Angiography

‘As an aid to diagnosis in ischaemic heart-disease’, Lancet editorialists wrote in 1966, coronary angiography ‘seems at present to offer little that cannot be more easily obtained by much simpler methods, such as good history-taking and electrocardiography’. Since its serendipitous origins at the Cleveland Clinic laboratory of Dr F. Mason Sones in 1958, selective coronary angiography has taken on central importance in the diagnosis of coronary artery disease and characterization of coronary anatomy prior to coronary artery bypass graft surgery. Performance has become simpler and safer, evolving from a brachial artery cut-down approach with stiff, large-calibre multipurpose catheters to percutaneous femoral, radial, and now ulnar approaches with softer, lower-profile catheters specially designed to atraumatically engage the coronary ostia.

High-frequency electrocardiography as an additional method for diagnosing myocardial ischemia in patients with СHD of various ages

Objectives: to study the relationship between high-frequency electrocardiography (ECG) and selective coronary angiography data.Materials and methods: the study was conducted on 125 patients with a diagnosis of coronary heart disease (CHD), who were sent for selective coronary angiography. Patients were divided into groups: I group - young age, II group 2- middle age, III group — senile and elderly age. All patients were recorded high-frequency ECG in 12 common leads using a computer electrocardiograph, the data obtained were analyzed by special software.Results: according to the selective coronary angiography data, hemodynamically insignificant lesions of the coronary arteries were present in 34 (27.2%) people, and in 49 (39.2 %) people - hemodynamically significant lesions of the coronary arteries. Hemodynamically significant coronary artery stenoses are more often detected in elderly and senile patients. Stenotic lesions of the coronary arteries were more common in group 3 as opposed to group 2 (p = 0.002). High-frequency ECG analysis revealed a significant difference in the amount of RAZ between elderly and senile patients compared to young and middle-aged patients (p 1–2 = 0.373; p 1–3 = 0.006; p 2–3 = 0.008). The RAZ parameter of a high-frequency ECG in 12 common leads has a relationship with the age of patients, the number of coronary arteries with stenotic lesions, and the number of hemodynamically significant stenoses.Conclusion: the results of the study show that high-frequency ECG can be further developed as an additional method for diagnosing myocardial ischemia.

The diagnostic value of low-dose chest computed tomography for calcium score determining compared with the standard method and the results of computed tomography and selective coronary angiography

Aim. Coronary artery calcification is a characteristic of coronary atherosclerosis, which is often detected by chest computed tomography (CT). The aim of this study is to assess the efficiency of low-dose chest CT in calcium score (CS) determining and to compare it with conventional method and results of CT and selective coronary angiography.Material and methods. A total of 251 patients underwent a low-dose chest CT and a CS determining. Coincidence between the two methods was evaluated by the absolute CS values and by stratification of patients into five risk categories (“zero” CS values were excluded from the analysis). Eighty patients underwent CT or selective coronary angiography and the results were divided into two groups according to the degree of coronary stenosis — ˂50% and ≥50%. The CS values determined by chest CT are compared with the results of coronary angiography. Results. In 79 patients (31%), the CS was 0 and they were excluded from further analysis. The absolute CS values comparability between the two scanning methods in other 172 patients was very high (r=0,978, p<0,05). The coincidence in stratification of patients by risk groups was also high (contingency coefficient k=0,846). The CS specificity compared with coronary angiography was 97,5%, but with a low sensitivity of 43,6%, if the CS value is set to 400, above which coronary stenosis will considered significant. In comparing CS values with results of CT, the relationship of high CS values with coronary stenosis, were statistically proved: in 17 patients from 18 with CS >400 significant coronary stenosis was detected, in comparison with 22 patients from 52 patients with a CS more than 400 (p<0,05). Conclusion. The research showed that low-dose chest CT can be used to determine CS. Studied values correlate with the results of coronary angiography.