Clinical significance of changes in blood fractional flow reserve(FFR)in coronary CT angiography(CCTA)in patients undergoing heart transplantation
Objective To analyze the clinical significance of changes in fractional flow reserve(FFR)of cor-onary CT angiography(CCTA)in patients undergoing heart transplantation.Methods 73 patients who were admitted and underwent heart transplantation between June 2020 and June 2023 were selected as the study subjects.Use CCTA to detect FFR values and divide them into a FFR reducing group(n=48)and an FFR increasing group(n=25)based on FFR changes.Collected and analyzed general clinical data of en-rolled patients,including age,gender,heart rate,transplant etiology,past history,donor age,organ cold ischemia time,etc.The enrolled patients were followed up for cardiac graft vascular disease,occurrence time and complications.Results The age,male proportion,body mass index(BMI),heart rate,systolic blood pressure and postoperative time of the patients in the FFR increasing group were lower than those in the FFR reducing group(P＜0.05).The most common cause of heart transplantation in the FFR decrea-sing and FFR increasing groups was dilated cardiomyopathy.The heart function of the FFR increasing group was better than that of the FFR reducing group(P＜0.05).The preoperative extracorporeal oxy-genation(ECMO)assistance rate,intraoperative ECMO assistance rate,postoperative ECMO assistance rate,postoperative ECMO duration,preoperative CRRT treatment rate,postoperative CRRT treatment rate and postoperative CRRT duration were lower in the FFR increasing group than in the FFR reducing group(P＜0.05).The left ventricular ejection fraction in the FFR increasing group was higher than that in the FFR reducing group(P＜0.05).The end diastolic volume,end systolic volumeand myocardial mass index of FFR increasing group were lower than those of the FFR reducing group(P＜0.05).The follow-up results showed that the incidence of non heart transplant vascular disease in the group with increased FFR was higher than that in the group with decreased FFR(P＜0.05).The results of multivariate logis-tic regression analysis showed that age,NYHA heart function grading,supportive treatment rate,left ventricular ejection fraction,end systolic volume and FFR were all influencing factors for the occurrence of major adverse cardiac events(MACE)in patients.The time of vascular lesions in heart grafts was lower in the FFR increasing group at 1～3 months and 6～12 months postoperatively compared to the FFR reducing group(P＜0.05),while the FFR reducing group had a lower incidence of vascular lesions at 3～6 months postoperatively compared to the FFR increasing group(P＜0.05).The incidence of hyperlipidemia and chronic renal dysfunction in the FFR increasing group was significantly lower than the FFR reducing group(P＜0.05).Conclusion The changes in FFR of patients undergoing heart transplantation have good diag-nostic efficacy for their cardiac function and prognosis,providing a basis for their subsequent clinical deci-sion-making.
heart transplantationcoronary CT angiography(CCTA)fractional flow reserve(FFR)cardi-ac function
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