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- 저자 : Karen Nel (검색결과 2 건)
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Abnormal Myocardial Blood Flow Reserve Observed in Cardiac Amyloidosis
Michael Chi Yuan Nam,Karen Nel,Roxy Senior,Kim Greaves 한국심초음파학회 2016 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.24 No.1
We performed real-time myocardial contrast echocardiography on a patient with cardiac amyloidosis and previous normal coronary angiography presenting with atypical chest pain to assess myocardial blood flow reserve (MBFR). Myocardial contrast echocardiography was performed and flash microbubble destruction and replenishment analysis was used to calculate myocardial blood flow. Dipyridamole was used to achieve hyperemia. MBFR was derived from the ratio of peak myocardial blood flow at hyperemia and rest. The results show a marked reduction in MBFR in our patient. Previous reports of luminal obstruction of intramyocardial rather than epicardial vessels by amyloid deposition may be causing microvascular dysfunction.
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Jing Xian Quah,Stephanie Sargent,Karen Nel,Christopher M. Anstey,Tony Stanton,Kim Greaves 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.1
Objective: Epicardial fat (EF) is metabolically active adipose tissue positioned between the epicardial surface of the heart and the pericardium. We investigated whether there is a relationship between EF and Coronary Microvascular Dysfunction (CMD) in patients presenting with chest pain and unobstructed coronary arteries. Materials and Methods: This study recruited patients referred to cardiology clinics for assessment of chest pain who subsequently underwent assessment via CT coronary angiogram (CTA). Myocardial blood flow reserve (MBFR) was assessed using myocardial contrast echocardiography. Epicardial fat volume (EFV) was measured by tracing serial slices on CTA with corresponding Hounsfield units of -195 to -45. Results: We recruited 134 participants with a mean age of 59.2 (9.8) years. CMD was present in 54 (40%) patients, and the measured mean EFV was 128 mm3 (96, 168). Fortythree patients (32%) had a coronary artery calcium score (CACS) of 0, 64 (48%) had a CACS of 1–100, 18 (13%) had a CACS of 101–400, and 9 (7%) had a CACS >400. Univariate regression analysis showed that EFV and MBFR had a correlation coefficient of R=-0.22, with a significant regression slope (β=-0.002, p=0.012). Multivariable linear regression analysis using MBFR as a continuous outcome variable revealed age (β=-0.012, p=0.011) and CACS (β=-0.003, p= 0.023) to be associated with MBFR. EFV was not associated with MBFR (β=-0.0007, p=0.538). Model repetition with MBFR as a dichotomous variable (MBFR ≥2 or <2) revealed no association with EFV. Conclusion: No relationship was found between EFV and MBFR when traditional cardiovascular risk factors and calcium score.
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