自动功能成像对无室壁运动异常患者冠状动脉狭窄的预测价值

Value of automated functional imaging in predicting coronary artery stenosis in patients without ventricular wall motion abnormalities

目的探讨自动功能成像(AFI)预测无室壁运动异常患者冠状动脉狭窄的价值。方法选择2018年7月至2019年9月新乡市中心医院收治的二维超声心动图检查无室壁运动异常且冠状动脉造影(CAG)证实冠状动脉狭窄≥70%的冠状动脉性心脏病患者40例为研究对象,比较AFI与CAG对冠状动脉狭窄≥70%的检出率;以CAG为金标准,评估AFI对冠状动脉狭窄≥70%的预测价值。结果AFI和CAG对冠状动脉狭窄≥70%的检出率比较差异无统计学意义(χ^(2)=1.667,P>0.05)。AFI预测左冠状动脉前降支狭窄≥70%的敏感度为100.0%、特异度为63.6%、阳性预测值为69.2%、阴性预测值为100.0%、准确度为80.0%;预测左冠状动脉回旋支狭窄≥70%的敏感度为56.2%、特异度为91.6%、阳性预测值为81.8%、阴性预测值为75.8%、准确度为77.5%;预测右冠状动脉狭窄≥70%的敏感度为95.6%、特异度为47.0%、阳性预测值为70.9%、阴性预测值为88.0%、准确度为75.0%;预测冠状动脉狭窄≥70%的总体敏感度为85.9%、特异度为69.8%、阳性预测值为72.0%、阴性预测值为84.6%、准确度为77.5%。结论AFI可以为临床早期预测无室壁运动异常患者冠状动脉狭窄≥70%提供一个灵敏、客观、无创、廉价的检查方法。

Objective To explore the value of automated functional imaging(AFI)in predicting coronary artery stenosis in patients without ventricular wall motion abnormalities.Methods A total of 40 patients without ventricular wall motion abnormalities under two-dimensional echocardiography and confirmed coronary artery heart diseases(CHD)(coronary stenosis≥70%)by coronary angiography(CAG)at the Xinxiang Central Hospital from July 2018 to September 2019 were selected as the research subjects.The detection rates of coronary artery stenosis≥70%by AFI and CAG were compared.With reference to CAG as the gold standard,the predictive value of AFI for coronary artery stenosis≥70%was evaluated.Results There was no significant difference in the detection rates of coronary artery stenosis≥70%by AFI and CAG(χ^(2)=1.667,P>0.05).The predictive efficacy of AFI for coronary artery stenosis≥70%was as follows:a sensitivity of 100%,a specificity of 63.6%,the positive predictive value of 69.2%,the negative predictive value of 100%,and an accuracy of 80%for predicting stenosis≥70%in the left anterior descending artery;a sensitivity of 56.2%,a specificity of 91.6%,the positive predictive value of 81.8%,the negative predictive value of 75.8%,and an accuracy of 77.5%for predicting stenosis≥70%in the left circumflex artery;a sensitivity of 95.6%,a specificity of 47.0%,the positive predictive value of 70.9%,the negative predictive value of 88.0%,and an accuracy of 75.0%for predicting stenosis≥70%in the right coronary artery;the overall sensitivity of 85.9%,the overall specificity of 69.8%,the overall positive predictive value of 72.0%,the overall negative predictive value of 84.6%,and the overall accuracy of 77.5%.Conclusion AFI can provide a sensitive,objective,non-invasive,and inexpensive examination method for the early clinical forecast of coronary artery stenosis.