1.Coronary artery anomalies: the left main coronary artery or left anterior descending coronary artery originating from the proximal of right coronary artery.
Weiguo XIONG ; Dongyong HE ; Chunpeng LU ; Xuguang QIN ; Hongliang LI ; Xinhua XU ; Lihua SHANG
Chinese Medical Journal 2014;127(12):2392-2394
3.The criterion of syndrome differentiation and quantification for stable coronary heart disease caused by etiological toxin of Chinese medicine.
Ke-ji CHEN ; Da-zhuo SHI ; Hao XU
Chinese Journal of Integrated Traditional and Western Medicine 2011;31(3):313-314
Contemporary Chinese medicine supposes that the blood stasis is a pivotal pathogenic mechanism of coronary heart disease (CHD). The presentation and pathological changes in acute cardiovascular events of CHD, however, seem to exceed the etiological category of blood stasis. The toxin or the combination and transformation of toxin and blood stasis of Chinese medicine are involved in the pathogenesis of CHD according to the basic theory of Chinese medicine. Therefore, to establish a criterion of differentiation and diagnosis for stable CHD caused by etiological toxin of Chinese medicine applying clinical epidemiological method, which is correlated to concept of evidence based medicine, is significant in early recognizing high risk patients and improving treatment of CHD.
Coronary Disease
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diagnosis
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pathology
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Humans
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Integrative Medicine
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Medicine, Chinese Traditional
4.Coronary-Subclavian Steal Syndrome Presenting with Ventricular Tachycardia.
Hurkan KURSAKLIOGLU ; Sedat KOSE ; Atila IYISOY ; Basri AMASYALI ; Turgay CELIK ; Kudret AYTEMIR ; Ersoy ISIK
Yonsei Medical Journal 2009;50(6):852-855
Coronary-subclavian steal through the left internal mammary graft is a rare cause of myocardial ischemia in patients who have had a coronary bypass surgery. We report a 70-year-old man who presented with sustained monomorphic ventricular tachycardia 5 years after the surgical creation of a left internal mammary to the left anterior descending artery. Cardiac catheterization illustrated that the left subclavian artery was occluded proximally and that the distal course was visualized by retrograde filling through the left internal mammary graft. Clinical ventricular tachycardia was reproducibly induced with a single ventricular extrastimulus, and antitachycardia pacing terminated the tachycardia. Restoration of blood flow by way of a Dacron graft placed between the descending aorta and the subclavian artery resulted in the total relief of symptoms. Ventricular tachycardia could not be induced during the control electrophysiologic study after surgical revascularization.
Aged
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Coronary Artery Bypass/adverse effects
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Coronary Artery Disease/*diagnosis/etiology/*pathology
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Humans
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Male
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Postoperative Complications/diagnosis/etiology
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Subclavian Steal Syndrome/*diagnosis/etiology/*pathology
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Tachycardia, Ventricular/*pathology
5.Intravascular Ultrasound Classification of Plaque in Angiographic True Bifurcation Lesions of the Left Main Coronary Artery.
Li LI ; Debabrata DASH ; Lu-Yue GAI ; Yun-Shan CAO ; Qiang ZHAO ; Ya-Rong WANG ; Yao-Jun ZHANG ; Jun-Xia ZHANG
Chinese Medical Journal 2016;129(13):1538-1543
BACKGROUNDAccurately, characterizing plaques is critical for selecting the optimal intervention strategy for the left main coronary artery (LMCA) bifurcation. Coronary angiography cannot precisely assess the location or nature of plaques in bifurcation lesions. Few intravascular ultrasound (IVUS) classification scheme has been reported for angiographic imaging of true bifurcation lesions of the unprotected LMCA thus far. In addition, the plaque composition at the bifurcation has not been elucidated. This study aimed to detect plaque composition at LMCA bifurcation lesions by IVUS.
METHODSFifty-eight patients were recruited. The location, concentricity or eccentricity, site of maximum thickness, and composition of plaques of the distal LMCA, ostial left anterior descending (LAD) coronary artery and, left circumflex (LCX) coronary artery were assessed using IVUS and described using illustrative diagrams.
RESULTSTrue bifurcation lesions of the unprotected LMCA were classified into four types: Type A, with continuous involvement from the distal LMCA to the ostial LAD and the ostial LCX with eccentric plaques; Type B, with concentric plaques at the distal LMCA, eccentric plaques at the ostial LAD, and no plaques at the LCX; Type C, with continuous involvement from the distal LMCA to the ostial LCX, with eccentric plaques, and to the ostial LAD, with eccentric plaques; and Type D, with continuous involvement from the distal LMCA to the ostial LAD, with eccentric plaques, and to the ostial LCX, with concentric plaques. The carina was involved in only 3.5% of the plaques. A total of 51.7% of the plaques at the ostium of the LAD were soft, while 44.8% and 44.6% were fibrous in the distal LMCA and in the ostial LCX, respectively.
CONCLUSIONSWe classified LMCA true bifurcation lesions into four types. The carina was always free from disease. Plaques at the ostial LAD tended to be soft, whereas those at the ostial LCX and the distal LMCA tended to be fibrous.
Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Artery Disease ; pathology ; Coronary Stenosis ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Plaque, Atherosclerotic ; diagnosis ; Ultrasonography, Interventional ; methods
6.Atherosclerotic Progression Attenuates the Expression of Nogo-B in Autopsied Coronary Artery: Pathology and Virtual Histology Intravascular Ultrasound Analysis.
Wang Soo LEE ; Sang Wook KIM ; Soon Auck HONG ; Tae Jin LEE ; Eon Sub PARK ; Hyoung Joong KIM ; Kwang Je LEE ; Tae Ho KIM ; Chee Jeong KIM ; Wang Seong RYU
Journal of Korean Medical Science 2009;24(4):596-604
The relation of Nogo-B to atherosclerotic plaque progression is not well understood. Thus, the purpose of this study was to assess the expression of Nogo-B in fibroatheromas (FA) of different stages, classified using virtual histology intravascular ultrasound (VH-IVUS) analysis in 19 autopsied cases of non-sudden cardiac death. VH-IVUS imaging analysis was performed 30 mm from the ostium of each coronary artery. VH-IVUS revealed 11 early FAs (34.5+/-8.3 yr), 12 late FAs (42.6+/-16.6 yr), 8 thick-cap FAs (TkCFAs) (46.4+/-11.1 yr), and 6 thin-cap FAs (TCFAs) (51.8+/-6.8 yr). TkCFAs and TCFAs were defined as advanced FA. FA progression advanced with age (P=0.04). VH-IVUS analysis of small, early FAs showed smaller necrotic cores and relatively less calcium compared to more advanced FAs with large necrotic cores (P<0.001). Histopathology and immunohistochemical stains demonstrated that early or late FAs had smaller necrotic cores, less empty space of decalcification, and greater Nogo-B expression compared to advanced FAs (vs. early FA, P=0.013; vs. late FA, P=0.008, respectively). These findings suggest that FA progression is inversely associated with Nogo-B expression. Local reduction of Nogo-B may contribute to plaque formation and/or instability.
Adult
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Age Factors
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Coronary Artery Disease/*diagnosis/pathology/ultrasonography
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Coronary Vessels/*pathology/*ultrasonography
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Disease Progression
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Female
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Humans
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Male
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Middle Aged
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Myelin Proteins/*metabolism
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Ultrasonography, Interventional
7.Relationship among peripheral leucocytes, coronary stenosis and Chinese medicine syndromes in patients with coronary heart disease.
Chinese Journal of Integrated Traditional and Western Medicine 2010;30(2):130-132
OBJECTIVETo study the relationship among peripheral leucocytes, coronary artery stenosis and Chinese medicine syndromes in patients with coronary heart disease (CHD).
METHODSThe Chinese medicine syndromes of 189 CHD patients were differentiated into six types: the turbidity-phlegm blood-stasis type (A), the qi-deficiency blood-stasis type (B), the cold-congealing blood-stasis type (C), the qi-stagnancy blood-stasis type (D), the qi-deficiency phlegm-stasis type (E) and the turbidity-phlegm blocking laterals type (F). Coronary angiography and peripheral leucocyte counting were performed simultaneously for determining the degree of blood-stasis by scoring (BSS), and the outcome of coronary angiography was evaluated depending Gensini scoring system. All data obtained were analyzed statistically.
RESULTSThe highest BSS, that means the highest degree of coronary artery stenosis, was shown in patients of Chinese medicine type C, following with type A, B and D in order, the lowest level was found in the non-blood-stasis groups, namely, patients of Chinese medicine type E and F. Peripheral count of leucocytes were correlated with the BSS and Gensini score, count of mononuclear cell was individually correlated with BSS, and that of neutrophil was individually correlated with Gensini score.
CONCLUSIONSBSS and distribution of peripheral leucocytes were different in CHD patients of various Chinese medicine types, count of peripheral mononuclear cell is individually correlated with BSS, and that of neutrophil is individually correlated with Gensini score.
Adult ; Aged ; Coronary Artery Disease ; blood ; diagnosis ; pathology ; Coronary Stenosis ; blood ; diagnosis ; pathology ; Female ; Humans ; Leukocyte Count ; Leukocytes ; Male ; Medicine, Chinese Traditional ; Middle Aged
8.Assessment of a sudden death case due to coronary artery disease based on the PMCT and forensic autopsy.
Lei WAN ; Jian-hua ZHANG ; Ping HUANG ; Chong-liang YING ; Ning-guo LIU ; Guang-you ZHU
Journal of Forensic Medicine 2012;28(5):379-382
It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT). This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan. The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR), and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software. The results showed that CAC was conspicuous; the total calcium score was 640.3, considerably higher than 400. The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found. The imaging results confirmed those of autopsy. In addition, the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.
Autopsy
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Calcinosis/diagnosis*
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Cause of Death
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Coronary Artery Disease/diagnosis*
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Coronary Vessels/pathology*
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Death, Sudden/etiology*
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Forensic Pathology
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Humans
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Tomography, X-Ray Computed/methods*
9.Stent Evaluation with Optical Coherence Tomography.
Seung Yul LEE ; Myeong Ki HONG
Yonsei Medical Journal 2013;54(5):1075-1083
Optical coherence tomography (OCT) has been recently applied to investigate coronary artery disease in interventional cardiology. Compared to intravascular ultrasound, OCT is able to visualize various vascular structures more clearly with higher resolution. Several validation studies have shown that OCT is more accurate in evaluating neointimal tissue after coronary stent implantation than intravascular ultrasound. Novel findings on OCT evaluation include the detection of strut coverage and the characterization of neointimal tissue in an in-vivo setting. In a previous study, neointimal healing of stent strut was pathologically the most important factor associated with stent thrombosis, a fatal complication, in patients treated with drug-eluting stent (DES). Recently, OCT-defined coverage of a stent strut was proposed to be related with clinical safety in DES-treated patients. Neoatherosclerosis is an atheromatous change of neointimal tissue within the stented segment. Clinical studies using OCT revealed neoatherosclerosis contributed to late-phase luminal narrowing after stent implantation. Like de novo native coronary lesions, the clinical presentation of OCT-derived neoatherosclerosis varied from stable angina to acute coronary syndrome including late stent thrombosis. Thus, early identification of neoatherosclerosis with OCT may predict clinical deterioration in patients treated with coronary stent. Additionally, intravascular OCT evaluation provides additive information about the performance of coronary stent. In the near future, new advances in OCT technology will help reduce complications with stent therapy and accelerating in the study of interventional cardiology.
Atherosclerosis/diagnosis/pathology/ultrasonography
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Coronary Artery Disease/*diagnosis/pathology/ultrasonography
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Humans
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Postoperative Complications/diagnosis/pathology/ultrasonography
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Stents/*adverse effects
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Tomography, Optical Coherence/*methods
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Ultrasonography, Interventional
10.Topological match method in 3D reconstruction of heart vessel.
Journal of Biomedical Engineering 2011;28(1):153-162
This paper presents a novel matching method of vessels in 3D reconstruction of heart vessel. The directed binary tree was used to describe the topological structure of heart vessel tree's skeleton. Based on topological property and epipolar property, the branch-points and end-points of each branch level could be automatically matched along the direction of blood stream. Thereupon it is easy to couple the corresponding vessels segments of two angiograms projected in different directions. The 3D heart vessel tree was successfully reconstructed from clinic coronary angiograms, which validates the presented method.
Algorithms
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Computer Simulation
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Coronary Angiography
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methods
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Coronary Disease
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diagnosis
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diagnostic imaging
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Coronary Vessels
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pathology
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Humans
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Image Processing, Computer-Assisted
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Imaging, Three-Dimensional
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methods
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Pattern Recognition, Automated
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methods