全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2016 

基于冠脉狭窄位置和优势型的血流储备分数与狭窄率的相关性分析

DOI: doi:10.7507/1001-5515.20160151

Keywords: 冠状动脉狭窄, 相关性分析, 心肌缺血, 血流储备分数

Full-Text   Cite this paper   Add to My Lib

Abstract:

临床上对冠状动脉疾病通常采用影像学诊断方法指导治疗,然而其只能反映病变几何特征而无法反映功能状态。本文探究冠脉狭窄形态学与功能学之间的相关性,以期提高影像学诊断的有效性。本研究共纳入39位患者55支狭窄血管,采用医学统计分析方法对冠脉血流储备分数(FFR)和狭窄率进行相关性分析,讨论冠脉优势型和狭窄位置因素对其相关性的影响。研究发现,按照冠脉狭窄位置和优势型进行分组后,冠脉右优势型的左前降支狭窄患者的冠脉FFR与狭窄率存在相关性(r≈0.79,P < 0.000 1);分组后狭窄率诊断心肌缺血的准确性从70.9%提高到了82.8%(参考FFR < 0.80),敏感度(从72.2%提高到78.6%)和特异性(从70.3%提高到86.7%)也有明显改善。研究提示,冠脉狭窄位置和优势型是FFR与狭窄率相关性的重要影响因素,依据影像学检查结果诊断心肌缺血时纳入考虑这两个因素将有助于提高诊断的有效性

References

[1]  14. TONINO P A, FEARON W F, DE BRUYNE B A, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation[J]. J Am Coll Cardiol, 2010, 55(25):2816-2821.
[2]  15. TAKAGI A, TSURUMI Y, ISHⅡ Y, et al. Clinical potential of intravascular ultrasound for physiological assessment of coronary stenosis:relationship between quantitative ultrasound tomography and pressure-derived fractional flow reserve[J]. Circulation, 1999, 100(3):250-255.
[3]  3. PANAICH S S, ARORA S, PATEL N, et al. Intravascular ultrasound in lower extremity peripheral vascular interventions:variation in utilization and impact on In-Hospital outcomes from the nationwide inpatient sample (2006-2011)[J]. Lancet, 2016, 23(1):65-75.
[4]  4. DUVALL W L, RAI M, AHLBERG A W, et al. A multi-center assessment of the temporal trends in myocardial perfusion imaging[J]. J Nucl Cardiol, 2015, 22:1-13.
[5]  13. MEIJBOOM W B, VAN MIEGHEM C A, VAN PELT N, et al. Comprehensive assessment of coronary artery stenoses:computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina[J]. J Am Coll Cardiol, 2008, 52(8):636-643.
[6]  16. JASTI V, IVAN E, YALAMANCHILI V, et al. Correlations between fractional flow reserve and intravascular ultrasound in patients with an ambiguous left main coronary artery stenosis[J]. Circulation, 2004, 110(18):2831-2836.
[7]  17. CHAMULEAU S J, MARTIJN M, KOCH K T, et al. Usefulness of fractional flow reserve for risk stratification of patients with multivessel coronary artery disease and an intermediate stenosis[J]. Am J Cardiol, 2002, 89(4):377-380.
[8]  18. SERRUYS P W, ONUMA Y, GARG S, et al. Assessment of the SYNTAX score in the Syntax study[J]. EuroIntervention, 2009, 5(1):50-56.
[9]  19. CHAKRAVARTY T, BUCH M H, NAIK H, et al. Predictive accuracy of SYNTAX score for predicting Long-Term outcomes of unprotected left main coronary artery revascularization[J]. Am J Cardiol, 2011, 107(3):360-366.
[10]  20. NAM C W, MANGIACAPRA F, ENTJES R, et al. Functional SYNTAX score for risk assessment in multivessel coronary artery disease[J]. J Am Coll Cardiol, 2011, 58(12):1211-1218.
[11]  2. MAZHAR J, SHAW E, ALLAHWALA U K, et al. Comparison of two dimensional quantitative coronary angiography(2D-QCA)with optical coherence tomography(OCT)in the assessment of coronary artery lesion dimensions[J]. IJC Heart & Vasculature, 2015, 101(9):14-17.
[12]  6. PIJLS N J, SELS J M. Functional measurement of coronary stenosis[J]. J Am Coll Cardiol, 2012, 59(12):1045-1057.
[13]  7. PIJLS N H, TANAKA N, FEARON W F. Functional assessment of coronary stenoses:can we live without it?[J]. Eur Heart J, 2013, 34(18):1335-1344.
[14]  8. PIJLS N J. Fractional flow reserve to guide coronary revascularization[J]. Circ J, 2013, 77(3):561-569.
[15]  21. YEW K L. The role of fractional flow reserve in pre-operative coronary angiography in redefining functional syntax score and cardiac risk in multivessel coronary artery disease[J]. Int J Cardiol, 2014, 177(3):E163-E164.
[16]  22. KOBAYASHI Y, NAM C W, TONINO P A, et al. TCT-37 the prognostic value of the residual SYNTAX score after "functionally" complete revascularization:insights from the FAME(fractional flow reserve versus angiography for multivessel evaluation)trial[J]. J Am Coll Cardiol, 2015, 66(15):1-14.
[17]  23. 萨建, 刘桂芬.定量测量结果的一致性评价及Bland-Altman法的应用[J].中国卫生统计, 2011, 28(4):409-411, 413.
[18]  9. PIJLS N J, FEARON W F, TONINO P L, et al. Fractional FlowReserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease 2-Year Follow-Up of the FAME(fractional flow reserve versus angiography for multivessel evaluation)study[J]. J Am Coll Cardiol, 2010, 56(3):177-184.
[19]  10. PIJLS N H, VAN SCHAARDENBURGH P, MANOHARAN G, et al. Percutaneous coronary intervention of functionally nonsignificant stenosis-5-year follow-up of the DEFER study[J]. J Am Coll Cardiol, 2007, 49(21):2105-2111.
[20]  11. DORBALA S, BLANKSTEIN R, SKALI H, et al. Approaches to reducing radiation dose from radionuclide myocardial perfusion imaging[J]. J Nucl Med, 2015, 56(4):592-599.
[21]  12. KLEIMAN N S. Bringing it all together integration of physiology with anatomy during cardiac catheterization[J]. J Am Coll Cardiol, 2011, 58(12):1219-1221.
[22]  1. KERL J M, HOFMANN L K, THILO C, et al. Coronary CTA-image acquisition and interpretation[J]. J Thorac Imaging, 2007, 22(1):22-34.
[23]  5. PIJLS N J, BRUYNE B D, PEELS K, et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses[J]. N Engl J Med, 1996, 334(26):1703-1708.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133