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- 주제어 : Infarct-related artery (검색결과 4 건)
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급성 심근경색증 발생 위험인자와 경색관련동맥의 협착정도와의 연관성
김영진(Young Jin Kim),이태일(Tae Il Lee),이재련(Jae Lyun Lee),조인호(In Ho Cho),신동구(Dong Gu Shin),김영조(Young Jo Kim),심봉섭(Bong Seop Sim),이현우(Hyun Woo Le) 대한내과학회 1995 대한내과학회지 Vol.49 No.5
N/A Objectives: The most common cause of myocardial infarction is atherosclerotic lesion of epicardial coronary artery. But coronary blood flow can also be dampered by the arterial emboli, spasm. and this may result in myocardial infarction. To investigate the risk factors of myocardial infarction with normal coronary artery, a study was conducted. Methods: This study was made on 122patients, admitted at Yeungnam University Hospital as their first attack for acute myocardial infarction, from August 1992 to May 1994. The patients undertook angiography with thrombolytic therapy at the earliest possible time. These patients were classified into four groups: group 1-patients with less than 25% stenosis of infarct related artery(IRA); group 2-between 25-50% stenosis of IRA; group 3-between 51-75% stenosis of IRA; group 4-between 76-99% stenosis of IRA. Results: Among 122patients with myocardial infarction, the mean age was 55.4years old and the ratio of male to female was 3.5:1. Group 1patients had a significantly lower mean age(44.6years) than group 3patients(55.8years) and group 4patients (59.1years). Of fifteen patients in group 1, 12 patients developed acute myocardial infarction under 50years of age. In frequency of risk factors of coronary heart disease, 84 of 122cases(68.9%) were smokers. The number of smokers was higher in group 1 (86.7%) than group 3 (58.6%) and group 4 (64%). The frequency of angina prior to myocardial infarction was lower in group 1 (7%) than group 3 (45%) and group 4 (46%). The frequency of multivessel disease was lower in group 1 (13%) than group 3 (31%) and group 4 (50%). There was no significant difference in the frequency of the hypertension, diabetes, dyslipidemia, and obesity among the groups. Conclusion: Acute myocardial infarction with near normal infarct related artery developed at young age compared with those with significant infarct related artery stenosis. The number of smokers was higher and the frequency of previous angina history was lower in the same group.
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Lee, Y.S.,Choi, J.W.,Oh, J.E.,Yun, C.O.,Kim, S.W. IPC Science and Technology Press 2016 Biomaterials Vol.97 No.-
<P>In consensus, myocardial infarction (MI) is defined as irreversible cell death secondary to prolonged ischemia in heart. The aim of our study was to evaluate the therapeutic potential of anti-fibrotic human Relaxin-expressing plasmid DNA with hypoxia response element (HRE) 12 copies (HR1) delivered by a dendrimer type PAM-ABP polymer G0 (HR1/G0) after MI on functional, hemodynamic, geometric, and cardiac extracellular matrix (ECM) remodeling in rats. HR1/G0 demonstrated significantly improved LV systolic function, hemodynamic parameters, and geometry on 1 wk and 4 wks after MI in rats, compared with I/R group. The resolution of regional wall motional abnormalities and the increased blood flow of infarct-related coronary artery supported functional improvements of HR1/G0. Furthermore, HR1/G0 polyplex showed favorable post-infarct cardiac ECM remodeling reflected on the favorable cardiac ECM compositions. Overall, this is the first study, which presented an advanced platform for the gene therapy that reverses adverse cardiac remodeling after MI with a HR1 gene delivered by a bioreducible dendrimer polymer in the cardiac ECM. (C) 2016 Elsevier Ltd. All rights reserved.</P>
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High Coronary Shear Stress in Patients With Coronary Artery Disease Predicts Myocardial Infarction
Kumar, Arnav,Thompson, Elizabeth W.,Lefieux, Adrien,Molony, David S.,Davis, Emily L.,Chand, Nikita,Fournier, Stephane,Lee, Hee Su,Suh, Jon,Sato, Kimi,Ko, Yi-An,Molloy, Daniel,Chandran, Karthic,Hossein Elsevier 2018 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY - Vol.72 No.16
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Coronary lesions with low fractional flow reserve (FFR) that are treated medically are associated with higher revascularization rates. High wall shear stress (WSS) has been linked with increased plaque vulnerability.</P> <P><B>Objectives</B></P> <P>This study investigated the prognostic value of WSS measured in the proximal segments of lesions (WSS<SUB>prox</SUB>) to predict myocardial infarction (MI) in patients with stable coronary artery disease (CAD) and hemodynamically significant lesions. The authors hypothesized that in patients with low FFR and stable CAD, higher WSS<SUB>prox</SUB> would predict MI.</P> <P><B>Methods</B></P> <P>Among 441 patients in the FAME II (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation II) trial with FFR ≤0.80 who were randomized to medical therapy alone, 34 (8%) had subsequent MI within 3 years. Patients with vessel-related MI and adequate angiograms for 3-dimensional reconstruction (n = 29) were propensity matched to a control group with no MI (n = 29) by using demographic and clinical variables. Coronary lesions were divided into proximal, middle, and distal, along with 5-mm upstream and downstream segments. WSS was calculated for each segment.</P> <P><B>Results</B></P> <P>Median age was 62 years, and 46 (79%) were male. In the marginal Cox model, whereas lower FFR showed a trend (hazard ratio: 0.084; p = 0.064), higher WSS<SUB>prox</SUB> (hazard ratio: 1.234; p = 0.002, C-index = 0.65) predicted MI. Adding WSS<SUB>prox</SUB> to FFR resulted in a significant increase in global chi-square for predicting MI (p = 0.045), a net reclassification improvement of 0.69 (p = 0.005), and an integrated discrimination index of 0.11 (p = 0.010).</P> <P><B>Conclusions</B></P> <P>In patients with stable CAD and hemodynamically significant lesions, higher WSS in the proximal segments of atherosclerotic lesions is predictive of MI and has incremental prognostic value over FFR.</P> <P><B>Central Illustration</B></P> <P>[DISPLAY OMISSION]</P>
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