• 제목/요약/키워드: Coronary

검색결과 2,243건 처리시간 0.026초

한국인 대동맥 근부의 해부학적 구조 (Anatomical Structures of the Aortic Root in Koreans)

  • 강민웅;유재현;임승평;이영;김시욱;김수일;정인혁;나명훈
    • Journal of Chest Surgery
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    • 제40권5호
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    • pp.321-328
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    • 2007
  • 배경: 대동맥 근부를 보존하는 심장수술이 점차 늘어남에 따라 대동맥 근부의 해부학적 구조에 대한 중요성 또한 증가하고 있다. 본 연구는 외과적 관점에서 필요한 대동맥 근부를 한국인 해부학 실습용 시신에서 실측하여 대동맥 근부의 진단 및 수술적 처치의 기준으로 하고자 한다. 대상 및 방법: 사인이 심혈관 질환이 아닌 시신 62구 중 대동맥 판막이 쌍엽인 1구, 기술적 오류로 대동맥 근부가 손상된 4구, 고정기간 중 변형이 심한 10구를 제외한 47예를 대상으로 하였다. 각 교련사이 간격, 대동맥 동의 높이, Sinotubular junction 및 aortic annulus의 길이를 측정하여 비교하였다. 결과: 시신의 사망 나이는 평균 61.3이었으며 남성이 31, 여성이 16구였다. 각 교련사이 간격은 Right coronary sinus $20.73{\pm}2.23mm$, Non coronary sinus $19.34{\pm}2.08mm$, Left coronary sinus $18.58{\pm}2.15mm$였다. 각 대동맥동의 높이는 Right coronary sinus $20.59{\pm}2.48$, Non coronary sinus $18.61{\pm}2.26mm$, Left coronary sinus $17.95{\pm}19mm$였으며, 통계 분석에서 교련사이에 길이 및 대동맥동의 높이는 Right coronary sinus가 가장 컸으며, Non coronary sinus, Left coronary sinus 순으로 나타났다. Sinotubular junction의 길이는 $70.73{\pm}5.94mm$, aortic annulus는 $77.94{\pm}5.63mm$였으며 Sinotubular junction의 길이, 대동맥 판륜의 길이와 대동맥 판륜에 대한 Sinotubular junction의 길이의 비를 각각 나이와 비교 분석했을 때 상관관계가 없었다(p=0.920, p=0.111, p=0.073). 대동맥 판륜과 sinotubular junction의 기울기는 $2.03^{\circ}$에서 $7.77^{\circ}$ (평균$=4.90^{\circ}$)였다. 결론: 각 교련 사이 간격 및 대동맥동의 높이는 non-parametric ANOVA test 결과 Right coronary sinus, Non coronary sinus, Left coronary sinus의 순으로 유의한 크기차이를 보였다(p=0.00). Sinotubular junction의 둘레 길이는 대동맥 판륜의 길이보다 9.3% 작았고 sinotubular junction이 aortic annulus에 대해 좌후측으로 기울어져 있었다.

관동맥혈관 내 방사선 근접 치료 (Intracoronary Radiation Therapy)

  • 문대혁;박성욱;홍명기;오승준;범희승;이희경
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 2001년도 제40차 춘계학술대회 및 연수교육
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    • pp.24-34
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    • 2001
  • Restenosis remains a major limitation of percutaneous coronary interventions. Numerous studios including pharmacological approaches and new devices failed to reduce the restenosis rate except coronary stenting. Since the results of $BENESTENT^{1)}\;and\;STRESS^{2)}$ studies came out, coronary stenting has been the most popular interventional strategy in the various kinds of coronary stenotic lesions, although the efficacy of stenting was shown only in the discrete lesion of the large coronary artery. The widespread use of coronary stenting has improved the early and late outcomes after coronary intervention, but it has also led to a new and serious problem, e.g., in-stent restenosis. Intravascular radiation for prevention of restenosis is a new technology in the field of percutaneous coronary intervention. Recent animal experiments and human trials have demonstrated that local irradiation, in conjunction with coronary interventions, substantially diminished the rate of restenosis. This paper reviews basic radiation biology of intracoronary radiation and its role in the inhibition of restenosis. The current status of intracoronary radiation therapy using Re-188 liquid balloon is also discussed.

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Comparison of Coronary Artery Bypass Graft-First and Percutaneous Coronary Intervention-First Approaches for 2-Stage Hybrid Coronary Revascularization

  • Choi, Hang Jun;Kang, Joonkyu;Song, Hyun;Kim, Do Yeon;Choi, Kuk Bin
    • Journal of Chest Surgery
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    • 제50권4호
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    • pp.247-254
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    • 2017
  • Background: Hybrid coronary revascularization (HCR) was developed to combine the advantages of coronary artery bypass graft (CABG) with percutaneous coronary intervention (PCI). However, it is still controversial whether it is more optimal to perform CABG or PCI first. The purpose of this study was to compare the clinical outcomes of these 2 approaches. Methods: Eighty patients who underwent HCR from May 2010 to December 2015 were enrolled in this retrospective analysis. The CABG-first group comprised 12 patients and the PCI-first group comprised 68 patients. Outcomes of interest included in-hospital perioperative factors, major adverse cardiac and cerebrovascular events (MACCEs), and the incidence of repeated revascularization, especially for the target vessel lesion. Results: No significant difference was found in the amount of postoperative bleeding (p=0.239). The incidence of MACCEs was similar between the CABG-first and PCI-first groups (1 of 12 [8.3%] vs. 5 of 68 [7.4%], p>0.999). Repeated revascularization was performed on 3 patients (25%) in the CABG-first and 9 patients (13.2%) in the PCI-first group (p=0.376). Conclusion: There were no significant differences in postoperative and medium-term outcomes between the CABG-first and PCI-first groups. Based on these results, it can be inferred that it is safe to opt for either CABG or PCI as the primary procedure in 2-stage HCR.

도시지역 주민의 관상동맥질환 위험인자에 관련한 비만지표의 유용성 검토 (The Usefulness of Obesity Indices for the Coronary Risk Factors in an Urban Inhabitants)

  • 박승경;김광환;조영채
    • Journal of Preventive Medicine and Public Health
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    • 제39권6호
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    • pp.447-454
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    • 2006
  • Objectives : To determine obesity for the screening of individuals at high risk of coronary heart disease in urban areas. Methods : Data were obtained from 4,137 adults between 19 and 85 years of age (2,372 males, 1,765 females), not recognized as taking medicines for cardiovascular diseases, who underwent a health check-up at the health promotion center of university hospitals in cities between Jan. 2003 and Dec. 2004. The variables studied were divided into two broad categories, and their relationships examined. obesity indices and risk factors for coronary heart disease. To reveal the relation between each of the obesity indices and the proportion of individuals at risk of coronary heart disease, the obesity indices were stratified and odds ratios obtained after age adjustment. Results : From a gender comparison of anthropometric measures, men were found to have significantly greater heights, weights, and waist and hip circumferences than women. From a gender comparison by the obesity indices, women were found to have significantly higher BMI, %Fat, waist to hip and waist to stature ratios than men. As obesity indices, the waist to stature ratio and the waist circumference were strongly correlated with coronary risk factors, both in men and women. The age-adjusted odds ratio of coronary risk factors increased significantly with increasing waist circumference, BMI, %fat, waist to hip and waist to stature ratios, and were highest specifically for the waist to stature ratio and the waist circumference. Conclusions : The study results showed that the waist to stature ratio and the waist circumference, as obesity indices, were most closely correlated with coronary risk factors. It is suggested that the waist to stature ratio and, specifically, the waist circumference can be effectively used in the field of health management for screening those with high levels of coronary risk factors.

Reperfusion Arrhythmia에 관한 연구 III. 관상동맥 폐색시의 혈액동력학적인 변화와 RA발생과의 관계 (A Study on Reperfusion Arrhythmia III. Relationship to Hemodynamics Changes and Occurrence of Reperfusion Arrhythmia after Occlusion of Coronary Artery in Dogs)

  • 최인혁;정인성;최은경;김희은
    • 한국임상수의학회지
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    • 제18권4호
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    • pp.402-410
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    • 2001
  • This study was performed to investigate the hemodynamic changes which occur after occlusion of coronary artery and relation to reperfusion arrhythmias(RA) which occur when occlusion materials were removed form coronary artery in dogs. The occlusion of coronary artery was designed by temporary ligation of left circumflex branch of coronary artery during 30 minutes in 16 dogs. During occlusion of coronary artery, cardiac output(CO), mean aortic pressure (mAP), aortic systolic pressure(ASP), aortic diastolic pressure(ADP). left ventricular systolic pressure(LVSP), left ventricular maximum dp/dt (LV max. dp/dt) and left ventricular end-diastolic pressure (LVEDP) were measured. The occurrence of RA were observed for 5 minute after reperfusion by explained of ligation. As a results, cardiac arrest occurred in 4 dogs during occlusion of coronary artery, and RA was not observed in 5 dogs while it was seen in 5 dogs when explained ligation(reperfusion) after 30 minutes, the rest 2 dogs occurred temporary tachycardia. In hemodynamics changes, LVSP decreased by 10.9% and LV max. dp/dt by 5.4 % in comparison to control value which not ligated coronary artery, and LVEDP increased by 73.3%. The CO/min and mAP also decreased by 10.7% and by 11.3% expectedly. In the relationship to occurrence RA and hemodynamics changes, the LVSP and LV max. dp/dt at the time of occlusion in the RA group decreased by 11.9% and 0.8% in comarison to the control value while the decrease was 7.7% and 10% in the non-RA group. But the LVEDP in creased by 109.1% in the RA group while the decreased was 44.6% in the non-RA group. Referring CO/min, the drop was 8.8% in the RA occurrence group and 12.9% in the non-occurence group. These parameters of LVEDP, LV max. dp/dt, and CO were significant difference(p<0.05). The mAP also decreased by 11.9 in the RA group and by 9.8% in the non-RA group, but these defference were not the significant difference.

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흉부 둔상 후 발생한 좌측 관상동맥 동맥류에 의한 급성 심근경색증 - 1예 보고 - (Acute Myocardial Infarction caused by Left Coronary Artery Aneurysm following Blunt Chest Trauma - A case report -)

  • 박일환;유경종;오중환
    • Journal of Chest Surgery
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    • 제40권3호
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    • pp.228-231
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    • 2007
  • 흉부 외상은 단순 부정맥에서 심근 파열 등 심장에 다양한 합병증을 일으킬 수 있다. 그중 관상동맥 손상은 매우 드문 합병증이고 특히 좌측 관상 동맥의 동맥류는 우측에 비해서 발생빈도가 작은 것으로 되어있다. 흉부 둔상 후 관상 동맥 내벽의 동맥류 형성, 박리, 열상, 동정맥루 및 혈전 등이 매우 드물게 생길 수 있으며, 혈관이 막히고 심근 경색이 발생하면 환자에게 치명적인 손상을 일으킨다. 교통사고로 인한 흉부의 둔상 후 발생한 심근경색증을 진단받은 33세 남자에서 관상동맥 우회로술을 통해 좋은 결과를 얻었기에 보고하는 바이다.

Framingham Coronary Risk Score를 이용한 화병과 심혈관계 질환과의 관련성 연구 (Corelationship Study between Hwa-Byung and Coronary Heart Disease, by using Framingham Coronary Risk Score)

  • 정하룡;고상백;박종구;유준상;이재혁
    • 동의신경정신과학회지
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    • 제22권3호
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    • pp.13-22
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    • 2011
  • Objectives : This study was to research the relationship between Hwa-Byung and Framingham coronary risk score(FRS), cardiovascular disease. Methods : 649 people participated in the community based cohort study in Wonju City of South Korea from July 2nd to August 30th in 2006. Educated investigators checked up systolic & diastolic blood pressure and surveyed Hwa-Byung Diagnostic Interview Schedule(HBDIS), cohort questionnaire about gender, age, smoking, diabetes. Blood sample was collected from participants to analyze total cholesterol, HDL-cholesterol. FRS was calculated from collected data. 10-year prediction of coronary heart disease was determined from FRS by using score sheet that is estimated by Wilson et al. Collected data were analyzed by the chi-square test. Results : 1. Low risk number of people was 18(52.9%) in Hwa-Byung group, 263(42.8%) in non Hwa-Byung group. p-value was 0.472. Difference of the two group was invalid. 2. The number of people below or equal to average 10-year prediction of coronary heart disease as gnder & age, Hwa-Byung group was 19(55.9%), non Hwa-Byung group was 412(67.0%). p-value was 0.251. Difference of the two group was invalid. Conclusions : There was no correlationship Between Hwa-Byung and 10-year prediction of coronary heart disease.

2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT)

  • Cherry Kim;Chul Hwan Park;Bae Young Lee;Chan Ho Park;Eun-Ju Kang;Hyun Jung Koo;Kakuya Kitagawa;Min Jae Cha;Rungroj Krittayaphong;Sang Il Choi;Hwan Seok Yong;Sung Min Ko;Sung Mok Kim;Sung Ho Hwang;Nguyen Ngoc Trang;Whal Lee;Young Jin Kim;Jongmin Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • 제25권4호
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    • pp.331-342
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    • 2024
  • The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

허혈성심장질환의 치료에서 관상동맥 우회술의 조기성적;53례의 임상적 결과 (Early Clinical Result of Coronary Artery Bypass Surgery for Ischemic Heart Diaseas)

  • 최종범
    • Journal of Chest Surgery
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    • 제26권4호
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    • pp.271-275
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    • 1993
  • In this country, the number of patients with coronary artery disease is progressively increasing with the change of life style and improvement of the diagnostic procedures. In addition, the medically invasive procedure for treating ischemic heart disease was rapidly developed and the surgical patients have more complex and multiple lesions and more surgical risks. Fifty three patients with ischemic heart disease underwent coronary bypass grafting [CABG] for recent 24 months. Twenty patients had three-vessel disease, 17 patients two-vessel disease, and 2 patients single-vessel disease. The average number of distal anastomoses was 3.3 per patient with the range of I to 6 grafts. Forty-one patients [77.4 %] had preoperative left ventricular ejection fraction of 50 % or more and 14 patients[26.4%] had a significant left main coronary lesion. Saphenous vein grafts were employed in 52/53 patients [98.1%] and internal mammary grafts, which were anastomosed to left anterior descending artery, in 38/53 patients[71.7%]. Two patients, whom percutaneous transluminal coronary angioplasty failed for, underwent emergency CABG with only saphenous vein grafts and both patients survived.The hospital mortality was 1.9 % and there was no late death. Perioperative myocardial infarction occurred in 1.9%. All survivors were asymptomatic[in 83% of the patients] and/or improved over their preoperative status. Twenty-nine patients were included in blood conservation group and 21 patients [72.4 %] underwent CABG without any homologous blood transfusion. Our early result of coronary bypass grafting was comparable to that which was reported in other coronary surgery units.

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허혈성 심질환 환자의 영양소 섭취실태에 대한 환자-대조군 연구 (A Case-Control Study for Dietary Intakes of Patients with Coronary Heart Disease)

  • 정효지;백희영;최영선;조성희;박의현
    • Journal of Nutrition and Health
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    • 제35권7호
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    • pp.763-770
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    • 2002
  • This study was carried out to see dietary intakes of patients with coronary heart disease since we don't understand their dietary patterns even though the mortality and prevalence rate of coronary hear disease are increasing in this country. We studied 75 coronary heart disease patients and 150 randomly selected controls, matched for age, sex, height and weight, in a population based study. All subjects completed a questionnaire that included disease history, diagnosis time, current treatment, etc., a 24 hour dietary recall, and measurement of height and weight. Compared to controls, patients had less likely to drink alcohol and smoke cigarette (p<0.05). The energy intake of patients was significantly lower than that of controls, but the intakes of fiber, $\beta$-carotene, sodium, folate, vitamin C, potassium in male patients and those of vitamin C and sodium in female patients were significantly higher than those of controls (p<0.05). Mean adequacy ratio and dietary variety score of patients were also higher than those of controls (p<0.05). Patient group's consumed less cereals than controls, but more vegetables, milk products, and nuts in male patients and fruits, beans and seasonings in female patients compared to controls'. There were not significant differences of lipid compositions between two groups, except linolenic acid. These data suggest that patients with coronary heart disease in Korea had better dietary nutrient intakes compared to healthy controls, which might be helpful to prevent recurrence of coronary heart disease.