首页|基于定量血流分数评估不同低密度脂蛋白胆固醇水平对冠状动脉临界病变的影响

基于定量血流分数评估不同低密度脂蛋白胆固醇水平对冠状动脉临界病变的影响

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目的:基于定量血流分数(QFR)评估探讨不同低密度脂蛋白胆固醇(LDL-C)水平对冠状动脉临界病变的影响以及导致冠状动脉临界病变进展的相关危险因素.方法:连续收集 2020 年 1 月至 2021 年 2 月于阜外华中心血管病医院行冠状动脉造影检查提示存在临界病变,并至少于 11 个月后行冠状动脉造影复查的 219 例患者,行离线QFR分析.根据随访时LDL-C水平将患者分为LDL-C达标组(LDL-C<1.8 mmol/L,148 例患者 191 支血管)与LDL-C不达标组(LDL-C≥1.8 mmol/L,71 例患者98 支血管),比较两组间冠状动脉血管QFR和解剖相关指标如最小管腔直径、最小管腔面积、最大直径狭窄百分比、最大面积狭窄百分比等的不同,进一步分析导致冠状动脉血管QFR改变的影响因素.结果:LDL-C达标组患者的血管QFR值与基线相比差异无统计学意义(P>0.05),LDL-C未达标组患者QFR值较基线下降(P<0.05).LDL-C达标组患者最大直径狭窄百分比和最大面积狭窄百分比更低,最小管腔直径和最小管腔面积更高(P均<0.05).多因素Logistic回归分析发现体重指数>28 kg/m2、随访时LDL-C≥1.8 mmol/L、既往曾发生过心肌梗死是导致血管QFR下降的独立危险因素(P均<0.05).结论:LDL-C达标组较LDL-C未达标组患者冠状动脉血管QFR、最小管腔直径和最小管腔面积更高,最大直径狭窄百分比和最大面积狭窄百分比更低.
Analysis of the Impact of Different Low-density Lipoprotein Cholesterol Levels on the Progression of Intermediate Coronary Stenosis Based on Quantitative Flow Ratio Quantification
Objectives:This study aims to investigate the impact of different Low-Density Lipoprotein cholesterol(LDL-C)levels on progression of intermediate coronary stenosis,and the associated risk factors leading to the progression of such lesions.Methods:Data were collected on 219 consecutive patients admitted at the Fuwai Central China Vascular Hospital from January 2020 to February 2021,underwent angiographic examinations and diagnosed with intermediate coronary stenosis,with at least one follow-up angiography after 11 months.Offline quantitative flow ratio(QFR)analysis was performed on these cases.Patients were divided into two groups:LDL-C controlled group(LDL-C<1.8 mmol/L,148 patients with 191 vessels)and LDL-C uncontrolled group(LDL-C≥1.8 mmol/L,71 patients with 98 vessels).Coronary artery QFR and anatomical indicators such as minimal lumen diameter,minimal lumen area,percentage diameter stenosis,percentage area stenosis were compared within and between the groups.Further analysis was performed to identify influencing factors leading to changes in coronary physiological parameters derived from QFR.Results:Within the LDL-C controlled group,there was no significant difference in the QFR values of the vessels compared to baseline(P>0.05),whereas in the LDL-C uncontrolled group(P<0.05),a notable decline in QFR was observed.Patients in the LDL-C controlled group had lower rates of maximum diameter and area stenosis and higher minimum lumen diameter and area(all P<0.05).Through multifactorial Logistic regression analysis,it was found that a body mass index>28 kg/m²,LDL-C≥1.8 mmol/L,and a history of myocardial infarction were independent risk factors leading to the decline in QFR(all P<0.05).Conclusions:It was found that patients in the LDL-C controlled group had higher coronary artery QFR,minimum lumen diameter and area,lower rates of maximum diameter and area stenosis.

low-density lipoprotein cholesterolquantitative flow ratiointermediate coronary stenosiscoronary atherosclerotic heart disease

崔启、张传奇、袁晓鹏、王潇、吕纳强、李爽、郭鹏召、张静、高传玉、党爱民

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郑州大学 阜外华中心血管病医院 心内科,郑州 451464

郑州大学 阜外华中心血管病医院 急诊科,郑州 451464

郑州大学 阜外华中心血管病医院 特需医疗中心,郑州 451464

中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院心内科,北京 100037

郑州大学 阜外华中心血管病医院 心脏重症监护室,郑州 451464

郑州大学 阜外华中心血管病医院冠心病一病区,郑州 451464

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低密度脂蛋白胆固醇 定量血流分数 冠状动脉临界病变 冠状动脉粥样硬化性心脏病

国家重点研发计划国家重点研发计划

2022YFC36024002022YFC3602405

2024

中国循环杂志
中国医学科学院

中国循环杂志

CSTPCD北大核心
影响因子:2.803
ISSN:1000-3614
年,卷(期):2024.39(1)
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