전신성 죽상동맥경화증 예측에 대한 목동맥 죽상동맥경화증과 심장내 석회화의 비교

다국어 초록 (Multilingual Abstract)

Background: Thickened carotid intima-media or a carotid plaque represents carotid atherosclerosis. Intracardiac calcification (ICC) is a marker of atherosclerosis. It is unknown which of these localized atherosclerosis is better to predict generalized atherosclerosis.
Subjects and Methods: This study comprised 282 patients (mean age, 58.2±10.7 years; female 45.4%) who underwent diagnostic coronary arteriography (CAG). Patients underwent carotid ultrasonography, transthoracic echocardiography, and measurements of brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABI) before CAG. Significant atherosclerosis were defined as follows: coronary artery stenosis ≥50% (coronary artery disease, CAD); carotid intima-media thickness ＞75th percentile, determined from data of healthy adults, or carotid plaque (carotid atherosclerosis, CA); aortic valve calcification (AVC) or mitral annulus calcification (MAC); baPWV ＞1450 cm/s (high baPWV); ABI ＜0.90 (peripheral artery disease, PAD).
Results: CA was associated with CAD (56.5 vs 29.5%, p＜0.001), AVC (57.1 vs 34.3%, p＜0.001), high baPWV (69.1 vs 43.7%, p＜0.001), and PAD (4.9 vs 0.0%, p=0.025), but not with MAC (51.4 vs 43.8%, p=NS). AVC was associated with CA (73.7 vs 52.4%, p＜0.001) and high baPWV (70.1 vs 49.3%, p=0.001), but neither with CAD (49.6 vs 43.4%, p=NS) nor PAD (3.1 vs 2.9%, p=NS). MAC was not associated with CAD, CA, high baPWV, and PAD. Among three findings of atherosclerosis (CAD, high baPWV, and PAD), CA discriminated two or more findings [AUC 0.66 (95% CI, 0.59-0.73; p＜0.001)], whereas AVC did not [AUC 0.57 (95% CI, 0.50-0.64; p=0.061)].
Conclusion: These suggest that CA is better than ICC in predicting generalized atherosclerosis.
KEY WORDS: Carotid atherosclerosis; Intracardiac calcification; Coronary artery disease; Brachial-ankle pulse wave velocity; Ankle-brachial pressure index.

목차 (Table of Contents)

• Ⅰ. 서론 = 1
• Ⅱ. 대상 및 방법 = 4
• 1.대상 = 4
• 2.방법 = 4
• Ⅲ. 결과 = 10
• 1.대상환자들의 임상적 특징 = 10
• 2.목동맥 죽상동맥경화증 유무에 따른 비교 = 10
• 3.심장내 석회화, 대동맥판 석회화, 승모판륜 석회화 유무에 따른 비교 = 10
• 4.전신성 죽상동맥경화증 예측에 대한 목동맥 죽상동맥경화증과 대동맥판 석회화의 비교 = 11
• Ⅳ. 고찰 = 12
• Ⅴ. 결론 = 18
• REFERENCE = 19
• ABSTRACT = 26