No Abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Cardiology*

Rationale: Coronary artery disease (CAD) is the leading cause of death worldwide and coronary angiography (CA) remains the gold standard for its diagnosis. However, proper patient selection for CA is important to avoid unnecessary risks and expense. The American College of Cardiology (ACC), with other major organizations, developed Appropriate Use Criteria (AUC) for CA. AUC assist clinicians in decision making on whether to use the tests according to indications and objectively assess if these tests are appropriately utilized. This is the first study to determine the appropriateness of CA performed and the clinical and angiographic profile among adult service patients in UP-PGH. Objectives: To determine (1) the indications for CA and its appropriateness based on 2012 AUC for Diagnostic Catheterization by the ACC, (2) the clinical profile of patients who underwent CA among adult service patients at UP-PGH and (3) the angiographic profile of these patients. Methods: This cross-sectional study included all CA studies performed on adult service patients from January to December 2019. Demographic and clinical profiles, non-invasive tests, and angiographic findings were collected. The primary outcome determined was the appropriateness of the indications for each CA performed based on AUC scores. Descriptive analysis using frequencies and mean values with standard deviations were used. Results: Among the 515 patients included, majority were males, above 50 years of age, with normal eGFR, presented initially with chest pain, and with a presenting diagnosis of chronic coronary syndrome. Majority of these patients had obstructive CAD (75%), with left anterior descending artery as the most frequently involved vessel. Non-obstructive CAD was found in 11% while normal coronaries were noted in 14% of these patients. Our findings showed that 99.8% of the CA performed were appropriate, of which majority (54%) had an AUC score of A9. STEMI or a suspicion of STEMI, with an A9 score, was the most frequently encountered indication at 33% of the time. Conclusion Majority (99%) of the CA studies performed in the PGH cardiac catheterization laboratory for the year 2019 were executed based on highly appropriate indications (AUC scores A7 to A9) and followed Class I and II recommendations from guidelines. The allocation of resources is deemed to be well-utilized based on the data generated from this study.
Coronary Angiography ; Cardiac Catheterization

Cardiac Catheterization ; Coronary Angiography ; Humans

Cardiac Catheterization ; standards ; Coronary Angiography ; Humans

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Exercise Tolerance* ; Humans ; Tetralogy of Fallot*

BACKGROUND: Early mitral inflow velocity(E) corrected for the influence of LV relaxation could give information about LV filling pressure. Early diastolic mitral annulus velocity(E') is a relatively load independent parameter reflecting LV relaxation. Therefore, correction for the influence of LV relaxation could be done with the ratio of early mitral inflow velocity to early mitral annulus velocity(E/E'). The aim of this study was to investigate the clinical utility of E/E' ratio in a large number of patients. METHODS: Simultaneous left ventricular pressure measurements and Doppler examinations were performed in 200 consecutive patients at the cardiac catheterization laboratory. RESULTS: E/E' ratio correlated well with pre-A pressure(r=0.74, p<0.001) regardless of LV systolic function(EF> or =50%; r=0.74, p<0.001 vs EF<50%; r=0.70, p<0.001). E/E' ratio of 9 best predicted the elevated(>12mmHg) pre-A pressure with the sensitivity of 81% and specificity of 80%. LV pre-A pressure could be estimated with the simplified equation of [pre-A pressure=E/E'+4]. CONCLUSIONS: E/E' ratio is useful in the estimation of LV filling pressure and in contrast to the conventional parameters, it is not dependent on the left ventricular systolic function.
Cardiac Catheterization ; Cardiac Catheters ; Humans ; Relaxation ; Sensitivity and Specificity ; Ventricular Pressure

The purpose of this study was to compare degree of complication and discomfort between application & non - application of a sand bag after 3hours, 6hours, 18hours of a cardiac catheterization. The results were as follows: 1) There was no difference in a degree of occurrence of a complication and pain of the femoral punture site between application and non-application of a sand bag after the cardiac catheterization. 2) A degree of a discomfort between application and non-application of a sand bag after the cardiac catheterization recorded the highest scores in the application group of a sand bag 6 hours after the cardiac catheterization.
Cardiac Catheterization* ; Cardiac Catheters* ; Silicon Dioxide* ; Child Health

The purpose of this study was to compare degree of complication and discomfort between application & non - application of a sand bag after 3hours, 6hours, 18hours of a cardiac catheterization. The results were as follows: 1) There was no difference in a degree of occurrence of a complication and pain of the femoral punture site between application and non-application of a sand bag after the cardiac catheterization. 2) A degree of a discomfort between application and non-application of a sand bag after the cardiac catheterization recorded the highest scores in the application group of a sand bag 6 hours after the cardiac catheterization.
Cardiac Catheterization* ; Cardiac Catheters* ; Silicon Dioxide* ; Child Health

Pulmonary hypertension is a hemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure > or =25 mmHg at rest as assessed by right heart catheterization. Clinical conditions of pulmonary hypertension are classified into 6 clinical groups with different pathological, pathophysiological, prognostic and therapeutic features. The treatment strategy is remarkably different among 6 clinical groups. Group 1 (pulmonary arterial hypertension) is the only clinical group with specific drug therapy and an evidence-based treatment algorithm is provided. Following descriptions are about the clinical classification of pulmonary hypertension updated at 4th World symposium of pulmonary hypertension held in 2008.
Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Hemodynamics ; Hypertension ; Hypertension, Pulmonary

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Pulmonary Valve Stenosis*