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ST분절의 상승을 보이지 않는 급성 흉통 환자에서 심근조영 심초음파의 역할

Other Titles
 The Role of Myocardial Contrast Echocardiography in Acute Chest Pain without ST Elevation 
Authors
 민필기  ;  김현주  ;  조승연  ;  정남식  ;  장양수  ;  임세중  ;  최동훈  ;  강석민  ;  홍그루  ;  변영섭  ;  정욱진  ;  강웅철  ;  정재헌  ;  안정아 
Citation
 KOREAN CIRCULATION JOURNAL, Vol.33(4) : 284-293, 2003 
Journal Title
 KOREAN CIRCULATION JOURNAL 
ISSN
 1738-5520 
Issue Date
2003
MeSH
chest pain ; myocardial isschemia ; echocardiogrphy ; contrast media
Keywords
chest pain ; myocardial isschemia ; echocardiogrphy ; contrast media
Abstract
Background and Objectives:We hypothesized that simultaneous assessment of myocardial perfusion and a regional wall motion abnormality, using real-time myocardial contrast echocardiography (MCE), provides more useful information than routine two-dimensional echocardiography (2DE) in the diagnosis of acute coronary syndrome in patients with a non-diagnostic ECG. Subjects and Methods:We prospectively enrolled 101 patients (age:61±10 years, 57 men) who presented with acute chest pain. A routine 2DE was performed to evaluate the regional wall motion abnormality, and a MCE to assess the perfusion defect. Coronary angiography was performed in all patients. The cardiac events (myocardial infarction, revascularization and death) were analyzed. Results:Of the 101 patients studied, 64 had significant coronary artery disease (diameter stenosis >70%). Cardiac events occurred in 58 patients; 21 myocardial infarction, 48 revascularization. The sensitivities of 2DE and MCE for significant coronary artery stenosis were 57.8 and 73.4%, and the specificities were 83.8 and 81.1%, respectively. Of the 58 patients with cardiac events, a regional wall motion abnormality was observed in 34 (59%), and a perfusion defect in 44 (76%). The specificities of 2DE and MCE for cardiac events were 79 and 77%, respectively. Cardiac events were more frequent in males, smokers and in those with an abnormal ECG (p<0.05), but only a perfusion defect independently predicted cardiac events (p<0.001, odds ratio=8.37). Conclusion:Real time MCE, in patients with acute chest pain, reasonably predicts significant coronary artery stenosis, and identifies those who will have cardiac events.
Files in This Item:
T200303943.pdf Download
DOI
OAK-2003-00546
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113706
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