冠脉造影脉冲响应原理评价心肌微循环

A Study on Myocardial Microcirculation with Coronary Angiographic Impulse Response Function

本方法采用冠脉造影脉冲响应原理,建立冠脉造影心肌微循环分析系统。结合定量冠脉造影(QCA),该系统提供有关心肌微循环(Tmicro-1)、冠脉几何形态(MLD)和血流动力学(mAP、CFV、Rcor)等定量指标,用以评价冠状动脉和心肌微循环,并临床应用20例。结果显示:随着近段冠脉狭窄MLD缩小,Tmicro-1减少;PCI治疗后,随着MLD增加,Tmicro-1增加,两者之间呈良好相关(r=0.87,P<0.001),并且CFV、Rcor均得到一致改善。因此,冠脉造影脉冲响应分析系统所提供的Tmicro-1、CFV等定量分析指标,可作为评估冠脉血流和心肌微循环功能状态的敏感参数,结合定量冠脉造影分析指标,有利于提高常规冠脉造影解剖形态与生理功能相结合,分析冠脉狭窄和介入治疗前、后心肌微循环和大-小循环动力学之间的变化关系。

We have established a digital coronary angiograph-analyzing system on the principle of coronary angiographic impulse response, and combined the system with the quantitative coronary analysis （QCA） for investigating the coronary microcirculation （Tmicro^-1） , the minimal stenotic diameter of coronary （MLD） and coronary hemodynamic parameters （mAP,CFV,Rcor） in 20 patients with coronary stenosis. The results showed the minimal stenotic diameter （MLD） and Tmicro^-1 decreased, with the increase of stenosis of proximal coronary. After successful percutaneous coronary intervention treatment, the Tmicro^-1 increased with the increase of MLD and was in linear correlation with MLD（r= 0. 87,P〈0. 001）. In conclusion, The index Tmicro^-1 detected by coronary digital angiographic impulse response analysis system in combination with CFV and QCA would help to evaluate the level of integrated diagnosis of coronary lesion in regard to anatomy and physiology as well as to macro and microcirculation.