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심근교 ( Myocardial bridge ) 의 임상적 의의
한성욱(Seong Wook Han),김윤년(Yoon Nyun Kim),허승호(Seung Ho Hur),현대우(Dae Woo Hyun),김기식(Kee Sik Kim),김권배(Kwon Bae Kim) 대한내과학회 1998 대한내과학회지 Vol.54 No.6
N/A Objective: A myocardial bridge is an anatomic arrangement in which an epicardial coronary artery becomes engulfed for a limited segment by myocardial fibers from birth. It is recognized angiographyically by systolic compression of coronary artery. A large discrepancy exist between pathological series, in which the incidence has varied from 15% to 85%, and angiographic seires, in which it is reported as being between 0.51% and 2.5%. A myocardial bridge has been associated with myocardial ischemia, infarction and sudden death, but its clinical significance is controversial, The aim of this study was to assess the clinical characteristics and significance of myocardial bridge based on our exerience. Method: We reviewed the consecutive 1554 cinean-giograms performed in the cardiac laboratory of the Keimyung University Hospital from Nov, 1992 to May 1996. Two groups were constituted according to percentage of systolic reduction of the arterial lumen assessed visually or by computerized digital caliper. We differentiated them between below 50% and above 50% in the systolic reduction. Comparison between variables in two groups were made. Results: 1) Myocardial bridges were present in 36 patients (2.3%). 2) Among these patients, 21 had angina (58.3%), 8 had myocardial infarction (22.2%), 6 had hypertension (16.7%) and 4 had hypertrophic cardiomyopthy, primary pulmonary hypertension, mitral regurgitation and aortic regurgitation, respectively. 3) The highest prevalance was found in the mid-left anterior descending (LAD) artery (80.5%), next in the distal LAD artery (11.1%). Two cases had myocardial bridges in two sites. 4) Isolated myocardial bridges which excludes those associated with concomitant cardiovascular diseases were present in 19 patients (1.22%). Initiol symptoms in patients with myocardial bridge are exercise induced angina in 10, atypical chest pain in 3, resting onset chest pain in 3 and palpitation in 1 at admission. Two patients had no specific symptoms except electrocardiographic abnormality. 5) Clinical diagnosis of patients with isolated myocardial bridges were anginal pectaris in 13, myocardial infarction in 2 and nonspecific in 4. Myocardial infarction was present in the group of above 50% of systolic reduction. Conclusion: A myocardial bridge may induce myocardial ischemia and myocardial infarction, but prognosis may be good if patients should avoid precipitating factors i,e. condition induce tachycardia or administered β-blocker etc.
실험연구 : 실험견에서 간혈류 차단 및 재관류 시 소량의 Nitroglycerin과 Dopamine 투여에 의한 신장 혈류 및 실시간 국소 신관류의 변화
한성욱 ( Seong Wook Han ),엄진원 ( Jin Won Uhm ),장영호 ( Young Ho Jang ),김애라 ( Ae Ra Kim ),김진모 ( Jin Mo Kim ),배정인 ( Jung In Bae ),정정길 ( Jung Kil Chung ),전재규 ( Jae Kyu Cheun ) 대한마취과학회 2003 Korean Journal of Anesthesiology Vol.44 No.6