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1.
Chinese Journal of Radiology ; (12): 1051-1057, 2022.
Article in Chinese | WPRIM | ID: wpr-956757

ABSTRACT

Objective:To evaluate the diagnostic performance of non-contrast-enhanced Dixon water-fat separation Compressed SENSE (CS-SENSE) whole-heart coronary magnetic resonance angiography (CMRA) at 3.0 T on patients with suspected coronary artery disease (CAD).Method:The study complied with the Declaration of Helsinki. Local ethics committee approved this study and written informed consent was obtained from each patient. In this prospective study, from March 2021 to September 2021, 53 consecutive participants with suspected CAD who were scheduled for X-ray coronary angiography (CAG) were prospectively recruited in Zhongshan Hospital. CMRA was performed with a 3.0 T scanner without contrast agent enhancement during free breathing with Dixon water-fat separation and CS-SENSE methods. The accuracy of CMRA for detecting a ≥ 50% reduction in diameter was determined using CAG as the reference method.Results:Acquisition of whole-heart CMRA images was successfully performed in 46 (86.8%) of 53 patients with an average imaging time of (7.8±1.8) min. The sensitivity, specificity, positive predictive values, negative predictive values, and accuracy of CMRA according to a patient-based analysis were 95.8%(95%CI 78.9%-99.9%), 81.8%(95%CI 59.7%-94.8%), 85.2%(95%CI 66.3%-95.8%), 94.7%(95%CI 74.0%-99.9%), 89.1%(95%CI 76.4%-96.4%), respectively. The areas under the receiver-operator characteristic curve (AUC) from CMRA images according to patient-, vessel-and segment-based analyses were 0.876(95%CI 0.745-0.955), 0.880(95%CI 0.814-0.929), 0.903(95%CI 0.877-0.926), respectively.Conclusion:3.0 T non-contrast-enhanced Dixon water-fat separation CS-SENSE whole-heart CMRA is a promising technique to detect clinically significant coronary stenosis on patients with suspected CAD.

2.
Journal of Medical Biomechanics ; (6): E562-E567, 2020.
Article in Chinese | WPRIM | ID: wpr-862347

ABSTRACT

Objective To establish a method for non-invasive calculation of fractional flow reserve (FFRCT) with the shape resistance of coronary artery stenosis as boundary condition, and to verify the accuracy of this method. Methods CT angiography images of 16 patients with coronary artery disease were reconstructed; the mathematical model of shape resistance was established by considering the minimum cross-sectional area and the length of stenosis of coronary artery stenosis, the induced pressure difference as the boundary condition was applied to calculate FFRCT (named as shape resistance method ). The values of clinical FFR were taken as the gold standard, previous diameter method and volume method were taken as control method, and accuracy of shape resistance method was investigated from the aspects of mean error rate, accuracy rate, sensitivity rate, positive prediction rate and negative prediction rate. Results The mean error rate of calculated FFRCT by the diameter method, volume method and shape resistance method were 11.76%, 10.46%, 4.82%, the accuracy rates were 85%, 65%, 90%, the sensitivity rates were 87.5%, 66.7%, 87.5%, the positive prediction rate were 75%, 25%, 87.5%, respectively, while the negative prediction rates were all 91.6%. Conclusions The established shape resistance method is better than the diameter method and volume method from the aspects of mean error rate, accuracy rate, sensitivity rate and positive prediction rate; the FFRCT based on the shape resistance method and clinical FFR have good consistency, and this work may provide a new way for the calculation and application of FFRCT.

3.
Acta Academiae Medicinae Sinicae ; (6): 766-770, 2020.
Article in Chinese | WPRIM | ID: wpr-878675

ABSTRACT

Objective To analyze the correlation between tortuosity and stenosis in patients with myocardial bridge(MB)on the left anterior descending artery(LAD). Methods Data of patients with MB on the LAD,which was discovered by coronary computed tomography angiography(CCTA),in the Affiliated Hospital of North China University of Science and Technology from October 2015 to December 2018 were retrospectively analyzed.Among them 278 patients with tortuosity on LAD and 278 patients without tortuosity were selected.The clinical charateristics(age,gender,hypertension,hyperlipidemia,diabetes,smoking history,and family history)as well as the incidence and severity of stenosis of LAD were recorded and compared. Results The incidence of coronary artery stenosis in the non-tortuosity group(57.6%)was significantly lower than that in the tortuosity group(71.9%)($\bar{χ}$=12.608,


Subject(s)
Humans , China , Constriction, Pathologic , Coronary Angiography , Coronary Stenosis/epidemiology , Coronary Vessels/diagnostic imaging , Myocardial Bridging/pathology , Retrospective Studies
4.
Article | IMSEAR | ID: sea-194369

ABSTRACT

Background: Left Main Coronary Artery (LMCA) Disease is among the most complex forms of the coronary artery stenosis, the leading cause of mortality in the world.Methods: In this analysis, 102 patients with elective angioplasty for LMCA stenosis with PCI from 6/2013 to 5/2016, 3 years (70 in GenxSync™ arm and 32 in other devices arm; 100 DES and 2 BMS) were included. RADHIKa Analysis compared post-hoc subgroups of GenxSync™ and control groups.Results: Mean population age was 59.99±12.03 years; 60.27±10.49 years in GenxSync™ arm, and 58.31±14.32 years in control arm. A significant population (44, 43.14%) had diabetes, renal impairment (14, 13.73%) and hypertension (25, 24.51%). The MACCE in GenxSync™ arm was 17 13(18.58%) Versus 5(15.63%) [RR=0.93, RR’=-0.07, ?=-14.01. p=0.3). Most patients presented with unstable Angina (41, 40.20%) in all, 31(44.29%) in GenxSync™ and 10 (31.25%) in Control arm. AWMI and IWMI were 18, 17.65% each, attributed to 12 (17.14%) in GenxSync™ 6 (18.75%) in Control. Effort angina was 15(21.43%) in GenxSync™ and 10 (31.25%) in Control and NSTEMI was 25,24.51% (18 (25.71%)- GenxSync™ 7(21.88%) Control). The MACE in GenxSync™ arm at 24, 12 and 6 months was 12(17.15%), 8(11.43%) and 4(5.71%) respectively versus corresponding MACE in the control arm as 5(15.63%), 2(2.86%) and 2(6.25%) respectively. The TVR was present only in GenxSync™ Arm, which was contributed by 2 CABGs and 12 months and 1 additional PCI at 24 months.Conclusions: In real-world scenario of LMCA cases, performance and safety of various stents were similar. GenxSync™ Sirolimus Eluting Stent, in the post-hoc bifurcation had results similar to other real-world cases, based upon RADHIKa analysis.

5.
Article | IMSEAR | ID: sea-204916

ABSTRACT

Objective: To investigate the correlation between EFV and severity of coronary artery stenosis using cardiac-CT in CAD subjects at Hasan Sadikin Hospital Bandung. Methods: It is an analytical observational study with a crosssectional design using retrospective data with ANOVA and Chi-square statistical testing. The EFV and severity of coronary artery stenosis were quantified from diagnosed CAD subjects and underwent cardiac-CT in Hasan Sadikin Hospital Bandung from January2018-August 2018. Results: In 33 subjects there were 16 male (48.5%), 17 female (51.5%), there were 9 mild (27.3%), 9 moderate (27.3%), and 15 severe (45.5%) stenosis. Abnormal EFV (>125 ml) were 14 subjects (42.4%) found most in severe stenosis (30.3%). Chi-Square analysis showed that EFV had a significantly positive correlation with coronary artery stenosis (p=0.006), respectively. Conclusion: EFV demonstrated a positive correlation with the severity of coronary artery stenosis in CAD subjects using cardiac-CT at Hasan Sadikin Hospital, Bandung.

6.
Japanese Journal of Cardiovascular Surgery ; : 107-110, 2019.
Article in Japanese | WPRIM | ID: wpr-738363

ABSTRACT

Alkaptonuria is a rare genetic disease, in which amino acids and tyrosine cannot be processed. A 72-year-old man with a history of aortic valve stenosis presented with coronary 3-vessel disease. Intraoperative findings included ochronosis, which is pigmentation caused by the accumulation of homogentistic acids in connective tissues, or on the severely calcified aortic valve, the intima of the aorta, and the coronary arteries. The pigmented region of the coronary arteries had significant stenosis. Aortic valve replacement and coronary artery bypass were performed. From these findings and his past history of arthritis, we diagnosed alkaptonuria. The patient had an uneventful recovery.

7.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 223-226, 2019.
Article in Chinese | WPRIM | ID: wpr-746173

ABSTRACT

Objective To investigate the effects of coronary artery bypass grafting in different bypass grafts on survival rate,angina recurrence rate and cardiac function in patients with diffuse right coronary artery disease.Methods Sixty-four patients with diffuse right coronary artery stenosis admitted to the hospital were enrolled.All patients underwent coronary artery bypass grafting and were divided into large saphenous vein group(40 cases) and internal mammary artery group(24 cases) according to the difference of graft vessels.The follow-up survival rate,bypass graft vascular/cardiac venous patency rate,angina recurrence rate,NYHA classification before and after surgery,left ventricular ejection fraction(LVEF),and left ventricular diastolic end diameter(LVEDD) level of both groups were compared.Results Comparison in the same group,NYHA cardiac function grading,LVEF and LVEDD levels were better than those before surgery(P < 0.05).Compared with the great saphenous vein group,the difference of the venous patency/intracardiac venous patency rate and angina pectoris was better in the internal mammary artery group (P < 0.05).At 1 year after operation,there was no significant difference in NYHA cardiac function grading,LVEF,LVEDD level and follow-up survival rate(P >0.05).Conclusion There is no significant difference in follow-up survival rate and long-term improvement of cardiac function between patients with diffuse right coronary artery stenosis undergoing coronary venous artery bypass grafting with saphenous vein and internal mammary artery bypass graft.However,the internal mammary artery is more helpful to improve the patency of the bypass graft vessel/cardiac vein and avoid the recurrence of angina pectoris.

8.
Journal of Xi'an Jiaotong University(Medical Sciences) ; (6): 255-258, 2019.
Article in Chinese | WPRIM | ID: wpr-844048

ABSTRACT

Objective: To investigate the correlation of Apo-A and Apo-B/Apo-A ratio with the degree of coronary artery stenosis (CHD) in patients with coronary heart disease. Methods: Totally 234 patients with coronary heart disease examined with coronary angiography were collected. We collected blood lipid and calculated blood lipid ratio, such as non-HDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, and Apo-B/Apo-A. Gensini score was calculated according to the result of CAG. We analyzed the correlation between the blood lipid indicators and the Gensini score with the Spearman correlation analysis. Linear regression analysis was made of the correlation between those meaningful indicators and the Gensini score. Results: There were no significant differences in age, hypertension, diabetes or smoking index between all Gensini score groups. The illness course in middle-score group was longer than that in low-score group and high-score group (P=0.023, P=0.002). There was a significant difference in Apo-A between the groups (P=0.009, P<0.001, P=0.013). The levels of TC, Apo-B and LPα in high-score group were lower than those in low-score group (P=0.008, P=0.001, P=0.002). The levels of HDL-C and Apo-B/Apo-A ratio in both middle-score and high-score group were lower than those in low-score group (P=0.008, P=0.001). The Spearman correlation analysis between various risk factors and Gensini score found that HDL-C and Apo-A had negative correlation with Gensini score (r=-0.166, r=-0.294), the ratios of LDL-C/HDL-C and Apo-B/Apo-A were positively correlated with Gensini score (r=0.159, r=0.170). By multi-factor linear regression, Apo-A was negatively related with Gensini score (β=-62.249), and Apo-B/Apo-A ratio was positively associated with Gensini score (β =31.311). Conclusion: Apo-A and Apo-B/Apo-A ratios are the independent risk factors for the stenosis degree of coronary artery in patients with CHD. They are reliable predictors for the risk of CHD.

9.
Korean Circulation Journal ; : 179-190, 2018.
Article in English | WPRIM | ID: wpr-738692

ABSTRACT

The presence of myocardial ischemia is the most important prognostic factor in patients with coronary artery disease, and ischemia-directed revascularization has been a standard of care. Fractional flow reserve (FFR) is an invasive method used to detect the functionally significant epicardial coronary stenosis, and FFR-guided revascularization strategy has been proven to be superior to angiography-guided strategy. Recently, a hyperemia-free index, instantaneous wave free ratio (iFR), was developed and showed its non-inferiority for clinical outcomes compared with FFR-guided strategy. While evidence supporting the benefit of pressure wire assessment exists, there remain several unresolved issues, such as the mechanism of discordance between resting and hyperemic physiologic indices, clinical outcomes of patient/lesions with discordant results among the physiologic indices, role of physiologic indices beyond per-vessel decision tool, and the role of microvascular dysfunction in patient prognosis. The current article will review the recent studies performed to address these questions.


Subject(s)
Humans , Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Methods , Myocardial Ischemia , Prognosis , Standard of Care
10.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 395-398, 2018.
Article in English | WPRIM | ID: wpr-718914

ABSTRACT

Neo-aortic insufficiency associated with root enlargement following an arterial switch operation is a serious late complication. To achieve successful surgical correction of this condition, multiple factors should be considered, including the individual patient's anatomy, the challenging nature of the redo procedure, and the patient's young age. However, limited publications have described the use of valve-sparing techniques for the treatment of neo-aortic insufficiency associated with root enlargement following an arterial switch operation. Herein, we report our recent experience of a valve-sparing aortic root procedure with ascending aorta and hemiarch replacement despite the presence of a discrepancy in leaflet size and nearby severe adhesions.


Subject(s)
Humans , Aorta , Arterial Switch Operation , Coronary Stenosis , Reoperation , Replantation
11.
Tianjin Medical Journal ; (12): 104-109, 2018.
Article in Chinese | WPRIM | ID: wpr-697984

ABSTRACT

Osteoprotegerin (OPG), as a member of the tumor necrosis factor (TNF) superfamily, is a soluble secretary glycoprotein, which is accompanied with NF-κB receptor activator (RANK), NF-κB receptor activator ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) to form osteoprotegerin system. A large number of clinical and experimental studies have confirmed that osteoprotegerin system participates in physiological processes such as endothelial function, inflammatory reaction, oxidative stress and apoptosis, which is expected to be a biomarker for the occurrence, development, severity and long-term prognosis of coronary heart disease. In this paper, we summarized the biological effects and mechanism of the osteoprotegerin system in the occurrence and development of coronary heart disease and its future clinical application.

12.
Journal of Medical Research ; (12): 179-181, 2017.
Article in Chinese | WPRIM | ID: wpr-659170

ABSTRACT

Objective To evaluate the AASI in the prognosis of patients with coronary heart disease by investigating the correlation between ambulatory arterial stiffness index and degree of coronary artery stenosis and risk score.Methods A total of 187 patients admitted to our hospital with diagnosis of coronary heart disease from Januaty 2015 to June 2016 were grouped by AASI.We compared the data in different groups about common character,coronary lesion count and investigate the correlation between ambulatory arterial stiffness index and Gensini scores and GRACE score.Results The general clinical data:there were no significant differences in male patients,the proportion of smoking,blood lipids,urea nitrogen (BUN),creatinine (Cr),body mass index (BMI) between the two groups.Significant differences were observed in older patients and those with hypertension and diabetes.The number of disease dvessels,three vascular lesions in the increased AASI group was more than normal AASI group.AASI was correlated with total Gensini scores positively.AASI was correlated with GRACE score positively.Conclusion AASI not only helps estimate the degree of coronary artery stenosis lesions,but also can be used to predict the prognosis of coronary heart disease.

13.
Journal of Medical Research ; (12): 179-181, 2017.
Article in Chinese | WPRIM | ID: wpr-657279

ABSTRACT

Objective To evaluate the AASI in the prognosis of patients with coronary heart disease by investigating the correlation between ambulatory arterial stiffness index and degree of coronary artery stenosis and risk score.Methods A total of 187 patients admitted to our hospital with diagnosis of coronary heart disease from Januaty 2015 to June 2016 were grouped by AASI.We compared the data in different groups about common character,coronary lesion count and investigate the correlation between ambulatory arterial stiffness index and Gensini scores and GRACE score.Results The general clinical data:there were no significant differences in male patients,the proportion of smoking,blood lipids,urea nitrogen (BUN),creatinine (Cr),body mass index (BMI) between the two groups.Significant differences were observed in older patients and those with hypertension and diabetes.The number of disease dvessels,three vascular lesions in the increased AASI group was more than normal AASI group.AASI was correlated with total Gensini scores positively.AASI was correlated with GRACE score positively.Conclusion AASI not only helps estimate the degree of coronary artery stenosis lesions,but also can be used to predict the prognosis of coronary heart disease.

14.
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 673-676, 2017.
Article in Chinese | WPRIM | ID: wpr-711694

ABSTRACT

Objective To compare the outcome of combined and staged approach on concomitant carotid and coronary severe stenosis.Methods From March 2013 to May 2015,27 patients with concomitant carotid and coronary severe stenosis were treated by carotid endarterectomy and coronary artery bypass grafting,15 cases received one-stage operation and 12 staged.The basic characteristics,details during surgery,complications,quality of life score,hospital stay and cost were compared.Results 27 patients received carotid endarterectomy and off-pump coronary artery bypass grafting under general anesthesia.Revascularization were performed on 27 carotid and 82 coronary artery.The characteristics of patients were similar between two groups,reflected with WIC,combined approach subgroup was (5.27 ± 0.88) and staged subgroup was (4.92 ± 1.24).The operation time was significantly decreased in the synchronous group [(295.33 ± 49.73)min vs (390.83 ± 73.45) min,P < 0.001].Hospital stay days was also reduced [(30.20 ± 12.91) days vs(44.67 ± 6.34) days,P =0.002],the medical cost was lower in combined approach group,but no significant statistical difference.The complications including 1 case TIA,1 recurrent nerve injury in one-stage group and 1 case myocardial infarction,1 mediastinal bleeding post-operation and 1 pulmonary infection in stage group.No cerebral infarction and death.Quality of life scores(SF-36) of the two groups was 5.53 ± 1.30 and 5.75 ± 1.36 respectively,no significant difference.Conclusion The efficacy and safety of treatment for concomitant carotid and coronary severe stenosis patients with combined or staged approach was similar.But the combined approach program can reduce the hospital stay time and cost in some degree.

15.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 114-118, 2017.
Article in English | WPRIM | ID: wpr-169845

ABSTRACT

Kimura disease (KD) is an immune-mediated chronic inflammatory disease of unknown etiology. KD has many complications associated with hypereosinophilia, including various forms of allergic reactions and eosinophilic lung disease. Additionally, hypereosinophilia is associated with hypercoagulability, which may lead to thromboembolic events. A 36-year-old man with KD presented with acute limb ischemia and coronary artery occlusion. He underwent thrombectomy, partial endarterectomy of both popliteal arteries, and coronary artery stent insertion. KD is a systemic disease that affects many organs and presents with thromboembolism and vasculitis. In a patient with KD, physicians should evaluate the vascular system, including the coronary arteries.


Subject(s)
Adult , Humans , Angiolymphoid Hyperplasia with Eosinophilia , Coronary Artery Disease , Coronary Stenosis , Coronary Vessels , Endarterectomy , Eosinophils , Extremities , Hypersensitivity , Ischemia , Lung Diseases , Popliteal Artery , Stents , Thrombectomy , Thromboembolism , Thrombophilia , Vasculitis
16.
China Medical Equipment ; (12): 57-60, 2016.
Article in Chinese | WPRIM | ID: wpr-487618

ABSTRACT

Objective:To investigate the effect and application feasibility of low tube voltage, low concentration of contrast agent volume to CTA in the diagnosis of coronary artery stenosis and its effect.Methods: Seventy two cases of suspected patients with coronary atherosclerosis selected as the object Using random number table method, all patients were divided into group A and group B 36 cases in each group, two groups of patients underwent 320 slice CTA examination, in group A the tube voltage is 120kV, the contrast agent was 350mgI/mL iodixanol group, B tube voltage is set to 100kV, the contrast agent was 270mgI/mL iodixanol. According to the examination results of group A, group B and catheter coronary angiography (CCA), evaluated group A, group B of acquiring the image quality and radiation dose of patients, and analyzed the sensitivity of A, B and CCA examination of the extent of coronary artery stenosis degree and deliberately.Results: The quartering method showed no significant difference between the group A and the group B of image quality. There was significant difference between the two groups of patients with the image noise and enhance the effect (t=-4.736, 11.927;P<0.05); Group B of coronary artery stenoses (more than 50%) and severe stenosis (more than 75%) sensitivity, specially degree and coincidence rate compared with the results of CCA showed no significant difference. Kappa consistency analysis showed that the two consistency is good(kappa=1.320,P<0.001).Conclusion: In the premise of ensuring the image quality with low tube voltage, low concentration of contrast agent volume coronary CTA examination had safety and reliability of inspection.

17.
Journal of Xi'an Jiaotong University(Medical Sciences) ; (6): 344-348, 2016.
Article in Chinese | WPRIM | ID: wpr-492444

ABSTRACT

Objective To investigate the relationship of glycated hemoglobin (HbA1c),fibrinogen (Fbg)and cystatin C (Cys C)with the severity of coronary artery lesions in non-diabetic patients.Methods We enrolled 358 patients who received coronary angiography (CAG)in this study.They were divided into coronary artery disease (CAD)group and non-CAD group according to CAG results.Moreover,according to different clinical types of CAD,all the CAD patients were further classified into stable angina pectoris (SAP)group and acute coronary syndrome (ACS)group.We calculated Gensini score and divided CAD group into A,B and C subgroups by Gensini score.HbA1 c,Fbg,Cys C and other clinical data were measured and compared between groups,and the correlation analysis was used to find the relationship of HbA1c,Fbg and Cys C with Gensini score.Results The levels of HbA1 c,Fbg and Cys C were significantly higher in groups A,B and C than in non-CAD group.When Gensini score increased,the three indexes were increased too (P<0.05).The levels of HbA1c,Fbg and Cys C were significantly higher in ACS group than in SAP and non-CAD group (P<0.05).After adjustment for the influencing factors, HbA1 c was still associated with Fbg (P<0 .0 5 ).The levels of HbA1 c and Fbg were closely related to Gensini score (P<0.05).Conclusion In non-diabetes patients,HbA1c and Fbg are significantly related to the severity of coronary artery stenosis,and Cys C may not be an independent risk factor of coronary artery stenosis.

18.
Rev. chil. cardiol ; 35(2): 177-182, 2016.
Article in Spanish | LILACS | ID: lil-796806

ABSTRACT

La angiografía coronaria ha sido y continúa siendo el pilar sobre el cual se deciden las intervenciones terapéuticas en la enfermedad coronaria constituyendo el grado de estenosis de las placas ateromatosas uno de los principales marcadores de isquemia miocárdica y por lo tanto del pronóstico de la enfermedad. Sin embargo, es un hecho repetidamente documentado que los fenómenos coronarios agudos se producen con mayor frecuencia en placas con estenosis angiográficamente no significativas; por lo tanto, la vulnerabilidad de las placas no parece tener relación con su grado de estenosis y en consecuencia tampoco con la producción de isquemia miocárdica. Esta conclusión no concuerda con los hallazgos histopatológicos ni con los grados de severidad de las estenosis que comprometen el flujo coronario. El objetivo de la presente comunicación es tratar de aclarar esta controversia analizando la información entregada por la histopatología de las lesiones agudas culpables de los infartos. Precisar si las lesiones coronarias crónicas que producen isquemia (probables causantes de futuros infartos) se correlacionan con el grado de estenosis anatómica; proponer el posible mecanismo que vincula el grado de estenosis a la vulnerabilidad de las placas y esbozar una explicación para conciliar los hallazgos angiográficos con los his-topatológicos y funcionales.


Coronary angiography has long been and is still the basic method for deciding coronary interventions, and the severity of stenosis remains the main prognostic marker of the disease. However, plaque vulnerability does not appear to be associated with a greater degree of angiographic stenosis, which is not consistent with histopathological findings or with physiological assessment of ischemia-producing lesions. The purpose of this article is to briefly review this controversy while suggesting that plaques vulnerability correlate with the degree of anatomical and functional stenosis, and to describe the potential mechanism that could determine this vulnerability as well as to give likely explanations that reconcile angiographic findings with histopathological and functional observations.


Subject(s)
Humans , Coronary Angiography , Coronary Stenosis/diagnostic imaging , Myocardial Infarction/etiology , Severity of Illness Index , Coronary Vessels/injuries , Coronary Stenosis/complications , Coronary Stenosis/physiopathology , Coronary Stenosis/pathology , Plaque, Atherosclerotic
19.
Journal of Interventional Radiology ; (12): 1044-1046, 2015.
Article in Chinese | WPRIM | ID: wpr-485122

ABSTRACT

Objective To evaluate the diagnostic accuracy of dual source CT angiography (DSCTA) for coronary artery stenosis.Methods During the period from November 2012 to November 2013, a total of 210 patients with coronary artery disease underwent DSCTA and selective coronary arteriography (CAG). Taking CAG as the gold standard, the diagnostic accuracy of DSCTA for coronary artery stenosis was evaluated. Thirty patients receiving DSCTA and 30 patients receiving CAG were selected, and all of them underwent stent implantation in the anterior descending branch after imaging examination. The angiography positions, the used time of PCI and the used dosage of contrast agent were compared between the two groups. Results DSCTA was performed in 210 patients and a total of 2 630 segments of coronary stenosis or occlusion were detected. Compared with CAG, the diagnostic sensitivity, specificity, positive predictive value and negative predictive value of DSCTA were 95.4%, 96.2%, 91.3%and 100%respectively, which were not significantly different from those obtained by CAG (P=0.066). In performing DSCTA, 2-3 angiography positions were used (2-4 positions less than that of CAG), the used time of PCI was about 15 min (about 10 min less than that of CAG), and the mean used dosage of contrast agent was 48 ml (30-150 ml) (about half less than that of CAG). Conclusion DSCTA has higher accuracy in diagnosing coronary artery stenosis, quite similar to that of CAG. DSCTA is a safe, reliable and noninvasive examination method. Preoperative DSCTA can reduce exposure positions during angiography, can reduce the dosage of contrast agent, and can shorten the time of PCI as well, thus, iatrogenic radioactive radiation dose can be reduced.

20.
Journal of Xi'an Jiaotong University(Medical Sciences) ; (6): 801-805, 2015.
Article in Chinese | WPRIM | ID: wpr-481152

ABSTRACT

Objective To study the correlation between single point pulse wave velocity (PWVβ)of different peripheral arteries and coronary artery stenosis quantity obtained by coronary arteriongraphy so as to explore the diagnostic value of PWVβin coronary heart disease.Methods We made a retrospective analysis of 183 patients receiving coronary arteriongraphy in our hospital from October 2013 to May 2014.Based on stenosis quantity of coronary artery,the patients were divided into one-vessel lesion group,double-vessel lesion group,multi-vessel lesion group,and nonstenosis as control group.Clinical data of all the patients were collected before coronary arteriongraphy.Different peripheral artery PWVβwas measured with vascular echo tracking (ET)technology for statistical analysis.Results As the lesion vessel number increased,PWVβandβvalues in three peripheral arteries presented a rising tendency.Correlation analysis indicated that PWVβvalues in the three peripheral arteries showed a positive correlation with coronary artery involvement degree.The correlation between PWVβvalue of the common carotid artery and coronary artery involvement degree was most obvious,followed by the femoral artery and the popliteal artery.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of the common carotid artery PWVβvalue to diagnose coronary heart disease were 91.2%,84.5%,92.7%,81.7 and 0.76,respectively.Non-conditional multi-factor Logistic regression analysis was implemented by choosing age, sex,smoking history,hypertension history,diabetes history,hyperlipemia,BMI,HDL-C,LDL-C,TC,TG,GLU,SBP,DBP,UA,Cr,and PWVβ value as independent variables,and the degree of coronary artery disease as dependent variable.The results revealed that age,hypertension history,diabetes history,and PWVβ value were independent risk factors for coronary heart disease.Conclusion PWVβ value can be regarded as one index for observing artherosclerosis lesion degree and predicting early lesion.PWVβvalue of the common carotid artery can be an important index for dynamically observing the occurrence and development of artherosclerosis.

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