발생시기 및 심방세동이 정상 동율동으로 돌아오는 시기를 알아보고자 하였다. 대상 및 방법: 2005년 1월 1일부터 2006년 2월 28일까지 개심술을 받은 환자 중 심방부정맥의 병력이 없는 82명의 환자를 대상으로 하였다. 혈중 BNP 농도 측정을 위한 혈액 채취는 술 전부터 술 후 7일째까지 매일 하였다. 술 후 심전도 검사는 퇴원 전까지 매일 시행하였다. 결과: 환자는 술 후 심방세동 발생 유무에 따라 두 군으로 나누었다. 술 후 심방세동은 26명(31.7%)에서 발생하였다. 심방세동 없는 군과 발생군 사이에 나이, 성별, 술 전 좌심실 구혈률, 고혈압, 좌심실 비대, 베타 차단제 복용 유무에 대해 통계학적인 의미 있는 차이는 없었다. 판막 수술을 받은 환자에서 술 후 심방세동의 발생이 많았다(39.3% vs 76.9%, p=0.002). 술 전 좌심방 크기는 심방세동 발생군에서 의미 있게 컸다($43.8{\pm}10.3 m$ vs $49.8{\pm}11.5 mm$, p=0.029). 술 전 혈중 BNP 농도는 심방세동 발생군에서 의미 있게 높았다($144.1{\pm}20.8 pg/mL$ vs $267.5{\pm}68 pg/mL$, p=0.034). 심방세동군에서 술 후 BNP 수치는 술 후 3일째 가장 높았고 심방세동 발생은 술 후 3일 이내가 가장 많이 발생하였고 술 후 일주일 이내 대부분 정상 동율동으로 돌아왔다. 결론: 혈중 BNP 농도의 증가는 심장 수술 후 심방세동 발생을 예측하는 데 유용한 인자이다. 심방세동 발생의 위험인자가 있는 경우 술 후 적극적으로 예방적 항부정맥제 사용을 고려해야 한다.