좌심실 기능부전을 동반한 만성 관상동맥질환에서 Dobutamine 심초음파의 역할

정보영,임세중,최승혁,고충원,하종원,정남식,유경종,강면식 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

심방중격 결손중에서 경흉부 및 경식도 심초음파도의 비교

김양수(Yang Soo Kim),김성훈(Sung Hoon Kim),강흥선(Heung Sun Kang),조정휘(Chung Whee Choue),김권삼(Kwon Sam Kim),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hoa Bae) 대한내과학회 1994 대한내과학회지 Vol.46 No.3

N/A Objectives: Transthoracic two-dimensional echocardiography and conventional Doppler color flow mapping studies have been to used in patients with congenital cardiac defect. However, the transthoracic approach is of limited value in patients with poor acoustic window, Recently transesophageal echocardiography provides high quality images of structure because of close proximity. The purpose of this study is the usefulness of transesophageal echocardiography compared with transthoracic echocardiogrphy in the diagnosis and assessment of the shunt volume in patients with atrial septal defect. Method: 13 patients with atrial septal defect documented at cardiac catheterization or surgery were evaluated. The study group consisted of 7 men and 6 women aged 15 to 59 years. Two-dimensional transthoracic echocardiogrphy with Doppler color flow mapping assessed the morphology and shunt of atrial septum. The size of atrial septal defect and the shunt volume across the defect were estimated by using the tranesophageal echocardiography. Results: 1) Transthoracic echocardiography identified 9 of 13 patients with and atrial septal defect (69%), whereas transesophageal echocardiography identified 13 of 13 patients and the diagnostic sensitivity was 100%. 2) Transesophageal echocardiography identified the site and size of defect correctly compared with operative findings (r=0.73, p<0.05). 3) The shunt flow volume by transesophageal echocardiography was compared with pulmonary to systemic blood flow ratios (Qp/Qs) by cardiac catheterization. The net shunt flow volume by transesophageal echocardiography and shunt flow ratio cardiac catheterization correlatie well (r=0.88, p<0.001). Conclusion: Transesophageal echocardiography was better and more usuful than transthoracic echocardiography in the diagnosis and in the assessment of shunt volume in the patients of atrial septal defect. However further studies with large number of patients and using the biplane or multiplane TEE will be required to determine the exact status of this the technique in assessment of shunt.

Evaluation of Left Atrial Volumes Using Multidetector Computed Tomography: Comparison with Echocardiography

권혜미,김상진,김태훈,이상민,홍유진,임세중 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.3

Objective: To prospectively assess the relationship between the two different measurement methods for the evaluation of left atrial (LA) volume using cardiac multidetector computed tomography (MDCT) and to compare the results between cardiac MDCT and echocardiography. Materials and Methods: Thirty-five patients (20 men, 15 women; mean age, 60 years) underwent cardiac MDCT angiography for coronary artery disease. The LA volumes were measured using two different methods: the two dimensional (2D) length-based (LB) method measured along the three-orthogonal planes of the LA and the 3D volumetric threshold-based (VTB) method measured according to the threshold 3D segmentation of the LA. The results obtained by cardiac MDCT were compared with those obtained by echocardiography. Results: The LA end-systolic and end-diastolic volumes (LAESV and LAEDV) measured by the 2D-LB method correlated well with those measured by the 3DVTB method using cardiac MDCT (r = 0.763, r = 0.786, p = 0.001). However, there was a significant difference in the LAESVs between the two measurement methods using cardiac MDCT (p < 0.05). The LAESV measured by cardiac MDCT correlated well with measurements by echocardiography (r = 0.864, p = 0.001), however with a significant difference (p < 0.01) in their volumes. The cardiac MDCT overestimated the LAESV by 22% compared to measurements by echocardiography. Conclusion: A significant correlation was found between the two different measurement methods for evaluating LA volumes by cardiac MDCT. Further, cardiac MDCT correlates well with echocardiography in evaluating the LA volume. However, there are significant differences in the LAESV between the two measurement methods using cardiac MDCT and between cardiac MDCT and echocardiography. Objective: To prospectively assess the relationship between the two different measurement methods for the evaluation of left atrial (LA) volume using cardiac multidetector computed tomography (MDCT) and to compare the results between cardiac MDCT and echocardiography. Materials and Methods: Thirty-five patients (20 men, 15 women; mean age, 60 years) underwent cardiac MDCT angiography for coronary artery disease. The LA volumes were measured using two different methods: the two dimensional (2D) length-based (LB) method measured along the three-orthogonal planes of the LA and the 3D volumetric threshold-based (VTB) method measured according to the threshold 3D segmentation of the LA. The results obtained by cardiac MDCT were compared with those obtained by echocardiography. Results: The LA end-systolic and end-diastolic volumes (LAESV and LAEDV) measured by the 2D-LB method correlated well with those measured by the 3DVTB method using cardiac MDCT (r = 0.763, r = 0.786, p = 0.001). However, there was a significant difference in the LAESVs between the two measurement methods using cardiac MDCT (p < 0.05). The LAESV measured by cardiac MDCT correlated well with measurements by echocardiography (r = 0.864, p = 0.001), however with a significant difference (p < 0.01) in their volumes. The cardiac MDCT overestimated the LAESV by 22% compared to measurements by echocardiography. Conclusion: A significant correlation was found between the two different measurement methods for evaluating LA volumes by cardiac MDCT. Further, cardiac MDCT correlates well with echocardiography in evaluating the LA volume. However, there are significant differences in the LAESV between the two measurement methods using cardiac MDCT and between cardiac MDCT and echocardiography.

Current Awareness and Use of the Strain Echocardiography in Routine Clinical Practices: Result of a Nationwide Survey in Korea

이주희,박재형,박승우,김우식,손일석,진정연,조정선,윤호중,정해억,이선화,김성환,정욱진,심지영,정진원,최의영,임세중,김장영,김계훈,신준한,김대희,전웅,최정현,김용진,주승재,김기홍,조경임,조구영 한국심초음파학회 2017 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.25 No.3

Background: Because conventional echocardiographic parameters have several limitations, strain echocardiography has oftenbeen introduced in clinical practice. However, there are also obstacles in using it in clinical practice. Therefore, we wanted to findthe current status of awareness on using strain echocardiography in Korea. Methods: We conducted a nationwide survey to evaluate current use and awareness of strain echocardiography from the membersof the Korean Society of Echocardiography. Results: We gathered total 321 questionnaires from 25 cardiology centers in Korea. All participants were able to perform orinterpret echocardiographic examinations. All participating institutions performed strain echocardiography. Most of our studyparticipants (97%) were aware of speckle tracking echocardiography and 185 (58%) performed it for clinical and research purposes. Two-dimensional strain echocardiography was the most commonly used modality and left ventricle (LV) was the most commonlyused cardiac chamber (99%) for clinical purposes. Most of the participants (89%) did not think LV strain can replace LVejection fraction (LVEF) in their clinical practice. The common reasons for not performing routine use of strain echocardiographywas diversity of strain measurements and lack of normal reference value. Many participants had a favorable view of the future ofstrain echocardiography. Conclusion: Most of our study participants were aware of strain echocardiography, and all institutions performed strain echocardiographyfor clinical and research purposes. However, they did not think the LV strain values could replace LVEF. The diversityof strain measurements and lack of normal reference values were common reasons for not using strain echocardiography inclinical practice.

게이트심장혈액풀스캔과 게이트심장혈액풀 SPECT로 측정한 심박출계수의 심초음파와의 비교 연구

정지욱,이효영,윤종준,이화진,이무석,송현석,박세윤,김재환,Jeong, Ji-Uk,Lee, Hyo-Yeong,Yun, Jong-Jun,Lee, Hwa-Jin,Lee, Moo-Seok,Song, Hyeon-Seok,Park, Se-Yun,Kim, Jae-Hwan 대한핵의학기술학회 2010 핵의학 기술 Vol.14 No.2

심장기능을 평가하는데 중요한 기준이 되는 심박출계수의 측정은 반복검사가 용이한 심초음파가 가장 흔히 사용되고 있다. 현재 게이트심장혈액풀스캔의 검사 빈도가 낮고 게이트심장혈액풀 SPECT를 이용한 좌심실 심박출계수의 결과는 게이트심장혈액풀스캔과 심초음파의 결과와 비교적 잘 맞는 것으로 알려져 있으나 임상적으로는 잘 이용되지 못하고 있다. 이에 본 연구에서는 게이트심장혈액풀스캔 및 SPECT에서의 심박출계수를 심초음파와 비교하여 분석하였다. 2007년 1월부터 2010년 5월까지 34명의 환자를 대상으로 심초음파 검사 후 게이트심장혈액풀스캔과 SPECT를 함께 시행하였다. 대상 환자 가운데 남자가 23명이었고 여자는 11명이었으며 평균연령은 $52.6{\pm}27.2$세였다. 환자에게 생리식염수로 희석한 pyrophosphate 1 cc를 먼저 정맥주사하고 15분 후 20 mCi의 $^{99m}{TcO_4}^-$를 정맥주사 하였다. 10분 후 안정 상태에서 심전도를 부착한 뒤 planar와 SPECT를 연속하여 촬영하고 ADAC Laboratories, Ver. 4.20 software를 이용하여 영상을 분석하고 각각의 심박출계수를 측정하였다. 일원배치 분산분석(one-way anova) 후 사후검정(Tukey test)을 통해 평균값을 비교하고 서로 간 pearson 상관계수를 구하였다(SPSS Ver 17.0). 심박출계수의 평균값과 표준편차값은 planar에서 $56.3{\pm}13.9$ (%), SPECT에서 $60.4{\pm}16.0$ (%), 심초음파에서는 $59.1{\pm}14.4$ (%)로 유의한 차이는 없었으며(p=0.486) 이에 대한 사후 검정은 planar-심초음파 p=0.697, SPECT-심초음파 p=0.928, planar-SPECT p=0.469로 유의한 차이가 없었다. 상관관계에서는 planar-심초음파 r=0.801, SPECT-심초음파 r=0.810, planar-SPECT r=0.873 비교적 높은 상관관계를 보였다(p<0.01). 게이트혈액풀스캔 및 SPECT와 심초음파를 이용하여 구한 좌심실의 심박출계수는 높은 상관성을 보였으며 평균값에서도 유의한 차이는 없었다. 현재 게이트혈액풀스캔은 시행건수가 줄어들고 스캔의 정확성이나 재현성에 대한 문제는 남아있으며 SPECT의 경우 임상적으로 잘 적용되지 못하고 있으나 다양한 심기능 지표들을 얻을 수 있고 혈액풀스캔에서의 심박출계수와 좋은 일치율을 보이므로 심초음파를 대체할 수 있는 유용한 검사법이라 생각된다. Purpose: Ejection fraction (EF) is one of the most important factors that evaluate heart function. Recently, according to echocardiography and myocardial perfusion SPECT, the number of gated blood pool scan (planar GBP) is declining. Measurement of left ventricular ejection fraction using gated blood pool SPECT (GBPS) is known as relatively correspond with echocardiography. We compared EF derived from plnar GBP, GBPS and echocadiography using modified simpson method to determine the accuracy. Materials and Methods: From January 2007 to June 2010, planar GBP and GBPS were performed on 34 patients who admitted to Pusan National University Hospital (men 23, women 11, mean age $52.6{\pm}27.2$). Each patient was injected with $^{99m}{TcO_4}^-$ of 20 mCi after pyrophosphate injection and then scanned using both planar GBP and GBPS techniques. For image analysis, we use ADAC Laboratories, Ver. 4.20 software. The result analyzed was processed by SPSS 17.0 Win statistic program and statistical method applied in data analysis is one-way anova, Tukey's post hoc test, pearson correlation test. Results: One-way anova test show no significant difference (planar GBP $56.3{\pm}13.9%$; GBPS $60.4{\pm}16.0%$; echocardiography $59.1{\pm}14.4%$, p=0.486, p>0.05). Tukey's post hoc test show no significant difference (planar GBP-echocardiography p=0.697; GBPS-echocardiography p=0.928; planar GBP-GBPS p=0.469, p>0.05). Values for EF obtained with planar GBP and GBPS correlated well with those obtained with echocardiography (planar-echocardiography r=0.697; GBPS-echocardiography r=0.928; planar GBP-GBPS r=0.469). Conclusion: The problems of accuracy and reproducibility for planar GBP still remain. But planar GBP is a safe and non-invasive method. In addition, planar GBP is useful to evaluate patient with low resolution echocardiography images. GBPS is not appicated clinically. but GBPS can be obtain various left ventricular functional parameters. planar GBP, GBPS and echocardiography show a good correlation between each other. Therefore, planar GBP and GBPS are useful for evaluating left ventricular ejection fraction.

The Correlation Analysis of Ejection Fraction: Comparison of $^{201}Tl$ gated Myocardial Perfusion SPECT and Echocardiography

윤순상,류재광,차민경,이종훈,김성환,Yoon, Soon Sang,Ryu, Jae Kwang,Cha, Min Kyung,Lee, Jong Hun,Kim, Sung Hwan The Korean Society of Nuclear Medicine Technology 2012 핵의학 기술 Vol.16 No.2

좌심실 용적 및 구혈률은 관상동맥질환 환자의 치료에 있어 예후예측 및 경과 관찰에 매우 중요한 지표이며, 현재 게이트 심근관류 SPECT (Myocardial perfusion SPECT)를 이용하여 심근관류 이상을 진단하는 동시에 좌심실 용적 및 구혈률(Ejection fraction, EF)을 측정하는 방법이 널리 사용되고 있다. 게이트 심근관류 SPECT와 심초음파(Echocardiography)로 산출한 좌심실 용적 및 구혈률이 높은 상관성을 가진다는 많은 보고들이 있으나 심근관류결손의 유무와 정도에 상관없이 비교되었으며, 제한된 환자들에서 비교 분석이 시행되었다. 이에 본 연구에서는 $^{201}Tl$ 게이트 심근 관류 SPECT에서 부하기(G-Stress) 및 휴식기(G-Rest) 좌심실 구혈률을 관류 결손 여부와 성별, 심실 용적에 따라 심초음파와 비교하여 그 상관성을 알아보고자 하였다. 2011년 4월부터 2012년 5월까지 본원에서 $^{201}Tl$ 게이트 심근관류 SPECT 검사와 심초음파를 일주일 내 시행한 환자 중 성인 291명(남:여=165:126, 평균나이 $64.6{\pm}10.8$세)을 대상으로 하였다. 이 중 정상으로 진단받은 환자 190명과 가역성 관류결손, 고정 관류결손으로 판정 받은 환자 58명, 43명을 대상으로 연구 분석하였다. 데이터 분석에는 QGS (Quantitative gated SPECT) 소프트웨어를 이용하였고, 자동화된 방식으로 EF, 확장기말 용적(End-diastolic volume, EDV), 수축기말 용적(End-systolic volume, ESV)을 산출하였다. 본 연구에서는 심근관류결손의 가역성 여부와 성별을 기준으로 게이트 심근 관류 SPECT에서의 부하기/휴식기와 심초음파에서의 EF, EDV, ESV를 반복측정 분산분석(repeated-measures anova)과 Bland-Altman 분석을 이용하여 차이를 비교하고, pearson 상관계수를 구하여 각각의 상관관계를 분석 하였다. 전체 환자 중 부하기와 휴식기, 심초음파에서의 EF는 높은 상관관계(G-Stress와 G-Rest r=0.909, G-Stress와 EC r=0.833, G-Rest와 EC r=0.825)를 나타냈으나, 전체 환자 중 EF, EDV, ESV는 통계적으로 유의한 차이를 보였다(p<0.01). 관류 결손 여부에 따른 EF값의 차이는 정상 군에서 통계적으로 유의한 차이를 보였고(p<0.01), 관류 결손이 있는 환자 군에서 통계적으로 유의한 차이를 보였다(가역성 관류결손, 고정 관류결손 p<0.01). 성별에 따라 차이를 분석한 결과, 정상 군 중 남성에서의 EF는 통계적으로 유의한 차이를 보이지 않았고(p>0.05), 여성에서의 EF는 통계적으로 유의한 차이를 보였다(p<0.01). 여성환자 중, 좌심실용적으로 분류하였을 때 평균 확장기말 용적보다 적은 군에서 유의한 차이를 보였고, 평균 보다 큰 군에서는 통계적으로 유의한 차이를 보이지 않았다. $^{201}Tl$ 게이트 심근 관류 SPECT 중 부하기 및 휴식기에서의 좌심실 구혈률과 심초음파와의 상관관계는 전체적으로 높은 것으로 나타났다. 하지만 EF, EDV, ESV는 통계적으로 유의한 차이를 보였다. 관류 결손의 정도, 성별, 좌심실 용적은 LVEF의 정확성에 영향을 미칠 수 있을 거라 사료되며, 이에 대한 추가적인 연구가 필요할 것이다. Purpose : Gated myocardial perfusion SPECT provides not only myocardial perfusion status, but various functional parameters of left ventricle (LV). The purpose of this study was to analyze ejection fraction (EF) for correlation and difference between $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography depending on extent of perfusion defect, gender and LV volumes. Materials and Methods : From April 2011 to May 2012, we analyzed 291 patients (male:female =165:126; mean: $64.6{\pm}10.8$ years) who were examined both $^{201}Tl$ gated myocardial perfusion SPECT and echocardiography at less than 7 days apart in our hospital. 101 patients showed perfusion defect and the rest of the people without any defect. We applied automatic analysis (Quantitative gated SPECT, QGS), and calculated EF, End-diastolic volume (EDV) and End-systolic volume (ESV) from Stress (G-Stress) and Rest (G-Rest) studies. And we analyzed the correlation and difference for EF between $^{201}Tl$ gated SPECT and echocardiography. Results : The correlation of LVEF among G-Stress, G-Rest and echocardiography was quite a good (G-Stress vs. G-Rest: r=0.909, G-Stress vs. echocardiography: r=0.833, G-Rest vs. echocardiography: r=0.825). And there were significant differences in EDV, ESV and EF in total patients (p<0.01). The normal group showed significant difference in EF (p<0.01) and the group with perfusion defect also demonstrated significant difference (a group with reversible defect: p<0.01, fixed defect: p<0.01) depending on extent of perfusion defect. We analyzed difference in normal group by gender. In normal group, there was no significant difference (p>0.05) in EF from men. However, there was a significant difference (p<0.01) from women. When we classified two groups by average size of EDV in Korean women, there was no significant difference in a group of above average size of EDV (p>0.05). Conclusion : When compared among Stress and Rest of $^{201}Tl$ gated SPECT and echocardiography, we confirmed that there was a good correlation for LVEF. But there were significant differences among three studies. And extent of perfusion defect, gender and LV volumes are independent determinants of the accuracy of LVEF. So, it is hard to compare and interchange quantitative indices among modalities. We should take additional researches to prove results of our study.

Impact of Contrast Echocardiography on Assessment of Ventricular Function and Clinical Diagnosis in Routine Clinical Echocardiography: Korean Multicenter Study

김두엽,최정현,홍그루,임세중,김장영,이상철,손일석,정욱진,서혜선,윤세정,조경임,최시완,이경진 한국심초음파학회 2017 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.25 No.1

Background: Fundamental echocardiography has some drawbacks in patients with difficult-to-image echocardiograms. Theaim of this study is to evaluate impact of contrast echocardiography (CE) on ventricular function assessment and clinical diagnosisin routine clinical echocardiography. Methods: Two hundred sixty patients were prospectively enrolled over 3 years in 12 medical centers in Korea. General imagequality, the number of distinguishable segments, ability to assess regional wall motion, left ventricular (LV) apex and right ventricle(RV) visualization, LV ejection fraction, changes in diagnostic or treatment plan were documented after echocardiographywith and without ultrasound contrast agent. Results: Poor or uninterpretable general image was 31% before contrast use, and decreased to 2% (p < 0.05) after contrast use. The average number of visualized LV segments was 9.53 before contrast use, and increased to 14.46 (p < 0.001) after contrast use. The percentage of poor or not seen LV regional wall motion was decreased from 28.4% to 3.5% (p < 0.001). The percentage ofpoor or not seen LV apex and RV was decreased from 49.4% to 2.4% (p < 0.001), from 30.5% to 10.5% (p < 0.001), respectively. Changes in diagnostic procedure and treatment plan after CE were 30% and 29.6%, respectively. Conclusion: Compared to fundamental echocardiography, CE impacted LV function assessment and clinical decision makingin Korean patients who undergo routine echocardiography.

조영 경식도 심초음파에 의한 난원공개존 유병율 및 임상적 의의

이만영(Man Young Lee),전두수(Doo Soo Jeon),전승석(Seung Suk Cheon),이길환(Gil Hwan Lee),강동헌(Dong Heon Gang),김철민(Chul Min Kim),채장성(Jang Seong Chae),박인수(In Soo Park),홍순조(Soon Jo Hong),최규보(Kyu Bo Choi) 대한내과학회 1994 대한내과학회지 Vol.47 No.2

N/A Objectives: Most of patients with patent formen ovale have normal intracardiac pressure and no other abnormality during their life. But because of the high prevalence of clinically latent venous thrombosis, paradoxical embolism through a patent foramen ovale may occur. Although this is a rare complication, the result can be devastating. Previously, contrast transthoracic echocardiography was used to demonstrate patent foramen ovale but the prevalence rate was less than the expected one based on autopsy in general population. These low detection rates have discouraged the use of contrast transthoracic echocardiography to diagnose patent foramen ovale. But transesophageal echocardiography provides larger tomographic field and more clear views around the interatrial septum than transthoracic echocardiography, We tried this study to evaluate the incidence of patent foramen ovale and its role as a possible cause of paradoxical embolism in cerebral infarction patients. Methods: Contrast transesophageal echocardiographic examinations with indocyanine green were performed in 426 patients including 32 patients with cerebral infarction. The prescence of the patent forancen ovale was confirmed by demonstrating echogenic contrast crossing the interatrial septum. Result: 1) Contrast transesophageal echocardiography is a useful technique to evalute right to left shunt, 2) Patent foramen ovale was demonstrated in 73 of 426 patients and 6 of 32 two patients with cerebral infarction showed pakent formen ovale. But patent formen ovale was thought to be a cause of paradoxical embolism only in 3 patients without accompanying cardiovascular disease or risk factors. 3) The prevalence of patent foramen ovale increased progressively with increasing age. 4) There are no serious complications during and after contrast transesophageal echocardiography. Conclussion: Contrast transesophageal echocardiography is a safe, and reliable technique for evaluating interatrial shunt provoked with cough or Valsalva maneuver. This technique should be considered in cerebrovascualr disease patients without known risk factors to evaluate the possible paradoxical embolism.

Arbutamine부하 심초음파도의 안정성과 유용성

신이철(Yi Chul Synn),김기식(Kee Sik Kim),배장호(Jang Ho Bae),한성욱(Seong Wook Han),박소영(So Young Park),남창욱(Chang Wook Nam),김기영(Ki Young Kim),김윤년(Yoon Nyun Kim),김권배(Kwon Bae Kim),김여희(You Hee Kim) 대한내과학회 2000 대한내과학회지 Vol.58 No.1

N/A Background : Exercise and pharmacologic stress echocardiography are widely used for detecting coronary artery disease. Arbutamine is a new synthetic mild α1-receptor and - receptor agonist developed specifically for stress echocardiography. Arbutamine is superior to dobutamine owing to its enforced chronotropic action than that of dobutamine. We intended to know safety and efficacy of arbutamine stress echocardiography in inducing myocardial ischemia and detecting coronary artery disease. Methods : We underwent arbutamine stress echocardiography on 52 patients, dobutamine stress echocardiography in 35 patients. Alteration of blood pressure, heart rate, regional wall motion on echocardiography were evaluated. Sensitivity and specificity were determined by coronary angiography for 61 patients(Arbutamine: 31, Dobutamine : 30) Results : 1) Hemodynamic alterations respect to stress agents Baseline Maximal Baseline Maximal Interval for Blood pressure Blood pressure Heartrate Heart rate maximal heartrate Arbutamine 122/70mmHg 138/72mmHg 69BPM 137BPM 8.2 min* Dobutamine 126/73mmHg 136/77mmHg 74BPM 102BPM 11.4 min* (* p < 0.05) 2) Comparison of Arbutamine and Dobutamine in sensitivity Sensitivity(Specificity) Side effects Atropine Arbutamine 80.1% (90%) 33(63.5%) 8(15.4%) Dobutamine 78.2% (71.4%) 21(60%) 7(20%) 3) Side effects of stress agents Hypotension Palpitation, tremor Arrhythmia Chest pain Arbutamine 15(28.8%)* 4(7.7%)* 21(40.4%) 8(9.2%) Dobutamine 3(8.6%)* 9(25.7%)* 12(34.3%) 5(5.7%) (* p < 0.05) 4) Premature ventricular contraction was most common arrhythmia in both group. There was no fatal or significant complication, and most complications were subsided after discontinuation of stress agents. Conclusion : Arbutamine is an effective and safe pharmacologic stress agent in detecting myocardial ischemia and superior to dobutamine in increasing heart rate. Sensitivity and specificity of arbutamine were higher than that of dobutamine.(Korean J Med 58:39-47, 2000)

Planimetric Measurement of the Regurgitant Orifice Area Using Multidetector CT for Aortic Regurgitation: a Comparison with the Use of Echocardiography

전민희,최연현,조수진,박승우,박표원,Jae K. Oh 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.2

Objective: This study compared the area of the regurgitant orifice, as measured by the use of multidetector-row CT (MDCT), with the severity of aortic regurgitation (AR) as determined by the use of echocardiography for AR. Materials and Methods: In this study, 45 AR patients underwent electrocardiography-gated 40-slice or 64-slice MDCT and transthoracic or transesophageal echocardiography. We reconstructed CT data sets during mid-systolic to enddiastolic phases in 10% steps (20% and 35-95% of the R-R interval), planimetrically measuring the abnormally opened aortic valve area during diastole on CT reformatted images and comparing the area of the aortic regurgitant orifice (ARO) so measured with the severity of AR, as determined by echocardiography. Results: In the 14 patients found to have mild AR, the ARO area was 0.18± 0.13 cm2 (range, 0.04-0.54 cm2). In the 15 moderate AR patients, the ARO area was 0.36 ± 0.23 cm2 (range, 0.09-0.81 cm2). In the 16 severe AR patients, the ARO area was 1.00 ± 0.51 cm2 (range, 0.23-1.84 cm2). Receiver-operator characteristic curve analysis determined a sensitivity of 85% and a specificity of 82%, for a cutoff of 0.47 cm2, to distinguish severe AR from less than severe AR with the use of CT (area under the curve = 0.91; 95% confidence interval, 0.84-1.00; p < 0.001). Conclusion: Planimetric measurement of the ARO area using MDCT is useful for the quantitative evaluation of the severity of aortic regurgitation. Objective: This study compared the area of the regurgitant orifice, as measured by the use of multidetector-row CT (MDCT), with the severity of aortic regurgitation (AR) as determined by the use of echocardiography for AR. Materials and Methods: In this study, 45 AR patients underwent electrocardiography-gated 40-slice or 64-slice MDCT and transthoracic or transesophageal echocardiography. We reconstructed CT data sets during mid-systolic to enddiastolic phases in 10% steps (20% and 35-95% of the R-R interval), planimetrically measuring the abnormally opened aortic valve area during diastole on CT reformatted images and comparing the area of the aortic regurgitant orifice (ARO) so measured with the severity of AR, as determined by echocardiography. Results: In the 14 patients found to have mild AR, the ARO area was 0.18± 0.13 cm2 (range, 0.04-0.54 cm2). In the 15 moderate AR patients, the ARO area was 0.36 ± 0.23 cm2 (range, 0.09-0.81 cm2). In the 16 severe AR patients, the ARO area was 1.00 ± 0.51 cm2 (range, 0.23-1.84 cm2). Receiver-operator characteristic curve analysis determined a sensitivity of 85% and a specificity of 82%, for a cutoff of 0.47 cm2, to distinguish severe AR from less than severe AR with the use of CT (area under the curve = 0.91; 95% confidence interval, 0.84-1.00; p < 0.001). Conclusion: Planimetric measurement of the ARO area using MDCT is useful for the quantitative evaluation of the severity of aortic regurgitation.