Clinical Cardiology, Ospedale S. Giovanni di Dio, University of Cagliari, Cagliari, Italy.
J Am Soc Echocardiogr. 2012 Aug;25(8):902-10. doi: 10.1016/j.echo.2012.04.022. Epub 2012 Jun 1.
Coronary restenosis is the most important clinical limitation after percutaneous coronary intervention (PCI), and coronary flow reserve (CFR) is reduced in the presence of significant coronary stenosis. This study evaluated whether detection of early reduction of Doppler echocardiographically derived CFR in the left anterior descending coronary artery can identify patients at high risk for developing restenosis after successful PCI.
Doppler echocardiographically derived CFR was studied in 124 consecutive patients at 1-month and 6-month follow-up after PCI in the left anterior descending coronary artery, together with coronary angiography.
Restenosis was detected in 39 angiographic examinations (group A) and no coronary restenosis in the remaining 85 (group B) at 6 months. At 1 month, CFR was reduced in group A compared with group B (P < .0001), and a significant reduction of CFR in group A (P < .0001) but not in group B (P = .89) was detected at 6 months. CFR ≤ 2.5 at 1 month was 67% sensitive and 87% specific for predicting significant restenosis, with positive and negative predictive values of 67% and 87%, respectively.
CFR ≤ 2.5 detected 1 month after PCI in the left anterior descending coronary artery has the potential to identify patients at higher risk for developing coronary restenosis and indicates the need for close clinical follow-up.
经皮冠状动脉介入治疗（PCI）后，冠状动脉再狭窄是最重要的临床限制因素，而在严重冠状动脉狭窄的情况下，冠状动脉血流储备（CFR）会降低。本研究评估了左前降支多普勒超声衍生 CFR 早期降低是否可以识别 PCI 后发生再狭窄的高危患者。
在左前降支 PCI 后 1 个月和 6 个月的随访中，对 124 例连续患者进行了多普勒超声衍生 CFR 研究，并进行了冠状动脉造影。
6 个月时，39 次血管造影检查（A 组）发现再狭窄，85 次无冠状动脉再狭窄（B 组）。A 组在 1 个月时 CFR 较 B 组降低（P<0.0001），A 组 CFR 显著降低（P<0.0001），但 B 组无显著降低（P=0.89）。1 个月时 CFR≤2.5 对预测明显再狭窄的敏感性为 67%，特异性为 87%，阳性预测值和阴性预测值分别为 67%和 87%。
左前降支 PCI 后 1 个月检测到的 CFR≤2.5 有潜力识别发生冠状动脉再狭窄的高危患者，并提示需要密切临床随访。
