초록 ▼

- 2D 스트레인 측정법의 신뢰도
PSLS의 신뢰도평가 관찰자내ICC = 0.89 (p<0.001) 관찰자간ICC = 0.89 (p<0.001).
- 관상동맥질환에서 PSLS 값이 저하되어 있음을 확인
관상동맥질환군과 정상군으로 나누어 PSLS값을 측정
질환군 (n = 82); -19.6 ± 2.0%
정상군 (n = 77); -21.8 ± 2.1% (p<0.001).
global PSLS가 -21.2% 이하로 저하되면 관상동맥질환을 민감도 78%, 특이도 71%로예측가능함
- 관상동맥 중재술 시

- 2D 스트레인 측정법의 신뢰도
PSLS의 신뢰도평가 관찰자내ICC = 0.89 (p<0.001) 관찰자간ICC = 0.89 (p<0.001).
- 관상동맥질환에서 PSLS 값이 저하되어 있음을 확인
관상동맥질환군과 정상군으로 나누어 PSLS값을 측정
질환군 (n = 82); -19.6 ± 2.0%
정상군 (n = 77); -21.8 ± 2.1% (p<0.001).
global PSLS가 -21.2% 이하로 저하되면 관상동맥질환을 민감도 78%, 특이도 71%로예측가능함
- 관상동맥 중재술 시행 후 PSLS값의 변화
총 72명의 환자에서 시술전 좌심실구혈률 59.0±6.0%, 확장기말용적 74.3±20.8ml, 수축기말용적 30.2±10.8ml이었으며global PSLS값은 -20.2±2.5%임.
시술 후 추적 검사상 좌심실구혈률 58.4±6.0% (p=0.435), 확장기말용적 71.7±20.0ml (p=0.098), 수축기말용적 30.2±11.2ml (p=0.970)으로 시술전과 차이 없음
Global PSLS값은 -18.6±2.1%로 유의하게 감소함 (p<0.001)
결론적으로 관상동맥중재술 후 global PSLS값은 호전되지 않고 악화되는 소견을 보임

Abstract ▼

Ⅰ. Aim
To confirm the usefulness of 2D strain measurement for the evaluation of changes before and after percutaneous coronary intervention (PCI) of the patients with chronic stable angina.
Ⅱ. Backgrounds and Methods
In the patients with chronic stable angina, resting echocardiographic para

Ⅰ. Aim
To confirm the usefulness of 2D strain measurement for the evaluation of changes before and after percutaneous coronary intervention (PCI) of the patients with chronic stable angina.
Ⅱ. Backgrounds and Methods
In the patients with chronic stable angina, resting echocardiographic parameters such as left ventricular (LV) ejection fraction (EF) and regional wall motion score are frequently normal.
Therefore, we could not use it for the detection of chronic stable angina.
With technical improvements in the temporal and spatial resolutions of 2-dimensional (2D) echocardiography, LV peak systolic longitudinal strain (PSLS) can now be measured using the 2D speckle tracking method. This method might provide a useful means of measuring LV long axis function, and might detect subtle changes in LV systolic function which could be caused by myocardial ischemia. Recently, a semi-automated algorithm for automated function imaging (AFI) was devised that can assist PSLS measurements. This method can provide quantitative measurements of global and segmental PSLS using a simple bull's eye display. This method allows global PSLS to be used in a routine clinical setting because it requires a very little additional time to routine wall motion analysis by visual estimation This method might provide a useful means of measuring LV long axis function, and might detect subtle changes in LV systolic function which could be caused by myocardial ischemia.
There were no effective noninvasive methods for the evaluation of LV function after PCI.
Therefore we evaluate to know whether PSLS will be improved or not after PCI after confirming the usefulness and clinical validity of PSLS in the patients with chronic stable angina.
Ⅲ. Results
- Interobserver and intraobserver variabililty
We checked intraclass correlation coefficients in 48 randomly selected patients.
ICC for intraobserver measurements = 0.89 (p<0.001)
ICC for interobserver measurements = 0.89 (p<0.001).
- Reduced PSLS in the patients with coronary arterial disease (CAD)
In the patients with CAD (n = 82, mean age 60 ± 10 years) PSLS was -19.6% ± 2.0%, which were significantly reduced in comparison with PSLS (-21.8% ± 2.1%, p < 0.001) in normal control subjects (n = 77, mean age 58 ± 10 years).
According to ROC curve analysis, the optimal cutoff value for mid and basal PSLS for the detection of CAD was -21.2% (sensitivity = 78%, specificity = 79%).
This result confirmed that resting PSLS in the patients with CAD are reduced.
- Changes of global PSLS after PCI
We evaluated 72 patients who underwent PCI for the treatment of CAD.
Before PCI, baseline LV EF was 59.0±6.0%, LV end-diastolic volume (EDV) was 74.3±20.8ml, LV end-systolic volume (ESV) was 30.2±10.8ml, and global PSLS was-20.2±2.5%.
After PCI, patients were followed-up with echocardiography. There were no significant changes in follow-up LVEF(58.4±6.0%, p=0.435), LVEDV(71.7±20.0ml, p=0.098), and LVESV (30.2±11.2ml, p=0.970). However, global PSLS had reduced to -18.6±2.1% compared to pre-PCI values (p<0.00001).
In 17 patients with cardiovascular adverse events such as readmission for chest pain and revascularization, but reduced follow-up PSLS was not associated with adverse events (odd ratio 0.932 95%CI 0.72-1.2, p=0.595).
In conclusion, global PSLS was rather aggravated after PCI compared to that measured before PCI.
Ⅳ. Future directions
- Reliability of 2D strain measurements
We confirmed the reliability of 2D strain measurements. So we can use this result as reference data for the other study using 2D strain for evaluation of cardiac function in CAD patients.
- Confirming the usefulness of 2D strain for the detection of CAD
- Can help to diagnose CAD noninvasively
- We usually performed stress tests for the detection of CAD causing myocardial ischemia during the tests. Considering this, we can safely diagnose CAD using PSLS.

목차 Contents

• I. 총괄현황 ...1
• 1. 겉표지 ...2
• 2. 제출문 ...4
• 3. 보고서 요약서 ...5
• 4. 요약문 (한글) ...6
• 5. 요약문 (영문) ...8
• 6. 연구 성과 실적 및 향후 계획 ...10
• 6.1 총괄연구개발과제의 연구성과 실적 및 향후 계획...10
• 6.2 연구성과 유형별 세부 내역 ...11
• 7. 참여연구원 현황표 ...14
• II. 총괄연구과제 연구결과 ...15
• 1. 연구개발과제의 배경 및 필요성 ...16
• 2. 국내외 기술개발 현황 ...19
• 3. 연구개발과제의 추진체계 ...19
• 4. 연구개발수행 내용 및 결과 ...20
• 5. 목표달성도 및 관련분야 기여도 ...24
• 5.1. 총괄연구개발과제의 목표달성도 ...24
• 5.2. 관련분야 기여도 ...24
• 6. 향후 연구성과 추진 계획 ...24
• 7. 연구개발결과의 파급효과 ...24
• 7.1. 기술적 파급효과 ...24
• 7.2. 경제.산업적 파급효과 ...25
• 7.3. 사회적 파급효과 ...25
• 8. 연구개발결과의 활용계획 ...25
• 8.1. 연구개발결과의 활용계획 및 추가연구의 필요성 ...25
• 8.2. 사업화(기업화) 목표 달성도 및 계획 ...25
• 8.3. 사업화 수준(계획 및 완료 포함) ...25
• 9. 연구개발과정에서 수집한 해외과학기술정보 ...25
• 10. 참고문헌 ...25
• III. 첨부서류 ...27
• 1. 자체평가의견서 ...29
• 2. 실적 증빙자료 ...33
• 3. 기타 첨부서류 ...40