冠状动脉血流成像测量冠状动脉血流储备与冠状动脉内多普勒的对照分析

Measurement of coronary flow reserve by coronary flow imaging: comparison with intracoronary Doppler

目的比较冠状动脉血流成像(CFI)测量冠状动脉血流储备(CFR)方法的准确性,以确定一种简便而准确的方法。方法利用CFI检测106例怀疑或已知冠心病患者基础状态和经静脉注射腺苷140μg/(kg·min)达到最大充血反应状态时左冠状动脉前降支(LAD)血流,分别通过舒张期最大峰值血流速度(PDV)、舒张期平均血流速度(MDV)和平均血流速度(APV)计算冠状动脉血流速度储备(CFVR)。与冠状动脉内多普勒(ICD)的测值相比较,分析CFI方法的准确性。结果CFI通过PDV、MDV和APV计算CFVR的测值与ICD测值的回归方程分别为y=0.61x+1.32、y=0.71x+0.96和y=0.91x+0.33,相关系数r分别为0.55、0.64和0.83(P<0.01)。结论CFI是一项准确测量CFVR的方法,通过MDV计算CFVR的测值准确且简洁、方便,可广泛用于临床。

Objective The purpose of this study was to explore the accuracy of coronary flow imaging （CFI） measurement of coronary flow velocity reserve （CFVR）, and to find out a easy and accurate method. Methods Coronary flow velocity was measured in the distal left anterior descending artery （LAD） by CFI at baseline and during intravenous adenosine infusion of 140 μg/kg per min in 106 patients with suspected or confirmed coronary artery disease. Peak velocity during diastole （PDV）, mean velocity during diastole （MDV） and average peak velocity （APV） were measured both at baseline and at peak hyperemic. CFVR was assessed respectively as the ratio of PDV, MDV and APV of peak hyperemic to basal coronary flow velocity. CFVR obtained by CFI was compared with those by （intracoronary Doppler） ICD. Results CFVR determined from CFI correlated closely with those from ICD measurements （CFVR determined by PDV： y= 0.61 x ＋1.32, r= 0.55, P 〈0.01; CFVR determined by MDV： y=0.71x＋0.96, r=0.64, P〈0. 001; CFVR determined by APV： y=0.91x＋0.33, r=0.83, P〈0. 001）. Conclusion CFI is an accurate assessment of CFVR, CFVR estimated by MDV is accurate, simple and convenient, that can be used widely in clinical.