Title冠状动脉临界病变定量冠状动脉造影参数与心肌流量储备分数的关系
Other TitlesAssociation between fractional flow reserve and quantitative coronary angiography parameters in intermediate coronary artery stenosis
Authors孙丽杰
米琳
崔鸣
郭丽君
张永珍
张福春
牛杰
李海燕
王贵松
韩江莉
高炜
李丹
李翠萍
Affiliation100191,北京大学第三医院心内科卫生部心血管分子生物学与调节肽重点实验室及分子心血管学教育部重点实验室
Keywords冠状动脉疾病
血流储备分数,心肌
冠状血管造影术
Coronary disease
Fractional flow reserve,myocardial
Coronary angiography
Issue Date2012
Publisher中华心血管病杂志
Citation中华心血管病杂志.2012,40,(9),742-746.
Abstract目的 评估冠状动脉临界病变定量冠状动脉造影(QCA)解剖学参数与心肌流量储备分数(FFR)的关系,筛选理想的评价心肌缺血的影像学参数.方法 共纳入106例患者121处临界病变,平均年龄(63±10)岁.按FFR值分成两组,FFR≤0.75组(n=19)及FFR>0.75组(n=102).采用相关分析和ROC曲线分析比较QCA参数和FFR的关系.结果 两组在QCA病变长度[(14.8±7.9)mm比(10.7±5.4)mm,P=0.024]、最小管腔开放直径[MLD,(1.47±0.31) mm比(1.82±0.51)mm,P=0.028]、参考血管直径[RVD,(2.30 ±0.50)mm比(2.81±0.64)mm,P=0.036]及最小管腔开放面积[ MLA,(2.30±1.50) mm2比( 3.60±2.30 )mm2,P=0.038]的差异均有统计学意义,并与FFR值存在不同程度的相关性(r分别为-0.209、0.414、0.302和0.315,P值分别为0.040、0.000、0.003和0.002).ROC曲线分析提示,MLD≥1.6 mm时,预测FFR值>0.75的敏感度为63%,特异度为82%,阳性预测值为96%.结论 在冠状动脉造影证实的临界狭窄病变中,QCA部分解剖学参数与FFR值存在相关性,其中MLD能够预测冠状动脉临界病变的血液动力学意义.
Objective To explore the relationship between quantitative coronary angiography (QCA) parameters and fractional flow reserve (FFR) for identifying ideal angiographic parameters predictive of myocardial ischemia.Methods The study included 121 lesions with QCA and FFR data from 106 patients [ mean age:(63 ± 10 ) years ].The lesions were grouped into FFR > 0.75 group and FFR ≤0.75 group.Assessed parameters by QCA included percentage diameter stenosis,minimum luminal diameter ( MLD),percentage area stenosis,minimum luminal area (MLA),reference vessel diameter (RVD) and lesion length (LL).Correlation analysis was used to identify the relationship between QCA parameters and FFR value,and receiver operating characteristic (ROC) curve was used to determine parameters predictive of FFR≤0.75.Results LL was significantly higher[ ( 14.8 ±7.9)mm vs.( 10.7 ±5.4) mm,P=0.024]whileMLD [(1.47 ±0.31)mm vs.(1.82 ± 0.51) mm,P=0.028],RVD [(2.30 ±0.50) mm vs.(2.81 ±0.64) mm,P=0.036],andMLA [(2.30±1.50)mm2 vs.(3.60 ±2.30) mm2,P=0.038]were significantly lower in FFR≤0.75 group than in FFR >0.75 group.LL (r =-0.209,P =0.040) was negatively correlated with FFR,and MLD ( r=0.414,P=0.040),RVD ( r =0.303,P =0.000) and MLA (r =0.315,P =0.002) were positively correlated with FFR.ROC analysis showed that MLD ≥ 1.6 mm was the best cut-off value to predict FFR > 0.75 with sensitivity 63%,specificity 82%,and positive predictive value 96%.Conclusions QCA derived anatomic parameters of intermediate coronary lesions correlate to FFR value in some extent.MLD ≥ 1.6 mm is the best cut-off value to predict FFR > 0.75 in patients with intermediate coronary lesions.
URIhttp://hdl.handle.net/20.500.11897/105123
ISSN0253-3758
DOI10.3760/cma.j.issn.0253-3758.2012.09.005
IndexedPubMed
中文核心期刊要目总览(PKU)
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
Appears in Collections:第三医院

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