基于默里定律的定量流量比诊断心脏结构异常和左心室舒张功能障碍患者的准确性
Accuracy of Murray Law Based Quantitative Flow Ratio in Diagnosing Patients with Cardiac Structural Abnormalities and Left Ventricular Diastolic Dysfunc-tion
赖迪生 1黄育铭 2陈美玲 3赖志斌 4韦成成5
作者信息
- 1. 南方医科大学附属广东省人民医院(广东省医学科学院) 心内科,广州 510080
- 2. 南方医科大学附属广东省人民医院(广东省医学科学院) 心导管室,广州 510080
- 3. 南方医科大学附属广东省人民医院(广东省医学科学院) 药学部,广州 510080
- 4. 肇庆高新区人民医院(肇庆汇康医院)内一科,广东肇庆 526238
- 5. 桐乡市第一人民医院心内科,浙江桐乡 314500
- 折叠
摘要
目的 旨在从单一血管造影角度深入探讨基于默里定律的定量流量比(Murray-law quantitative flow ratio,μQFR)在诊断心脏结构异常和左心室舒张功能障碍患者中的准确性.方法 回顾分析2018年1月至2018年12月期间广东省人民医院收治的90例患者的90条血管数据.这些患者在接受干预前接受了血流储备分数(fractional flow reserve,FFR)和μQFR检测,同时通过超声心动图评估了心脏结构和功能.FFR≤0.80被定义为具有血流动力学意义的冠状动脉缺血.结果 μQFR与FFR之间存在中等程度的相关性(r=0.75,P<0.001),但Bland-Altman图显示两者之间存在一定的差异(平均差异=0.00;标准差=0.08;P=0.69).根据FFR标准,μQFR的诊断准确率、敏感度、特异度、阳性预测值(positive predictive value,PPV)和阴性预测值(negative predictive value,NPV)分别为95.56%(95%CI:89.01%～98.78%)、90.91%(95%CI:89.01～98.09)、98.25%(95%CI:90.61～99.96)、96.77(95%CI:81.04～99.53)和94.92%(95%CI:86.38～98.21).进一步分析表明,μQFR/FFR的一致性与左心室舒张功能和心脏结构异常之间无显著相关性(P>0.05).结论 μQFR与FFR之间存在良好的一致性,且在心脏结构异常和左心室舒张功能障碍患者中,μQFR的诊断准确性并未受到显著影响.
Abstract
Objectives To explore the accuracy of Murray-law quantitative flow ratio(μQFR)in diagnosing patients with cardiac structural abnormalities and left ventricular diastolic dysfunction from a single angiographic perspective.Methods This study retrospectively analyzed 90 patients with 90 vessels from January 2018 to December 2018 in Guang-dong Provincial People's Hospital.These patients underwent fractional flow reserve(FFR)and μQFR measurements before intervention,and cardiac structure and function were evaluated using echocardiography.A FFR≤0.80 was defined as hemodynamically significant coronary ischemia.Results There was a moderate correlation between μQFR and FFR(r=0.75,P<0.001),but the Bland-Altman plot showed a certain difference between the two(mean difference=0.00;standard deviation=0.08;P=0.69).According to the FFR criteria,the diagnostic accuracy,sensitivity,specificity,posi-tive predictive value(PPV),and negative predictive value(NPV)of μQFR were 95.56%(95%CI:89.01%～98.78%),90.91%(95%CI:89.01～98.09),98.25%(95%CI:90.61～99.96),96.77(95%CI:81.04～99.53),and 94.92%(95%CI:86.38～98.21),respectively.Additional analysis showed no significant correlation between the consistency of μQFR/FFR and left ventricular diastolic function and cardiac structural abnormalities(P>0.05).Conclusions There is a good consistency between μQFR and FFR,and the diagnostic accuracy of μQFR is not significantly affected in patients with cardiac structural abnormalities and left ventricular diastolic dysfunction.
关键词
冠状动脉疾病/冠状动脉血流动力学/超声心动图/血流储备分数/定量流量比Key words
coronary heart disease/coronary hemodynamics/echocardiography/fractional flow reserve/quantitative flow ratio引用本文复制引用
出版年
2024
NETL
NSTL
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