1.Three Dimensional Quantitative Coronary Angiography Can Detect Reliably Ischemic Coronary Lesions Based on Fractional Flow Reserve.
Woo Young CHUNG ; Byoung Joo CHOI ; Seong Hoon LIM ; Yoshiki MATSUO ; Ryan J LENNON ; Rajiv GULATI ; Gurpreet S SANDHU ; David R HOLMES ; Charanjit S RIHAL ; Amir LERMAN
Journal of Korean Medical Science 2015;30(6):716-724
Conventional coronary angiography (CAG) has limitations in evaluating lesions producing ischemia. Three dimensional quantitative coronary angiography (3D-QCA) shows reconstructed images of CAG using computer based algorithm, the Cardio-op B system (Paieon Medical, Rosh Ha'ayin, Israel). The aim of this study was to evaluate whether 3D-QCA can reliably predict ischemia assessed by myocardial fractional flow reserve (FFR) < 0.80. 3D-QCA images were reconstructed from CAG which also were evaluated with FFR to assess ischemia. Minimal luminal diameter (MLD), percent diameter stenosis (%DS), minimal luminal area (MLA), and percent area stenosis (%AS) were obtained. The results of 3D-QCA and FFR were compared. A total of 266 patients was enrolled for the present study. FFR for all lesions ranged from 0.57 to 1.00 (0.85 +/- 0.09). Measurement of MLD, %DS, MLA, and %AS all were significantly correlated with FFR (r = 0.569, 0609, 0.569, 0.670, respectively, all P < 0.001). In lesions with MLA < 4.0 mm2, %AS of more than 65.5% had a 80% sensitivity and a 83% specificity to predict FFR < 0.80 (area under curve, AUC was 0.878). 3D-QCA can reliably predict coronary lesions producing ischemia and may be used to guide therapeutic approach for coronary artery disease.
Aged
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Coronary Angiography/*methods
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Coronary Circulation
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Coronary Stenosis/etiology/*physiopathology/*radiography
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Female
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*Fractional Flow Reserve, Myocardial
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Humans
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Imaging, Three-Dimensional/*methods
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Male
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Myocardial Ischemia/complications/physiopathology/*radiography
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Radiographic Image Enhancement/methods
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Radiographic Image Interpretation, Computer-Assisted/methods
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Reproducibility of Results
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Sensitivity and Specificity
2.Successful Treatment of Ischemic Dysfunction of the Sinus Node with Thrombolytic Therapy: A Case Report.
Jong Seon PARK ; Dong Gu SHIN ; Young Jo KIM ; Gu Ru HONG ; Hyung Jun KIM ; Bong Sup SHIM
The Korean Journal of Internal Medicine 2006;21(4):283-286
We report on a case of ischemic dysfunction of the sinus node as a complication after percutaneous transluminal coronary angioplasty of the distal left circumflex artery. After local thrombolytic therapy in the sinus node artery, sinus node arterial flow was re-established and sinus node function normalized over the period of a week. Our experience suggests that immediate reperfusion of a totally occluded nodal artery can be re-established. Ischemic dysfunction of the sinus node, as a complication of angioplasty, is generally transient and requires a prolonged period for recovery. Therefore the decision to implant a permanent pacemaker should be delayed for at least one week after the ischemic insult.
Urinary Plasminogen Activator/administration & dosage/*therapeutic use
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Thrombolytic Therapy/*methods
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Sinoatrial Node/*physiopathology
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Myocardial Ischemia/*complications/radiography/therapy
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Middle Aged
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Male
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Infusions, Intravenous
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Humans
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Follow-Up Studies
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Fibrinolytic Agents/administration & dosage/*therapeutic use
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Electrocardiography
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Coronary Angiography
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Arrhythmia/diagnosis/*drug therapy/etiology
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Angioplasty, Transluminal, Percutaneous Coronary/adverse effects