No abstract available.
Animals ; Linoleic Acid* ; Mice* ; Sarcoma 180* ; Sarcoma*

A bicuspid aortic valve is one of common congenital cardiac anomaly. But the septic embolism from bicuspid aortic valve into the left anterior descending artery (LAD) resulting in acute inferior myocardial infarction is very rare. A twenty eight year-old man suffered from severe chest pain and fever of four-week's duration. Acute inferior myocardial infarction was diagnosed on electrocardiogram. Transesophageal echocardiogram demonstrated vegetation on the bicuspid aortic valve directed into left coronary artery ostium, and diagnostic coronary angiogram revealed round filling defect within the distal LAD. He underwent operation for aortic valve replacement, which indicated vegetated bicuspid aortic valve directed into the ostium of left coronary artery.
Aortic Valve* ; Arteries* ; Bicuspid* ; Chest Pain ; Coronary Vessels ; Electrocardiography ; Embolism* ; Fever ; Inferior Wall Myocardial Infarction*

A 25-year-old woman presented with effort-induced chest pain. Physical examination revealed different blood pressures, 180/100 mmHg in right arm and 100/60 mmHg in left arm. Resting electrocardiogram was normal, but down-slope depression of ST segment more than 3 mm in V3-6, II, III, aVF developed at the stage 1 of treadmill exercise test. Stress Thallium-201 scan showed severe ischemia in the anteroseptal and lateral wall of left ventricle. Diagnostic coronary angiogram showed critical stenosis in the ostium of left main coronary artery. The left subclavian artery was occluded totally with well-developed collateral circulation. The patient underwent ostioplasty of left coronary ostium using pericardial patch, and her symptom improved after surgery. Follow-up coronary angiogram one year after surgery showed patent coronary artery ostium with good flow and myocardial perfusion improved on follow-up Thallium-201 SPECT. She has no major cardiac events during 7-year clinical follow-up.
Adult ; Arm ; Chest Pain ; Collateral Circulation ; Constriction, Pathologic ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Ischemia ; Perfusion ; Physical Examination ; Subclavian Artery ; Takayasu Arteritis* ; Tomography, Emission-Computed, Single-Photon

BACKGRUOND: Platelets are known to play a major role in the ischemic complications of percutaneous coronary intervention (PCI). Accordingly, we evaluated the effect of rescue use of a platelet glycoprotein IIb/IIIa receptor blocker (Abciximab; Reo-Pro ) in Korean patients with acute myocardial infarction (AMI) at high risk for the ischemic complications who underwent PCI. METHOD: Sixty eight patients (54 male, 59.1+/-9.96 years) treated by the rescue use of Reo-Pro out of 1,117 patients underwent PCI at Chonnam National University Hospital from Mar 1999 to Feb 2000. All of target lesions were thrombus-containing lesions in patients with AMI. The primary end points consisted of any of the followings : cardiac death, nonfatal MI, repeated revascularization. The number of end-point events were tabulated at 6 months after PCI. RESULTS: The primary success rate was 92.6% (63/68). At primary end points, there were 5 cases (7.3%), composed of 2 deaths (2.9%), 1 MI, 2 repeated revascularization (2.9%). There was no major bleeding complication after PCI. At secondary end point, there were 23 cases (34.9%) including primary end point, composed of 3 deaths (4.4%), 1 MI and 19 revascularization (28.0%). CONCLUSION: The rescue Reo-Pro can be used safely and effectively in high-risk Korean patients with AMI.
Blood Platelets* ; Death ; Glycoproteins* ; Hemorrhage ; Humans ; Jeollanam-do ; Male ; Myocardial Infarction* ; Percutaneous Coronary Intervention*

Aneurysms of sinus of Valsalva often remain undiagnosed until they rupture. A huge, heavily calcified unruptured aneurysm originating from the right sinus of Valsalva was detected incidentally in a 61-year-old man. Chest X-ray showed cardiomegaly and 10 cm sized huge calcified mass lesion around the cardiac shadow. Two-dimensional echocardiogrm revealed pericardial effusion with huge calcified mass compressing right ventricular outflow and color-flow Doppler echocardiogram visualized blood flow from aortic root into aneurysm. Chest CT scan and MRI revealed a large thrombosed aneurysm arising from aortic root measuring 1010cm. After pericardiocentesis cardiac catheterization was performed, which showed elevated right ventricular systolic pressure up to 80 mmHg. Aortic root angiogram revealed huge unruptured calcified aneurysm in the sinus of Valsalva arising from the right coronary sinus. The patient underwent surgical correction for the prevention of aneurysmal rupture and the relief of right ventricular outflow obstruction.
Aneurysm* ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Sinus ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Pericardial Effusion ; Pericardiocentesis ; Rupture ; Sinus of Valsalva* ; Thorax ; Tomography, X-Ray Computed ; Ventricular Outflow Obstruction

BACKGROUND AND OBJECTIVES: In-stent coronary restenosis remains one of major clinical problems in percutaneous coronary intervention. Long stent has been known to be associated with high restenosis rate. Predictive clinical and angiographic factors were analyzed after long coronary stenting. METHODS: One hundred four patients (57.2+/-9.6 year-old, 105 male) who underwent long coronary stent implantation and follow-up coronary angiogram, out of 237 patients implanted long coronary stents between June 1996 and January 1999 at Chonnam National University Hospital. RESULTS: Primary success rate was 100%. Lesion length was 18.5 +/- 9.2 mm and the length of stent was 27.3 +/- 6.1 mm. Mean duration of clinical follow-up and follow-up coronary angiogram was 20.1+/-6.8 months and 6.3+/-2.7 months respectively. Restenosis rate according to follow-up coronary angiogram was 42.5% (57/134). Clinical variables of age, sex, clinical diagnosis, risk factors, and angiographic variables of target artery and lesion types, indications for stenting, stent types, reference diameter, lesion length, minimal luminal diameter, and acute gain were not related with late stent restenosis. Diameter stenosis before stenting was higher in the group with restenosis (81.9+/-16.9 %) than in group without restenosis (71.1+/-18.5%; p<0.05), and lower lower in the group with restenosis (-7.6+/-15.7%) and in the group without restenosis (5.6+/-22.4%; p<0.05) after stenting. CONCLUSIONS: Primary success rate was comparable. Severe luminal stenosis before stenting and overdilation after stenting are associated with restenosis after long coronary stenting.
Arteries ; Constriction, Pathologic ; Coronary Restenosis ; Diagnosis ; Follow-Up Studies ; Humans ; Jeollanam-do ; Percutaneous Coronary Intervention ; Phenobarbital ; Risk Factors ; Stents*

BACKGROUND: Lipoprotein (a) [Lp(a)] contains apolipoprotein(a), which is a structural homologue of plasminogen and competes with it for binding sites. It also acts by increasing plasminogen activator inhibitor-1 expression. The objective of this study was to evaluate the relationship between Lp(a) levels and restenosis rate after successful coronary stent placement. METHODS: The study included 306 patients who underwent coronary stent placement and follow-up coronary angiogram at Chonnam National University Hospital from August 1996 to June 2000. Restenosis rate was analyzed according to the level of Lp(a); Group I with high Lp(a) (n=7, Lp(a) 36 mg/dL, 58.98.8 years, female: 35.1%) and Group II with low Lp(a) (n=29, Lp(a) < 36 mg/dL, 57.79.8 years, female: 18.8%). RESULTS: 1) There was no significant differences in risk factors of atherosclerosis, clinical diagnosis, the number of involved coronary artery, left ventricular function, angiographic lesion characteristics by American College of Cardiology/American Heart Association clasification and Thrombolysis In Myocardial Infarction flow in two groups. 2) Angiographic restenosis rates were not different between two groups (group I : 33.8%, group II : 35.4%). CONCLUSION: Plasma Lp(a) levels are not related with the angiographic restenosis rate after coronary stent placement.
Apoprotein(a) ; Atherosclerosis ; Binding Sites ; Coronary Vessels ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Jeollanam-do ; Lipoprotein(a)* ; Myocardial Infarction ; Plasma ; Plasminogen ; Plasminogen Activators ; Risk Factors ; Stents* ; Ventricular Function, Left

BACKGROUND: The problems of coronary stent thrombosis and restenosis still remain to be solved.The glycoprotein IIb/IIIa receptor blocker, Abciximab (ReoPro), plays important roles in the treatment of high-risk patient with acute platelet-rich thrombus and in the inhibition of smooth muscle cell proliferation. The aim of this study was to determine whether the use of ReoPro-coated stents could reduce the neointimal formation in a porcine coronary stent restenosis model. METHODS: ReoPro was coated on the surface of stent by means of plasma polymerization followed by chemical grafting. Stent overdilation injury was performed with control bare stent (Group I, n=13), and ReoPro-coated stents (Group II, n=14). Follow-up quantitative coronary angiogram was performed at 4 weeks after stenting and histopathologic assessment were compared in both groups. RESULTS: The diameter stenosis by QCA between two groups was significantly higher in Group I (23+/-5 % vs. 15+/-7 %, p=0.003). On histopathologic examination, no in-stent thrombus was observed. The percent area stenosis was significantly higher in Group I than in Group II (48+/-17 % vs. 30+/-16 %, p=0.01). The area of neoinima was larger in Group I than in Group II (3.2+/-1.2 mm2 vs. 2.0+/-1.0 mm2, p=0.01). By immunocytochemistry, proliferation cell nuclear antigen indices were higher in Group I (4.2+/-2.1 %, vs 2.4+/-1.8 % p=0.03). CONCLUSION: The ReoPro-coated stent is safe and effective in the prevention of in-stent thrombus and restenosis, which may be related with the inhibition of platelet thrombus and neointimal cell proliferation.
Blood Platelets* ; Cell Proliferation ; Constriction, Pathologic ; Follow-Up Studies ; Glycoproteins* ; Humans ; Immunohistochemistry ; Myocytes, Smooth Muscle ; Neointima ; Plasma ; Polymerization ; Polymers ; Stents* ; Thrombosis ; Transplants

BACKGROUND AND OBJECTIVES: New coronary stents are displacing for the broader array of lesions, but disagreement remains which device is more advantageous and whether design determines outcomes. The present study investigates the impact of stent design on early and one year outcomes. MATERIALS AND METHODS: A retrospective analysis of 350 patients with 378 lesions (60+/-10 years, 265 male), that underwent 181 CrossFlex, 95 GFX, 102 NIR coronary stentings at Chonnam National University Hospital from January 1996 to December 1999, was performed. Early procedural success rates, major adverse cardiac event (MACE) within one year and follow-up angiographic findings in 227 patients (240 lesions, follow-up duration=8.1+/-5.9 months) were compared among three groups. METHODS: 1) There were no significant differences in the baseline clinical and angiographic characteristics except the lesion length (CrossFlex: GFX: NIR=11.5+/-5.2: 14.5+/-6.7: 13.9+/-5.7 mm, p<0.05). 2) There were no significant differences in early angiographic success rates among three groups (CrossFlex: 98.9%, GFX: 100.0%, NIR: 99.0%). 3) There were no significant differences in late luminal loss (CrossFlex: GFX: NIR=1.03+/-0.69: 1.11+/-0.75: 1.09+/-0.70 mm, p=NS), restenosis rates (CrossFlex: 30.6%, GFX: 30.8%, NIR: 28.4%, p=NS) and MACE (CrossFlex: GFX: NIR=27.6%: 29.5%: 27.5%, p=NS) among three groups. CONCLUSION: Despite different lesions length, the early and late angiographic outcomes, and MACE within one year were not different among three different types of coronary stents.
Follow-Up Studies ; Humans ; Jeollanam-do ; Phenobarbital ; Retrospective Studies ; Stents*

BACKGROUND: The early assessment of cardiac risk is important in patients with unstable angina (UA). The present study investigates the prognostic value capacities of cardiac specific troponin T (cTnT), cardiac specific troponin I (cTnI) and ECG change in Korean patients with UA. METHODS: Two hundred thirty patients (61+/-11 year, male:female=172:58) admitted to Chonnam National University Hospital via emergency room under the diagnosis of UA and underwent diagnostic coronary angiography (CAG) between July 1998 and June 1999, were analyzed according to the ECG findings of ST depression (STD), T wave inversion (TWI), cTnT and cTnI. Clinical characteristics, initial and follow-up CAG findings, and major adverse cardiac events (MACE) within one year were compared. RESULTS: Among the enrolled patients, 164 (71.3%) patients had significant coronary artery stenosis (CAS). During the one-year follow-up period, 40 patients developed MACE : 2 patients died, 7 patients had acute myocardial infarction and 34 patients developed restenosis. Positivity of cTnT and cTnI was associated with presence of CAS (p<0.001) and multi-vessel diseases (p<0.001). Levels of cTnT (5.7+/-8.4 vs 1.6+/-3.1 mg/dL, p<0.001) and cTnI (0.11+/-0.18 vs 0.03+/-0.19 mg/dL, p<0.001) were associated with MACE. The presence of STD was associated with the presence of CAS (p<0.001), multi-vessel diseases (p<0.001), low Thrombolysis In Myocardial Infarction (TIMI) flow (p<0.01), ACC/AHA types (p<0.001) and MACE (p<0.05). TWI was associated with TIMI flow (p<0.05), ACC/AHA types (p<0.001). In the patients with negative cTnT or cTnI, the negative predictive value of MACE within 1 year was 87.1% and 93.4%, respectively. In the absence of STD, that of MACE within 1 year was 87.1%. CONCLUSION: The level of troponin and electrocardiograhic findings are valuable in the early stratification of cardiac risks in Korean patients with UA and the prediction of MACE.
Angina, Unstable* ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Depression ; Diagnosis ; Electrocardiography* ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Jeollanam-do ; Myocardial Infarction ; Troponin I ; Troponin T ; Troponin*