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RISS 인기검색어
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- 저자 : 도현국(Hyun Kuk Dho) (검색결과 2 건)
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관상동맥 협착 환자에서의 관동맥 혈류 예비능 - Doppler Guidewire Study-
김무현(Moo Hyun Kim),배성진(Sung Jin Bae),양창호(Chang Ho Yang),김상곤(Sang Gon Kim),손지원(Ji Won Son),도현국(Hyun Kuk Dho),김종성(Jong Seong Kim) 대한내과학회 1996 대한내과학회지 Vol.50 No.2
N/A Objectives: Coronary flow reserve(CFR) is the ratio of the maximal hyperemic to basal coronary blood flow velocity hyperemia, which was introduced by Gould et al, as a functional parameter in the coronary artery stenosis. Methods: To evaluate the difference of the CFR between the significant and insignificant coronary artery narrowings, we measured coronary flow velocity in 17 patients(11 nonstenotic group and 6 stenotic patients) by 0.0l4 inch intracoronary Doppler-tipped guidewire after nitroglycerine 200㎍ intracoronary infusion during coronary arteriography. We measured coronary flow velocity in 11 left coronary artery and 6 right coronary artery before and after adenosine intracoronary infusion(LCA 12㎍, RCA 6㎍). Results: 1) Average peak velocity(APV, cm/sec) of steno- tic patients was higher than nonstenotic group(19.8 vs 36.6, p<0.05), but diastolic systolic velocity ratio (DSVR) were not significantly different between both groups. 2) APV after adenosine infusion in stenotic and nonstenotic group were 56.3±16.4, 60±23.4cm/sec, respectively, which are significantly increased compared to the basal state(p<0.01). 3) Mean coronary flow reserve(CFR) in the stenotic group was significantly lower than nonstenotic group(1.98±0.9 vs 3.57±1.0, p<0.01). 4) Systolic and diastolic blood pressure decreased significantly after adenosine intracoronery bolus infusion(p<0.01), but heart rate did not changed significantly(p>0.05). The mean time that came back to the baseline flow velocity after adenosine infusion was 27.1 seconds. Conclusion: Coronary flow reserve decreased significantly in the coronary artery stenosis compared to normal or insignificant stenosis. And adenosine caused significant fall in blood pressure after intracoronary infusion, but did not in heart rate
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심근 손상에 있어서 심근 Troponin - T 측정의 유용성
김상곤(Sang Gon Kim),이성욱(Sung Wook Lee),김병철(Byeong Cheol Kim),이혁(Hyuck Lee),배상문(Sang Moon Bae),안원석(Won Suk An),도현국(Hyun Kuk Dho),김무현(Moo Hyun Kim),김영대(Young Dae Kim),김종성(Jong Seong Kim) 대한내과학회 1997 대한내과학회지 Vol.52 No.6
N/A Objectives: In coronary arterial disease, quantitative assessment of the extent of myocardial damage is important both in management of the patient and prediction of prognosis. Measurement of serum Troponin-T is a new method for detecting myocardial cellular injury, used as more specific marker of tissue damage and reperfusion status in acute myocardial infarction, This study was performed to evaluate the significance of serum Troponin-T measurement in various acute chest pain syndrome. Methods: 37 patients who presented anterior ischemic chest pain enrolled from April, 1994 to September, 1995, From the initial period of admission, serial measurements of serum level of cardiac enzymes (CK, CK MB, Myoglobin, Troponin-T) were made. Then release time, peak time and normalization time of each enzyme were derived and compared each other. To evaluate whether Troponin-T level can reflect the extent of ischemic injury, correlation between peak Troponin-T level and peak CK MB level was analysed by regression method. Results: 1) Acute myocardial infarction was confirmed in 15 cases; Q-wave myocardial infarction was 10 cases(anterior wall-5 cases, inferior wall-4 cases, lateral wall-1 cases), and non Q-wave myocardial infarction was 5 cases. Unstable angina was 22 cases. All cases had significant stenosis in coronary angiography. 2) The appearance in the serum level of 4 cardiac enzymes was as follows. The release time(hours) of 4 cardiac enzymes(Troponin-T, CK, CK MB, Myoglobin) were 7.1(1-30), 9.3(1-30), 9.9(1-30), 6.2(1-30). The peak time(hours) of 4 cardiac enzymes were 23.0(1.5-96), 21.6(2-66), 16.9(2-42), 12.7(3-40). The normalization time(hours) of the enzymes were over 72, 53.7(11-86), 52.3(11-94), 32.3(10-82). 3) Elevation pattern of cardiac enzymes showed concordance of all 3 enzymes(Troponin-T, CK MB, Myoglobin) in 29 of 43 cases(67.4%), There was concordance of 2 enzymes in 10 cases; 5 cases of CK MB and Myoglobin, 5 cases of Troponin-T and Myoglobin. In 4 cases, only Myoglobin level was in- creased. 4) There was significant correlation between peak Troponin-T level and peak CK level(r=0.66, p=0.0178), significant correlation was also observed between peak Troponin-T level and peak CK MR level(r=0.90, p=0.0001). Conclusion: In acute myocardial infarction serum Troponin-T was detectable as early as CK MB, and lasted longer after other enzyme level was normalized. There was significant correlation between peak Troponin-T level and peak CK, CK MB level, suggesting Troponin-T as useful marker for assessing the extent of myocardial damage.
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