Sahin Durmuş Yıldıray, Gür Mustafa, Elbasan Zafer, Uysal Onur Kadir, Özaltun Betül, Şeker Taner, Özkan Buğra, Kalkan Gülhan Yüksel, Kıvrak Ali, Çaylı Murat
Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey.
Echocardiography. 2013 Apr;30(4):385-91. doi: 10.1111/echo.12077. Epub 2012 Dec 10.
The aim of the study was to investigate the relationship between severity of coronary artery disease (CAD) assessed with SYNTAX score (SS) and myocardial performance index (MPI) in stable CAD.
The study participants consisted of 106 consecutive patients (mean age: 57.6 ± 9.5 years) with angiographically proven obstructive stable CAD and 30 patients with nonobstructive CAD (control group) (mean age: 58.0 ± 7.6 years). The MPI was calculated by using pulsed-wave Doppler before coronary angiography. Coronary angiography was performed in all patients. The SS was prospectively calculated in 106 obstructive CAD patients. Patients were partitioned into 3 groups based on SS. Frequencies of risk factors, biochemical and hematological data were recorded in all patients.
The SS tertiles were defined as SS(low) ≤ 8 (n = 35), SS(mid) ≤ 17 (n = 36), and SS(high) > 17 (n = 35). The patients with SS(high) group (mean MPI; 0,48 ± 0.06) based on SS had significantly higher MPI values compared with the SS(mid) (mean MPI; 0,44 ± 0.05), SS(low) (mean MPI; 0.43 ± 0.06), and control (mean MPI; 0.41 ± 0.05) groups (P < 0.05 for all). The MPI levels of control group were also lower than compared with SS(mid) group (P = 0.006). The MPI value was significantly correlated with SS (r = 0.564, P < 0.001), diabetes (r = 0.355, P < 0.001), hypertension (r = 0.326, P < 0.001), and ejection fraction (EF) (r = -0.224, P = 0.018) in bivariate analysis. Multivariate regression analysis showed that MPI was independently associated with SS (β = 0.486, P < 0.001) and diabetes (β = 0.205, P = 0.028).
Although the normal EF, MPI value was impaired in proportion to the severity of CAD in patients with stable CAD.
本研究旨在探讨用SYNTAX评分(SS)评估的稳定型冠心病(CAD)严重程度与心肌性能指数(MPI)之间的关系。
研究参与者包括106例连续的经血管造影证实为阻塞性稳定型CAD患者(平均年龄:57.6±9.5岁)和30例非阻塞性CAD患者(对照组)(平均年龄:58.0±7.6岁)。在冠状动脉造影前使用脉冲波多普勒计算MPI。所有患者均进行冠状动脉造影。对106例阻塞性CAD患者前瞻性计算SS。根据SS将患者分为3组。记录所有患者的危险因素频率、生化和血液学数据。
SS三分位数定义为SS(低)≤8(n = 35)、SS(中)≤17(n = 36)和SS(高)>17(n = 35)。基于SS的SS(高)组患者(平均MPI;0.48±0.06)与SS(中)组(平均MPI;0.44±0.05)、SS(低)组(平均MPI;0.43±0.06)和对照组(平均MPI;0.41±0.05)相比,MPI值显著更高(所有P<0.05)。对照组的MPI水平也低于SS(中)组(P = 0.006)。在双变量分析中,MPI值与SS(r = 0.564,P<0.001)、糖尿病(r = 0.355,P<0.001)、高血压(r = 0.326,P<0.001)和射血分数(EF)(r = -0.224,P = 0.018)显著相关。多变量回归分析显示,MPI与SS(β = 0.486,P<0.001)和糖尿病(β = 0.205,P = 0.028)独立相关。
在稳定型CAD患者中,尽管EF正常,但MPI值随CAD严重程度成比例受损。