• Title/Summary/Keyword: Myocardial disease

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Diagnosis of Coronary Artery Disease Using Myocardial Perfusion SPECT (심근 SPECT를 이용한 관상동맥질환의 진단)

  • Won, Kyoung-Sook;Kim, Hae-Won
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.196-202
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    • 2009
  • Myocardial perfusion scintigraphy is currently by far the most commonly performed cardiac nuclear study, constituting approximately one third of all nuclear medicine procedure. It plays an important role in the diagnosis, prognosis, risk assessment and management of heart disease. Aim of this review is to describe recent evolution of myocardial perfusion imaging on the focus of diagnosis of coronary artery disease. In addition, current status of other imaging modalities will be reviewed.

Association between periodontal disease and coronary heart disease (치주질환과 관상동맥질환의 관련성에 대한 임상적 연구)

  • Lee, Jun-Ho;Chung, Hyun-Ju;Kim, Ju-Han
    • Journal of Periodontal and Implant Science
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    • v.35 no.1
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    • pp.111-121
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    • 2005
  • Coronary heart disease is the leading cause of mortality in adult population. Whereas the association between periodontal disease and coronary heart disease (CHD) are controversial, recent studies reported the association between periodontal disease and acute myocardial infarction or prognosis of CHD. This study was aimed to investigate the relationship between periodontal disease and angiographically defined CHD, and acute myocardial infarction, and the prognosis of treated CHD. Patients under the age of 60 who had undergone the diagnostic coronary angiography were enrolled in this study, Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=20) without stenosis. After recording the number of missing teeth, periodontal disease status was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), Positive CHD subjects were classified into acute myocardial infarction group (AMI), and non-AMI with angina pectoris and old myocardial infarction. Six months postoperatively, positive CHD subjects were followed and had undergone the coronary angiography again. Even though there was no significant difference in the periodontal parameters and status between positive CHD and negative CHD, some periodontal parameters, such as mean probing depth and proportion of sites with probing depth greater than 4mm or 6mm were significantly different between AMI and Non-AMI(p<0.05). There was no significant difference in the periodontal parameters according to in angiographically follow-up status. These results indicate that periodontal disease may be associated with the occurrence of acute myocardial infarction.

Myocardial Perfusion PET (심근관류 PET)

  • Cho, Ihn-Ho;Kong, Eun-Jung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.207-214
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    • 2009
  • Positron emission tomogrpahy (PET) represents the most advanced scintigraphic imaging technology. With the increase in availability of PET, the clinical use of PET has grown in medical fields. This can be employed for cardiovascular research as well as for clinical applications in patients with various cardiovascular disease. PET allows non-invasive functional assessment of myocardial perfusion, substrate metabolism and cardiac innervation and receptors as well as gene expression in vivo. PET is regarded as the gold standard for the detection of myocardial viability, and it is the only method available for the quantitative assessment of myocardial blood flow. This review focuses on the clinical applications of myocardial perfusion PET in coronary artery disease.

Stress Testing and Imaging Protocols for Myocardial Perfusion Studies (심근관류영상을 위한 심근부하 방법 및 검사 프로토콜)

  • Kim, Seong-Min
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.179-195
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    • 2009
  • Scince $^{201}$TI was introduced as a myocardial perfusion imaging agent in the early 1970s, scintigraphic evaluation of myocardial perfusion for the diagnosis of coronary artery disease is a valuable noninvasive diagnostic imaging modality. Stress radionuclide myocardial perfusion imaging is widely accepted to have high diagnostic and prognostic use in the assessment of patients with known or suspected coronary artery disease. With wise use of this nonivasive imaging technique, more patients are referred for stress perfusion imaging. Until now various protocols for stress testing and myocardial imaging were developed and used in worldwide. This article presented various protocols of stress testing and myocardial imaging for clinical use.

Global Left Ventricular Myocardial Work Efficiency in Patients With Severe Rheumatic Mitral Stenosis and Preserved Left Ventricular Ejection Fraction

  • Estu Rudiktyo;Amiliana M Soesanto;Maarten J Cramer;Emir Yonas;Arco J Teske;Bambang B Siswanto;Pieter A Doevendans
    • Journal of Cardiovascular Imaging
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    • v.31 no.4
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    • pp.191-199
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    • 2023
  • BACKGROUND: Assessment of left ventricular (LV) function plays a pivotal role in the management of patients with valvular heart disease, including those caused by rheumatic heart disease. Noninvasive LV pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate global LV systolic function, integrating longitudinal strain by speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work. The aim of this study was to characterize global LV myocardial work efficiency in patients with severe rheumatic mitral stenosis (MS) with preserved ejection fraction (EF). METHODS: We retrospectively included adult patients with severe rheumatic MS with preserved EF (> 50%) and sinus rhythm. Healthy individuals without structural heart disease were included as a control group. Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS: A total of 45 individuals with isolated severe rheumatic MS with sinus rhythm and 45 healthy individuals were included. In healthy individuals without structural heart disease, the mean global LV myocardial work efficiency was 96% (standard deviation [SD], 2), Compared with healthy individuals, median global LV myocardial work efficiency was significantly worse in MS patients (89%; SD, 4; p < 0.001) although the LVEF was similar. CONCLUSIONS: Individuals with isolated severe rheumatic MS and preserved EF, had global LV myocardial work efficiencies lower than normal controls.

Clinical Analysis of Cardiovascular Surgery -Report of 2094 Cases- (심혈관질환수술에 대한 임상적 고찰 -2094례 보고-)

  • 김병열
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1030-1039
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    • 1988
  • From 1985 through Oct. 1988, we have experienced 5 cases of Aorto-Coronary Bypass Surgery [ACBS] and 3 cases of Percutaneous Transluminal Coronary Anogioplasty [PTCA]under the diagnosis of unstable angina. There were 6 males and 2 females who ranged from 48 to 70 years old. Almost all patients had a evidence of hypertension & hyperlipidemia. Two patients showed old myocardial infarction and remaining patients showed myocardial ischemia on resting state. The patterns of involvement of coronary artery disease were single vessel disease [4 cases], double vessel disease [3 cases], Triple vessel disease [1 case]. Among 5 cases of ACBS, double bypass graft was in 3 cases and single bypass graft was in 2 cases. Mode of anastomosis were all individual anastomosis, using Saphenous vein graft. Postoperative complications were perioperative myocardial infarction [2 cases], postoperative bleeding [1 case], leg wound disruption [1 case]. Perioperative myocardial infarction cases didn*t survive. In cases of PTCA, there were no complications. Follow up periods were ranged from 1 month to 25 months. All survived cases were asymptomatic except one case, who showed Functional Class II.

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Quantitative gated myocardial perfusion SPECT (정량적 게이트 심근관류 SPECT)

  • Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.207-218
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    • 2003
  • Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

Acute myocardial infarction with a giant left main aneurysm in atypical Kawasaki disease (비전형적인 가와사키 병 환자에서 발생한 좌주간지 거대 동맥류를 동반한 급성심근경색)

  • Kim, Min Wook;Kim, Hyun Soo;Lee, Myung Dong;Jung, Hyun Sook;Yoon, Seong-Bo;Kim, Young Woo
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.106-110
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    • 2017
  • Kawasaki disease (KD) is an acute vasculitis of small and medium sized arteries. Even many years after onset, aneurysms and stenosis in coronary arteries may lead to an acute myocardial infarction, which is described as atypical or missed KD in childhood. KD is an underlying disease of young adults with acute myocardial infarction. We report on a rare case involving a total occlusion in the proximal left anterior descending coronary artery combined with a giant left main aneurysm in a young adult patient with acute myocardial infarction ascribed to antecedent KD that is undefined but almost certain.

Review of the coronary artery disease in terms of insurance medicine (관상동맥질환의 보험의학적 이해)

  • Lee, Sinhyung
    • The Journal of the Korean life insurance medical association
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    • v.32 no.2
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    • pp.33-38
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    • 2013
  • Coronary artery diseases are very important agenda in the insurance medicine. Insurance medicine is defined as using medical knowledge for insurance administration such as underwriting, claims, and customer satisfaction. This review article contains review of coronary artery disease in terms of insurance medicine. Estimation of extra-risks for acute myocardial infarction are MR of 349% and EDR of 41‰. In medical underwriting, individual life applicants can be assessed by Framingham's CHD risk assessment model. In claims, medical claims review is a useful method of consulting for claims staffs. Several diagnostic criteria of acute myocardial infarction are introduced in time. The universal definition of myocardial infarction by ESC/ACCF/WHF was demonstrated the most valuable predictor of 10-year mortality. Contents for State-Of-The-Art of the coronary artery disease are current antithrombotics. There are many novel anti-thrombotic agents such as ticagrelol, dabigatran, rivaroxaban, and pegnivacogin.

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