RESUMO
@#Association between diagonal earlobe crease (DELC), also known as Frank’s sign and CAD was first found by Sanders T. Frank in 1973. Since its first description, others have shown it to be associated with the presence, as well as the extent and severity of CAD, independent of traditional CAD risk factors, such as serum lipids, diabetes mellitus, and smoking status.DELC is also associated with higher risk of major adverse cardiac events in patients with known CAD.Recent studies have suggested that DELC may also be a marker of generalized atherosclerotic disease. This study evaluates the association between the presence of diagonal earlobe creases (DELC) and coronary artery disease (CAD). Four hundred people (246 men and 154 women, aged 28 to 92 years) were examined for the presence of DELC.400 people participated. In case group 200 people(142 men and 58 women, aged 30-87) who were getting treatment at State’s central 3rd hospital participated. In control group 200 people(104 men and 96 women, aged 28-92 who were getting treatment at State’s central 3rd hospital, National Traumatology Center included.We did statistic processing with MS Excel 2013, SPSS 20.0 DELC was present in 164 patients (82%) and absent in 36 patients (18%) of 200 participants documented with CAD (presence of > or = 50% coronary diameter stenosis at angiography). DELC was present in 42 people (21%) and absent in 158 people (79%) of 200 people documented without CAD. 82% of individuals with CAD had DELC. There was significant association between diagonal earlobe crease (DELC) and coronary artery disease (CAD), (p=0.039).
RESUMO
Objective To investigate the characteristics of risk factors and coronary angiography (CAG)in young patients with acute myocardial infarction(AMI).Methods A total of 36 consecutive AMI female patients (age≤44 years)who underwent coronary angiography were retrospectively retrieved from the database,and 90 AMI patients whose age >44 years who also underwent coronary angiography were enrolled as a control (elderly)group.Characteristics of risk factors and coronary angiography were com-pared between the two groups.Results The risk factors:BMI,family history of coronary heart disease and high triglycerides(TG)were major in the youth group.The percentage of single-branch lesion was lower in the young patients.The prevalence of left anterior descending (LAD)was higher in the young patients(P <0.05).Conclusions The main risk factors in young and elderly patients are significantly different.The out-comes of CAG in the young patients show the coronary lesion are mostly single vessel lesion,and early inter-vention may improve prognosis.
RESUMO
Objective To investigate the image quality and radiation dose of 640-slice CT coronary arteriography(CTCA) with adaptive iterative dose reduction three-dimensional (AIDR3D)reconstrucction algoritym.Methods 640-slice CTCA with auto-matic exposure was performed on 84 consecutive patients.The original image data were reconstructed with AIDR3D and the filtered back-projection (FBP)algorithms at the image postprocessing workstation.Two experienced radiologists without knowing clinical information and reconstruction algorithms independently measured and calculated the image noise,signal-to-noise ratio and contrast-to-noise ratio with AIDR3D and FBP reconstruction algorithms.The qualitative image quality was assessed by using the 4-point scale.The radiation dose was calculated based on dose-length product exported on CT scanner.The quantitative and qualitative im-age quality with two kinds of reconstruction algorithm was analyzed statistically.Results The CTCA image noise was (27.20± 4.40)HU with AIDR3D and (60.00±12.40)HU with FBP,which with AIDR3D was decreased by 46.10% than that with FBP;the signal-to-noise ratio was 21.10 ± 5.10 with AIDR3D and 11.40 ± 2.80 with FBP,which with AIDR3D was increased by 84.70% than that with FBP;the contrast-to-noise ratio was 24.70±5.10 with AIDR3D and 13.50±3.20 with FBP,which with AIDR3D was raised by 82.20% than that with FBP,the differences in 3 indexes between the two kinds of reconstruction algorithm were statistically significant(P < 0.05 ).The CTCA qualitative image quality scores of proximal,middle and distal parts with AIDR3D were (3.90±0.30),(3.70±0.50)and (3.60±0.60)respectively,which all were higher than (2.60±0.60),(2.30± 0.60)and (2.10±0.70)with FBP respectively,the differences in 3 items between 2 kinds of algorithm had statistical significance (P <0.05).The total segments which could be used to diagnose the CTCA images with AIDR3D and FBP algorithms were 1 216 segments (96.50%)and 504 segments (40.00%),respectively,the difference had statistical significance(P <0.05).The mean ef-fective radiation dose was (2.10±1.00)mSv.Conclusion 640-slice CTCA with AIDR3D reconstruction algorithm not only signifi-cantly reduces the image noise than the conventional FBP algorithm,improves the quantitative and qualitative image quality,but also decreases the effective radiation dose.
RESUMO
Objective To investigate the feasibility of double low scanning technique using the gem spectrum CT coronary artery angiography among the patients at low heart rate≤ 65 beats per minute.Methods This prospective study was approved by the institutional re-view board with patient informed consent.Ninty patients (heart rate≤65 beats per minute)were randomly devided into 3 groups.Group A un-derwent spectral CCTA with iodixanol (Visipaque,270mg/mL)and low scanning technique,Group B conventional CCTA with iohexol (Omnipaque,370 mg/mL)and Group C conventional CCTA with iodixanol (Visipaque,270 mg/mL),Routine scan mode was used in Group B and Group C.Prospective ECG gating mode was used in all groups.120kVp polychromatic images with FBP algorithm (Group B and Group C)were reconstructed for conventional CCTA,60 keV monochromatic images with FBP algorithm (Group A) or with a fixed blending level (40%)of ASiR (Group A1 )were reconstructed for spectral CCTA.Compared the image quality of four groups and ED in three groups.Results The difference was ststistically significant between four groups with the CT value,im-age noise,SNR and CNR of coronary (each P<0.001.Group A1 has the highest SNR and CNR.Group C has the lowest image noise.There were no significant difference of coronary score between group A1 and group B(χ2=0.01,P=1.000)).There was significant difference of coronary score between group A and group B (χ2=22.428,P<0.001),group B and group C (χ2=39.005,P<0.001), group A1 and group A (χ2=21.854,P<0.001).Effective radiation dose in the group A(ED2.60±0.26 mSv)was lower than that of group B (ED3.02±0.36 mSv)(t=3.738,P=0.001)and group C (ED3.11±0.23)(t=3.725,P=0.001).Conclusion Double low scan-ning technique using the gem spectrum CT coronary artery angiography with 40% blending level of ASiR is able to provide better im-age quality than using conventional CCTA and to reduce the effective radiation dose and contrast dose.
RESUMO
Objective To investigate the relationship of resting electrocardiogram (ECG) ST-T wave change and posi-tive outcome of coronary angiography (CAG). Methods A comparison was made between CAG results and routine 12-channel resting ECG of 1173 patients diagnosed as coronary heart disease (CHD) clinically in cardiovascular depart-ment of internal medicine in the first affiliated hospital of Chongqing medical university ,and their correlation was ana-lyzed. Results ECG ST-T change was not significantly correlated to the CAG positive outcome (Kappa=0.161,P<0.01);There was significant difference of the positive rates between those two examinations(P<0.01);The ECG positive result rates in different coronary artery lesion groups were significantly different (P<0.01); With the increase of coro-nary artery stenosis number, the positive rate of ECG significantly increased. (P<0.01). Conclusion ECG ST-T wave change might partially predict the coronary artery stenosis, but its clinical utility is limited for CHD diagosis compared with CAG. Therefore,it should be careful to diagnose CHD only according to ECG ST-T change in clinic,and clinical diagnosis shuld be made based on clinical symptom and other examinations.
RESUMO
Objective To compare coronary artery abnormality between patients with silent myocardial ischemia (SMI)and pa-tients with symptomatic myocardial ischemia using coronary artery CT angiography.Methods Forty-three patients with SMI and 45 patients with symptomatic myocardial ischemia were collected and underwent coronary CT angiography using 128-slices spiral CT scanner,respectively.Results Stenosis of coronary artery detected in 23 patients with SMI was (23/43,53.49%),and stenosis in 21 patients with symptomatic myocardial ischemia was (21/45,46.67%).The difference of incidence had no statistical significance, but the degree of stenosis and the number of stenosis vessel had statistical significance(P <0.05).The number of atherosclerotic plaque of coronary artery detected in patients with symptomatic myocardial ischemia was significantly more than that in patients with SMI(P <0.05).Conclusion There are no significant difference in the incidence of coronary stenosis between the patients with SMI and patients with symptomatic myocardial ischemia.However,the degree of stenosis and incidence of atherosclerotic plaque are sig-nificant different.
RESUMO
Objective To determine the diagnostic value of the change of different parts of electrocardiogram in treadmill exercise test (TET) for coronary heart disease (CHD).MethodsFrom Jan.2006 to Mar.2011,445 patients with CHD underwent treadmill exercise test and coronary angiography (CAG) in our hospital.We analyzed retrospectively the diagnostic value of the change of different parts of electrocardiogram in TET test.Results ( 1 ) There were 200 cases who had positive results during treadmill exercise test and 150 cases of them had been diagnosed of CHD by coronary angiography;The other 245 cases had negative results during treadmill exercise test and 39 cases of them had been diagnosed as CHD by coronary angiography.The sensitivity and specificity rates of treadmill exercise test in diagnosis of CHD were 79.36％( 150/189 ) and 80.47％ ( 206/256 ) respectively. ( 2 ) Of the 200 positive cases tested by coronary angiography,150 cases were diagnosed of CHD,including 22,58 and 70 cases with limb,chest and combined chest and limb leads positive results respectively.The positive rates for the groups of combined chest and limb leads and limb ST leads were significantly higher than that of the chest leads only group ( x2:6.34,3.93 ; P ＜0.05).(3)R wave amplitude of the CAG negative group after exercise (17.54 ± 2.52)mm was significantly lower than the CAG positive group ( 19.42 ± 3.46 )mm ( t =6.33,P ＜ 0.05 ).( 4 ) For the 200 cases with positive TET,there were no significant statistical difference ( P ＞ 0.05 ) on CAG positive rate between T wave normalization group [ 73.3％ (44/60) ] with and TET positive group [ 75.0％ (105/140) ].But these two groups had significantly higher ( x2:80.21,132.82 ; P ＜ 0.05 ) CAG positive rates than TET negative group [ 15.9％ (39/245) ].ConclusionThe treadmill exercise test is valuable in noninvasive diagnosis of CHD.The severity of CAG can be preliminarily estimated by analyzing the pattern of the change of different parts of electrocardiogram
RESUMO
OBJECTIVE: We wanted to evaluate the impact of two reconstruction algorithms (halfscan and multisector) on the image quality and the accuracy of measuring the severity of coronary stenoses by using a pulsating cardiac phantom with different heart rates (HRs). MATERIALS AND METHODS: Simulated coronary arteries with different stenotic severities (25, 50, 75%) and different luminal diameters (3, 4, 5 mm) were scanned with a fixed pitch of 0.16 and a 0.35 second gantry rotation time on a 64-slice multidetector CT. Both reconstruction algorithms (halfscan and multisector) were applied to HRs of 40-120 beats per minute (bpm) at 10 bpm intervals. Three experienced radiologists visually assessed the image quality and they manually measured the stenotic severity. RESULTS: Fewer measurement errors occurred with multisector reconstruction (p = 0.05), a slower HR (p < 0.001) and a larger luminal diameter (p = 0.014); measurement errors were not related with the observers or the stenotic severity. There was no significant difference in measurements as for the reconstruction algorithms below an HR of 70 bpm. More nonassessable segments were visualized with halfscan reconstruction (p = 0.004) and higher HRs (p < 0.001). Halfscan reconstruction had better quality scores when the HR was below 60 bpm, while multisector reconstruction had better quality scores when the HR was above 90 bpm. For the HRs between 60 and 90 bpm, both reconstruction modes had similar quality scores. With excluding the nonassessable segments, both reconstruction algorithms achieved a similar mean measured stenotic severity and similar standard deviations. CONCLUSION: At a higher HR (above 90 bpm), multisector reconstruction had better temporal resolution, fewer nonassessable segments, better quality scores and better accuracy of measuring the stenotic severity in this phantom study.
Assuntos
Algoritmos , Artefatos , Simulação por Computador , Angiografia Coronária/métodos , Estenose Coronária/diagnóstico por imagem , Eletrocardiografia , Frequência Cardíaca , Processamento de Imagem Assistida por Computador/métodos , Modelos Cardiovasculares , Variações Dependentes do Observador , Imagens de Fantasmas , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Tomografia Computadorizada Espiral/métodosRESUMO
Objective To observe the role of dual-source CT (DSCT) in the diagnosis of coronary artery fistula. Methods Nine patients with coronary artery fistula were examined with dual-source CT coronary artery angiography. Then the source images were post processed using volume rendering (VR), multiple planar reformation (MPR), maximum intensity projection (MIP) and curved planar reformation (CPR), and sequential segmental analysis of the intracardiac and extracardiac anomalies was performed. Results Coronary artery fistula in all the 9 patients were accurately displayed with DSCT, including 2 with left main trunk to right ventricle fistula, 7 with left main trunk and (or) left anterior descending artery to main pulmonary trunk fistula, 5 with complex coronary-pulmonary artery fistula. Conclusion Dual-source CT coronary artery angiography is convenient, fast, non-invasive, and may be the preferable method for diagnosis of coronary artery fistula.
RESUMO
Objective To investigate the clinical characteristics of the results of coronary artery CT angiography and coronary artery angiography in 36 patients with probable positive results of treadmill exercise test(TET).Methods Thirty-six patients due to chest pain received 1ET and coronary artery CT angiography and coronary artery angiography in 2 weeks after admission.The coronary plaques were categorized as noncalcified and calcified plaque on CTA images.Results In 36 patients with probable positive results of TET.23 patients were confirmed as coronary artery disease by coronary artery angiography,and the other 13patients had normal coronary artery.Of 23 coronary artery disease patients,9 patients were presented as onevessel disease,5 patients were presented as two-vessel disease,and 9 patients were presented as three-vessel disease,29 non-calcified plaques and 23 calcified plaques were demeted On CTA.Conclusion TET was useful in confirming the diagnosis of coronary artery disease.The characteristics of the coronary artery plaque is correlated with probable positive results of TET.
RESUMO
Objective To study the clinical characteristics of acute non-ST segment elevation myocardial infarction(NSTEMI).Methods 211 patients of NSTEMI and STEMI underwent coronary artery angiography and echocardiogram.Patients'history and symptome were collected and the data of coronary artery angiography and echocardiogram were analyzed.Results Compared with STEMI,NSTEMI patients had more risk factors and postinfarction angina pectoris;severe coronary artery disease and three coronary vessel disease.But NSTEMI had relatively little effects on cardiac function.Conclusion NSTEMI always has more severe coronary artery disease and postinfarction ischemic effects.So more attention should be paid to its standard therapy.
RESUMO
Objective To investigate the relationship between serum uric acid(SUA)and clinic characteristics and result of coronary artery angiography of patients with coronary heart disease(CHD).Methods Two hundreds and seven patients for coronary artery angiography were divided into CHD group and control group.Their clinical data and results of coronary artery angiography were analyzed through statistics.Results SUA levels of CHD patients were significantly higher than the control subjects SUA(P
RESUMO
Objective To study the safety and the comfort degree for patients after coronary artery angiography without heparin when shorten their in-bed time. Methods 490 patients after coronary artery angiography without heparin were in the observation group,512 patients after coronary artery angiography with heparin were in the control group.Different immobilization methods were adopted in the different group,and then compared the incidence rates of complications between the 2 groups. Results There was no significant difference between the observation group and the control group in the hemorrhage rate after the puncture,P
RESUMO
Objective To study the relationship between Noble grade and distribution of myocardial bridge and atherosclerosis. Methods The clinical data of 192 patients with myocardial bridge diagnosed by coronary artery angiography were retrospectively analysed.The clinical symptoms,electrocardiographic and echocardiographic findings were analysed to explore the relationship between Noble grade and distribution of myocardial bridge and atherosclerosis,and the outcomes of medical treatment were also investigated. Results The positive rate of myocardial bridge detected by coronary artery angiography was 10.2%,which was usually observed in the middle part of left anterior descending coronary artery.All the patients with grade 3 of Noble grade experienced chest pain or palpitation,43.8% had ischemic ST-T changes on electrocardiogram,and 37.5% had abnormal segmental ventricular wall on echocardiography.However,patients with Noble grade 1 and 2 did not have ischemic ST-T changes on electrocardiogram or abnormal segmental ventricular wall on echocardiography.The prevalence of atherosclerosis in proximal coronary artery of myocardial bridge was significantly higher than those of mural coronary artery and distal coronary artery(P
RESUMO
Objective To evaluate the significance of myocardial bridge and find a reasonable diagnosis and treatment strategy.Methods Sixty-three myocardial bridge patients and sixty-three patients with negative results of coronary artery angiography were reviewed.The clinical data of symptoms,electrocardiogram,exercise tests,coronary artery angiography,therapeutics and the serum levels of C-reactive protein(CRP)were analyzed.Results The symptoms of chest distress and chest pain were found in myocardial bridge patients.Myocardial consumption of oxygen augmentation causes the symptoms of aggravation.Positive results of electrocardiogram and exercise tests in many of myocardial bridge patients were examined.There were no relationship with severity of myocardial bridge artery stenosis.Most of myocardial bridge were discovered in anterior descending branch.At present,the main treatment of myocardial bridge was drug therapeutics.After treatment,the serum levels of CRP was significantly decreased.Conclusion Myocardial bridge was anatomy abnormality with important clinical significance.The serum levels of CRP can be used to evalue the therapeutic efficacy of myocardial bridge.
RESUMO
Objective To evaluate the diagnostic value and limits of 64-slice spiral coronary artery imaging,by com- parison with selective coronary angiography,in detection of coronary heart disease.Methods Fourty-two patients sus- pected CAD were performed 64-slice spiral CT coronary imaging and selective coronary artery angiography in two weeks, comparative analysis of results were progressed consequently.Results The sensitivity,specificity and positive and nega- tive predictive value to identify≥50% stenosis branches was 90.5%,96.6%,85.9% and 97.8%,respectively.The sen- sitivity,specificity and positive and negative predictive value to identify≥75% stenosis branches was 93.5%,98.9%, 87.9% and99.4%,respectively.Conclusion As a noinvasive quantitative assessment of coronary artery stenoses exami- nation,64-slice spiral CT is a valuable method to detect and diagnose the disease of coronary artery,but its clinical use maybe presently be limited due to image quality in a number of cases.
RESUMO
Objective To identify the different causes of atrial fibrillation (AF) in Chinese by coronary artery angiography,and to compare the episode of stroke in different patients.Method A total of 782 adult patients diagnosed with AF were identified from Anzhen Hospital over a 8-year period.There were 273 patients with rheumatic valvular AF and 509 patients with nonvalvular AF.The results of electrocardiogram,echocardiography and coronary artery angiography were retrospectiwely analyzed to find out the proportion of causes and to compare the episode of stroke in patients with rheumatic valvular AF with those having nonvalvular AF.Results The patients with rheumatic valvular atrial were significantly younger than of coronary heart disease (52.40?5.03 years old vs 64.30?3.25 years old,P
RESUMO
Objective Although congenital heart diseases are uncommon in the elderly, coronary artery anomalies may be incidentally discovered in old age. We sought to determine the incidence and clinical features of coronary artery anomalies (CAAs) in patients over 65 years of age. Patients and methods Medical records of patients undergoing coronary artery angiography in the years 1997-2002 at the Legnago General Hospital were retrospectively reviewed, The clinical profiles of all patients with CAAs and CAA subtypes were noted. Comparison between patients under and over 65 was performed. Data are given as mean standard deviation and as percentages. Results Sixtysix patients (1.21%, Female/Male 22/44, mean age 65.3 ± 10.6 years) out of the 5450 who underwent coronary angiography in the years 1997-2002 had CAAs. In mast cases (63%, 41/66 patients), the patients were over 65.CAAs were discovered incidentally in these elderly patients while undergoing coronary artery angiography for dilated cardiomyopathy, ischemic heart disease, and valvular heart disease in 75% of the cases (30/41 patients). Patients over 65 had more cardiac comorbidities and .a higher incidence of coronary atherosclerosis. Conclusions The angiographic incidence of CAAs in elderly patients is increasing as the population ages and this occurrence calls for a wider knowledge of the anatomy and pathophysiology of CAAs among geriatric cardiologists. Elderly patients seem to present with lower risk coronary anomalies (separated origin of left anterior descending coronary artery and circanfflex artery, origin of circumflex artery from the right sinus or the right coronary artery, double coronary artery)but have a higher risk profile compared to younger patients due to the frequency of cardiac comorbidities and superimposed coronary artery atherosclerosis.
RESUMO
BACKGROUND: There have been many reports of coronary angiographic findings aft er coronay bypass grafting,most of which are focused on the graft patency rate of the bypass conduits. However,postoperative angiography can provide numerous informations other than patency rates that are useful for establishing operative strategy. MATERIAL AND METHOD: We studied 73 patients in whom coronary angiography was done after more than 1 month of CABG.Mean interval from the operation to coronary angiography was 10.6 months and the reasons for coronary angiography follow up were residual or recurrent angina in 54 patients, abnormalities on myocardial perfusion scan or echocardiography in 13 patients,and for simple follow up in 6 patients. RESULT: Overall graft patency rate was 80.9% (internal thoracic artery 100%,saphenous vein 75.0%) in patients of simple follow up and 61.6% (internal thoracic artery 81.1%,saphenous vein 55.3%) in patients with ischemia. Progression of native coronary arterial disease proximal to the grafting site was found in 50 patients(68.5%). Among 201 coronary arterial branches that had not been completely occluded preoperatively, ninty five branches(47.3%)revealed progression of diameter stenosis by more than 20%on the follow up study. Among them,64 branches(31.8%)progressed to total occlusion.The incidence of disease progression was highter in the coronary arteries with patent grafts (57.5%)than in those with occluded grafts(36.3%)(p < 0.05). Comparing internal thoracic artery graft with saphenous vein graft, internal thoracic artery was superior to saphenous vein,not only in terms of patency(83.3% vs 56.6%), but also in terms of result of later percutaneous intervention success rate(100% vs 62%,p < 0.05). CONCLUSION: Due to the considerable incidence of progression of native coronary artery stenosis in the early postoperative periods, bypass grafting of a vessel with borderline stenosis,especially with vein graft,must be done prudently. And it was confirmed again that revascularization of left anterior descending artery is most important and that internal thoracic artery was superior to saphenous vein.
Assuntos
Humanos , Angiografia , Artérias , Constrição Patológica , Angiografia Coronária , Ponte de Artéria Coronária , Estenose Coronária , Vasos Coronários , Progressão da Doença , Ecocardiografia , Seguimentos , Incidência , Isquemia , Artéria Torácica Interna , Perfusão , Período Pós-Operatório , Veia Safena , Artérias Torácicas , Transplantes , VeiasRESUMO
Objective: To investigate the findings of coronary artery angiography in coronary artery disease patients with diabetes mellitus. Methods: The angiographic fingings of 153 coronary artery disease patients from 1995 to 1997 were reviewed. Among them, 33 were diabetic,23 were impaired glucose tolerance(IGT) and 97 were nondiabetic patients. Results: The age, sex, hypertension, hypercholesterolemia, smoking and the rate of myocardial infarction were the same among 3 groups. But the 2 vessel and 3 vessel disease were more frequent in diabetic group(66.7% ,30.3%) than in nondiabetic group (26.8%,19 6%). Two vessel disease were more frequent in diabetic group(66.7%) than in IGT group (13.1%). Single vessel disease were less frequent in diabetic group(3.0%) than in IGT group(52.2%)and nondiabetic group(53.6%)( P