• Title/Summary/Keyword: Coronary artery atherosclerosis

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Coronary Artery Calcium Data and Reporting System (CAC-DRS): A Primer

  • Parveen Kumar;Mona Bhatia
    • Journal of Cardiovascular Imaging
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    • v.31 no.1
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    • pp.1-17
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    • 2023
  • The Coronary Artery Calcium Data and Reporting System (CAC-DRS) is a standardized reporting method for calcium scoring on computed tomography. CAC-DRS is applied on a per-patient basis and represents the total calcium score with the number of vessels involved. There are 4 risk categories ranging from CAC-DRS 0 to CAC-DRS 3. CAC-DRS also provides risk prediction and treatment recommendations for each category. The main strengths of CAC-DRS include a detailed and meaningful representation of CAC, improved communication between physicians, risk stratification, appropriate treatment recommendations, and uniform data collection, which provides a framework for education and research. The major limitations of CAC-DRS include a few missing components, an overly simple visual approach without any standard reference, and treatment recommendations lacking a basis in clinical trials. This consistent yet straightforward method has the potential to systemize CAC scoring in both gated and non-gated scans.

Coronary Physiology-Based Approaches for Plaque Vulnerability: Implications for Risk Prediction and Treatment Strategies

  • Seokhun Yang;Bon-Kwon Koo
    • Korean Circulation Journal
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    • v.53 no.9
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    • pp.581-593
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    • 2023
  • In the catheterization laboratory, the measurement of physiological indexes can help identify functionally significant lesions and has become one of the standard methods to guide treatment decision-making. Plaque vulnerability refers to a coronary plaque susceptible to rupture, enabling risk prediction before coronary events, and it can be detected by defining a certain type of plaque morphology on coronary imaging modalities. Although coronary physiology and plaque vulnerability have been considered different attributes of coronary artery disease, the underlying pathophysiological basis and clinical data indicate a strong correlation between coronary hemodynamic properties and vulnerable plaque. In prediction of coronary events, emerging data have suggested independent and additional implications of a physiology-based approach to a plaque-based approach. This review covers the fundamental interplay between coronary physiology and plaque morphology during disease progression with clinical data supporting this relationship and examines the clinical relevance of physiological indexes in prediction of clinical outcomes and therapeutic decision-making along with plaque vulnerability.

Correlations between Risk Factors for Atherosclerosis and Histopathologic Findings of Radial Artery (동맥경화증 위험인자와 요골동맥 병리소견과의 상관 관계)

  • Lee, Won Jai;Lee, Seung Jong;Pae, Jae Young;Ryu, Dae Hyun;Park, Beyoung Yun;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.619-624
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    • 2005
  • Patency of the radial artery plays an important role in the survival of radial forearm fasciocutaneous free flap and artery conduit of coronary artery bypass graft procedure. Even though Allens' test has been used for evaluating the patency of radial artery, the studies on the correlations between risk factors for atherosclerosis and histopathologic findings of radial arteries are rare, until now. Therefore, the authors investigated the correlations between these two factors, and tried to estimate the feasibility of the radial artery in high-risk groups for artherosclerosis. The risk factors for atherosclerosis and lipid profiles were investigated in 38 patients by history taking, physical examinations and blood analysis. And 38 cases of segments of vessel were harvested during the elevation of the flap. The degrees of vessel medial sclerosis were estimated by R values(by Kobayashi and colleagues) that is the median value between the thickness of the intima and that of the media. The measured mean R value was $0.210{\pm}0.05$. Thirty one cases belonged to Grade I(R<0.25), 7 cases belong to Grade II(0.25

Flow Visualization in Realistic Arterial Bypass Graft Model

  • Singh, Megha;Shin, Se-Hyun
    • International Journal of Vascular Biomedical Engineering
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    • v.3 no.1
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    • pp.1-5
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    • 2005
  • Background: Coronary atherosclerosis artery disease is the leading cause of morbidity and mortality. Coronary artery bypass grafting (CABG) which utilizes the saphenous vein graft, has helped in alleviating the suffering of these patients. Newer techniques are being developed to improve upon the techniques. Still there is significant number of failures, leading to re-grafting or re-vascularization. Some studies have helped in identifying the high and low shear stress regions. Further studies based on their realistic models are required. Material, methods and results: we developed the realistic model of fully blocked right coronary with bypass graft placed at angle of $5^0$ with curvature similar to that of artery. Pulsatile flow of birefringent solution through this model by polarized light was visualized. The images of complete flow field in the model were recorded and analyzed. Regions of high flow disturbances which are prone to further changes are identified. Existence of recirculation in the blocked coronary may initiate new blood-tissue interactions deleterious to bypass graft. Conclusion: Our study shows that by selecting the procedure to place bypass graft at minimum angle with curvature similar to that of artery and smooth sutures may improve the life span of the graft. This study also identified that coronary blocked regions contributing by recirculation flow at the proximal and distal regions of bypass which may require further studies.

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The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Comparison of Steady and Physiological Blood Flow Characteristics in the Left Coronary Artery Bifurcation (좌관상동맥 분지부내의 정상혈류와 박동성혈류의 유동특성비교)

  • Suh, S.;Yoo, S.S.;Kwon, H.M.;Roh, H.W.
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.11
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    • pp.57-60
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    • 1995
  • The objective of this investigation is to understand the role of hemodynamics in the formation and development of atherosclerosis lesions in the human left coronary artery This study also aims to compare the blood flow characteristics of steady and physiological flows. Three dimensional, steady and physiological flows of blood in the left coronary artery are simulated using the Finite Volume Method. Apparent viscosity of blood is represented as a function of shear rate by the Carreau model. Distributions of velocity, pressure and shear stress in tile left coronary artery bifurcation are presented to compare tile steady and physiological flow characteristics.

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When Should Familial Hypercholesterolemia Be Suspected?: A Case of Dyslipidemia in Young Patient without Coronary Artery Disease (가족성 고콜레스테롤혈증은 언제 의심해야 할까?: 관상동맥 질환이 없는 젊은 이상지질혈증 환자 증례)

  • In Sun Ryou
    • Archives of Obesity and Metabolism
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    • v.2 no.1
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    • pp.29-35
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    • 2023
  • Familial hypercholesterolemia (FH) is a genetic disease that is not well known or diagnosed in Korea. This disease is associated with persistently high levels of low-density lipoprotein cholesterol (LDL-C), which increase the risk of coronary artery disease at a young age. Therefore, early diagnosis and treatment are important; however, there are no global consensus diagnostic criteria. In Korea, the Dutch Lipid Clinic Network diagnostic criteria, and the Simon Broome diagnostic criteria were used for diagnosis of FH according to the agreement announced at the Korean Society of Lipid and Atherosclerosis (KSoLA) in 2022. Recently, the absence of coronary artery calcification has been considered a good prognostic factor, even among patients with very high LDL-C levels who are considered to be at high risk for atherosclerotic cardiovascular disease. We describe throughout this paper the diagnosis and treatment of FH in a young male without coronary artery calcification.

Effect of Polygoni Multiflori Radix on the Atherosclerotic Coronary Artery of Rabbits Induced by High Cholesterol Diet (적하수오(赤何首烏)가 고(高)Cholesterol식이(食餌)에 의하여 유발(誘發)된 가토(家兎) 관상동맥(冠狀動脈)의 죽상경화(粥狀硬化)에 미치는 영향(影響))

  • Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.16 no.1 s.29
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    • pp.425-436
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    • 1995
  • In order to evaluate the effect of Polygoni Multiflori Radix on the atherosclerosis induced by high cholesteol diet, rabbits were fed with 4% cholesterol diet, 4% cholesterol-4% Polygoni Multiflori Radix diet during 12 weeks. After 12 weeks, histological changes in coronary artery of rabbits were studied. The results were obtained as follows; 1. At the area % of lumen in coronary arteries, Polygoni Multiflori Radix group showed significant inhibitory effect against decrease of area % in control group. 2. At the atheroma formation in coronary arteries, Polygoni Multiflori Radix group showed decrease effect as compared with control group. 3. At the mucoprotein formation in wall of coronary arteries, Polygoni Multiflori Radix group showed decrease effect as compared with control group. 4. At the lesion of elastic fibers in coronary arteries, Polygoni Multiflori Radix group didn't show effective changes as compared with control group.

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Comparison of Blooming Artifact Reduction Using Image Segmentation Method in CT Image (CT영상에서 이미지 분할기법을 적용한 Blooming Artifact Reduction 비교 연구)

  • Kim, Jung-Hun;Park, Ji-Eun;Park, Yu-Jin;Ji, In-Hee;Lee, Jong-Min;Cho, Jin-Ho
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.295-301
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    • 2017
  • In this study, We subtracted the calcification blooming artifact from MDCT images of coronary atherosclerosis patients and verified their accuracy and usefulness. We performed coronary artery calcification stenosis phantom and a program to subtract calcification blooming artifact by applying 8 different image segmentation method (Otsu, Sobel, Prewitt, Canny, DoG, Region Growing, Gaussian+K-mean clustering, Otsu+DoG). As a result, In the coronary artery calcification stenosis phantom with the lumen region 5 mm the calcification blooming artifact was subtracted in the application of the mixture of Gaussian filtering and K- Clustering algorithm, and the value was close to the actual calcification region. These results may help to accurately diagnose coronary artery calcification stenosis.

The role of carotid screening by duplex sonography in patients with coronary artery disease (관동맥 우회술 환자에서의 경동맥 협착을 진단하기 위한 Duplex sono 선별검사의 의의)

  • Chung, Cheol-Hyun;Chae, Hurn;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.833-837
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    • 1993
  • In an effort to reduce the stroke rate of patients after coronary artery bypass, many authors have studied the prevalence of the extracranial carotid disease and its role in determining neurologic morbidity and mortality rates. From April 1992 to August 1993, Seventy-five patients undergoing coronary artery bypass were preoperatively evaluated for presence of carotid and femoral stenosis by Duplex sono. Among them, fourteen patients was positive by Duplex sono and overall prevalence of carotid or femoral stenosis was 18.7%. And significant carotid stenosis [ > 60% ] had proved to be in 3 patients [ 4.0% ].Prophylatic bilateral carotid endarterectomy was performed in one patient, at 5 months prior to and , 1 week prior to coronary artery bypass respectively. Their mean age was 57.6 years [ ranged from 40 to 70 years] and were composed of 10 males and 4 females. There was no postoperative morbidiry and mortality related to neurologic complications. Our data, although small, suggest that preoperative carotid screening is helpful to determine patients at high risk of stroke, and significant simultaneous carotid and coronary atherosclerosis should be corrected in selected patients by staged operations when feasible.

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