[1]邵杨歌 尹德录 赵新华李群星 陈心怡 薛婷 张鹏英.冠状动脉造影剂循环时间对冠心病患者的心肌灌注及功能的评估价值[J].心血管病学进展,2021,(10):951.[doi:10.16806/j.cnki.issn.1004-3934.20.10.021]
　SHAO YanggeYIN DeluZHAO XinhuaLI QunxingCHEN XinyiXUE TingZHANG Pengying.Evaluation Value of Coronary Contrast Agent Transit Time on Myocardial Perfusion and Myocardial Function in Patients with Coronary Heart Disease[J].Advances in Cardiovascular Diseases,2021,(10):951.[doi:10.16806/j.cnki.issn.1004-3934.20.10.021]
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冠状动脉造影剂循环时间对冠心病患者的心肌灌注及功能的评估价值()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2021年10期
页码:
951
栏目:
论著
出版日期:
2021-10-25

文章信息/Info

Title:
Evaluation Value of Coronary Contrast Agent Transit Time on Myocardial Perfusion and Myocardial Function in Patients with Coronary Heart Disease
作者:
邵杨歌 尹德录1 赵新华1李群星1 陈心怡1 薛婷 张鹏英2
1.徐州医科大学附属连云港医院心内科,江苏 连云港 222000;2徐州医科大学附属连云港医院超声科,江苏 连云港 222000 【
Author(s):
SHAO Yangge1YIN Delu1ZHAO Xinhua1LI Qunxing1CHEN Xinyi1XUE Ting2ZHANG Pengying2
(1.Department of Cardiology,Lianyungang Hospital Affiliated to Xuzhou Medical University,Lianyungang 222000,Jiangsu,China;2.Department of Ultrasound,Lianyungang Hospital Affiliated to Xuzhou Medical University,Lianyungang 222000,Jiangsu,China)
关键词:
冠心病; 造影剂循环时间; 校正TIMI帧数; 二维斑点追踪; 分层心肌应变
Keywords:
Corrected TIMI frame countCoronary contrast transit time; Two-dimensional speckle tracking; Layer-specific strain
DOI:
10.16806/j.cnki.issn.1004-3934.20.10.021
摘要:
目的 应用校正TIMI帧数（CTFC）、斑点追踪分层应变技术探讨造影剂循环时间（CCTT）对冠心病（CHD）患者心肌组织灌注及心肌功能的评估价值，并分析影响CCTT的相关因素。方法 （CAG）CHD 的患者100例为研究组，另选CAG正常者例为对照组。术前应用二维斑点追踪技术测定患者各层心肌整体纵向应变（GLS），计算CCTT、 CTFC和Gensini 积分，通过Pearson相关分析探讨CCTT与CTFC、分层GLS之间的相关性，并应用ogistic回归分析探讨影响CHD患者CCTT改变的相关因素。 结果 CHD患者CTFC、CCTT、分层GLS与正常对照组比较有差异（P＜0.05）。Pearson相关分析显示：CHD患者仅在冠脉轻度或单支血管病变时CCTT与CTFC有弱相关性，r值分别为-0.247-0.332，P均＜0.05。ogistic回归分析显示：年龄和冠脉病变的支数是CCTT降低的独立危险因素(OR分别为1.0892.084，P均＜0.05)。结论 CHD患者CCTT较正常对照组缩短，CCTT对CHD患者的心肌灌注及心肌功能评估价值有限，年龄和冠脉病变支数是CCTT降低的独立危险因素。
Abstract:
Objective orrected TIMI frame count(CTFC) and speckle tracking layer-specific strain are used to evaluate the value of coronary contrast agent transit time(CCTT) on myocardial perfusion and myocardial function in patients with coronary heart disease,?and to analyze the factors affecting CCTT. Methods 100 patients with CHD diagnosed by coronary angiography (CAG) in the Department of Cardiology, Lianyungang Hospital affiliated to Xuzhou Medical University were selected as the study group, and 50 patients with normal CAG were selected as the control group. 2D speckle tracking imaging technology was used to measure the global longitudinal strain (GLS) of each layer of myocardium before surgery. CCTT, CTFC and Gensini integrals were calculated according to CAG results.Pearson correlation analysis was used to explore the correlation between CTFC and CCTT,CTFC and layer-specific GLS.and logistic regression analysis was used to explore the influencing factors of CCTT reduction in CHD patients.?Results There are significant differences in CTFC,CCTT, and layer-specific GLS between CHD patients and the normal control group (P<0.05).Pearson correlation analysis shows that there is a weak correlation between CCTT and CTFC in patients with CHD only in patients with mild coronary artery disease or single vessel disease(r =-0.247,-0.332,P<0.05).Logistic regression analysis shows that age and number of coronary artery lesions are independent risk factors for CCTT reduction (OR=1.089 ,2.084,P<0.05). Conclusion CCTT in CHD patients is shorter than that in the normal control group, and CCTT has limited value in evaluating myocardial tissue perfusion and myocardial function in CHD patients. Age and number of coronary artery lesions are independent risk factors for the reduction of CCTT

参考文献/References:

[1] Gibson CMSchomig A. Coronary and myocardial angiography:angiographic assessment of both epicardial and myocardial perfusion[J]. Circulation,2004,109(25):3096-3105.
[2] Gibson CM,Cannon CP,Daley WL,et al. TIMI frame count:a quantitative method of assessing coronary artery flow[J]. Circulation,1996,93(5):879-888.
[3] Lopez-Hidalgo M,Eblen-Zajjur A. Coronary blood flow measurement in conventional coronary angiograms by a new method based on contrast density detection. a physiological insight[J]. Arq Bras Cardiol,2020,115(3):503-512.
[4] 何东方刘梅颜张丽军等. 冠状动脉中度狭窄伴胸痛患者的冠状动脉微循环阻力状况及其相关因素分析[J]. 中华内科杂志2018,57(4):270-274.
[5] Enge I,Nitter-Hauge S. Left coronary artery contrast transit time[J]. Br J Radiol,1975,48(566):108-112.
[6] Haridasan V,Nandan D,Raju D,et al. Coronary sinus filling time:a novel method to assess microcirculatory function in patients with angina and normal coronaries[J]. Indian Heart J,2013,65(2):142-146.
[7] Hagemann CA,Hoffmann S,Hagemann RA,et al. Usefulness of layer-specific strain in diagnosis of coronary artery disease in patients with stable angina pectoris[J]. Int J Cardiovasc Imaging,2019,35(11):1989-1999.
[8] Skaarup KG,Iversen A,Jorgensen PG,et al. Association between layer-specific global longitudinal strain and adverse outcomes following acute coronary syndrome[J]. Eur Heart J Cardiovasc Imaging,2018,19(12):1334-1342.
[9] Zhang L,Wu WC,Ma H,et al. Usefulness of layer-specific strain for identifying complex CAD and predicting the severity of coronary lesions in patients with non-ST-segment elevation acute coronary syndrome:compared with Syntax score[J]. Int J Cardiol,2016,223:1045-1052.
[10] Wang Y,Ma C,Zhang Y,et al. Assessment of left and right ventricular diastolic and systolic functions using two-dimensional speckle-tracking echocardiography in patients with coronary slow-flow phenomenon[J]. PLoS One,2015,10(2):e117979.
[11] Haridasan V,Nandan D,Raju D,et al. Coronary sinus filling time:a novel method to assess microcirculatory function in patients with angina and normal coronaries[J]. Indian Heart J,2013,65(2):142-146.
[12] Rampidis GP,Benetos G,Benz DC,et al. A guide for Gensini Score calculation[J]. Atherosclerosis,2019,287:181-183.
[13] Leclercq F. Anatomy and physiology of the heart and coronary arteries[J]. Soins,2015,(793):28-31.
[14] Gibson CM,Cannon CP,Daley WL,et al. TIMI frame count:a quantitative method of assessing coronary artery flow[J]. Circulation,1996,93(5):879-888.
[15] Pride YB,Mohanavelu S,Zorkun C,et al. Association between angiographic complications and clinical outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention:an EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome) angiographic substudy[J]. JACC Cardiovasc Interv,2012,5(9):927-935.
[16] Diez-Delhoyo F,Gutierrez-Ibanes E,Fernandez-Aviles F. Functional disorders in non-culprit coronary arteries and their implications in patients with acute myocardial infarction[J]. Trends Cardiovasc Med,2020,30(6):346-352.
[17] Onishi T,Saha SK,Delgado-Montero A,et al. Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging:comparison with left ventricular ejection fraction[J]. J Am Soc Echocardiogr,2015,28(5):587-596.
[18] Luis SA,Chan J,Pellikka PA. Echocardiographic assessment of left ventricular systolic function:an overview of contemporary techniques,including speckle-tracking echocardiography[J]. Mayo Clin Proc,2019,94(1):125-138.
[19] Buckberg GD,Clemente C,Cox JL,et al. The structure and function of the helical heart and its buttress wrapping. Ⅳ. The normal macroscopic structure of the heart[J]. Semin Thorac Cardiovasc Surg,2001,13(4):301-319.
[20] Chen W,Zhu W,Wang Y. Evaluation of myocardial perfusion and systolic function in patients with different degree of coronary artery stenosis by MCE and 2D-STI[J]. Zhong Nan Da Xue Xue Bao Yi Xue Ban,2020,45(1):35-39.
[21] 张洁樊继绪任斐等. 经胸超声心动图评估冠脉循环时间的可行性分析[J]. 南京医科大学学报(自然科学版)2016,36(2):228-230.
[22] Eriksseen J,Enge I. Left coronary artery transit time in latent coronary heart disease[J]. Acta Radiol Diagn (Stockh),1977,18(4):385-391.
[23] Enge I,Nitter-Hauge S. Left coronary artery contrast transit time[J]. Br J Radiol,1975,48(566):108-112.
[24] Padro T,Manfrini O,Bugiardini R,et al. ESC Working Group on Coronary Pathophysiology and Microcirculation position paper on ’coronary microvascular dysfunction in cardiovascular disease’[J]. Cardiovasc Res,2020,116(4):741-755.
[25] Gibson CM,Kirtane AJ,Murphy SA,et al. Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic,electrocardiographic,and clinical outcomes following thrombolytic administration in acute myocardial infarction[J]. Catheter Cardiovasc Interv,2001,53(1):6-11.
[26] Ding S,Shi Y,Sun X,et al. Contrast agent dose and slow/no-reflow in percutaneous coronary interventions:a case-control study of patients with non-ST-segment elevation acute coronary syndromes[J]. Herz,2019,44(1):69-75.
[27] Ul AR,Ahmedani M,Karim M,et al. Correlation between gensini score and duration of diabetes in patients undergoing coronary angiography[J]. Cureus,2019,11(2):e4010.
[28] Leung M,Leung DY. Coronary microvascular function in patients with type 2 diabetes mellitus[J]. EuroIntervention,2016,11(10):1111-1117.

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更新日期/Last Update: 2021-12-02