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计算机断层扫描测量心肌桥可预测临床症状的存在及不良心脏事件的结局:一项来自中国大量人群的回顾性研究

Measurements of myocardial bridges on computed tomography predict presence of clinical symptoms and outcomes of adverse heart events: a retrospective study in a large population from China.

作者信息

Liu Guobing, Qu Yanjuan, Chen Xin, Liao Meiyan, Hu Huijuan, Cao Yiyuan, Tian Zhixiong

机构信息

1 Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, PR China.

2 Department of Radiology, Wuhan Asia Heart Hospital, Wuhan, PR China.

出版信息

Acta Radiol. 2017 Sep;58(9):1068-1076. doi: 10.1177/0284185116682380. Epub 2016 Dec 14.

DOI:10.1177/0284185116682380
PMID:28194992
Abstract

Background Clinical-radiological correlation of myocardial bridge (MB) remains unclear. Purpose To correlate clinical symptoms and outcomes of MBs with computed tomography (CT) coronary angiography findings. Material and Methods A total of 2092 patients with CT coronary angiography were collected. Patients were divided into symptomatic and asymptomatic groups, adverse heart events (AHE) and non-AHE groups, MB and non-MB groups, as well as left anterior descending (LAD)-MB and non-LAD-MB groups. Statistical analyses were performed to identify inter-group differences, and clinical-radiological correlations of MBs or mural coronary arteries (MCAs). Results The prevalence of MB, the MCA stenosis either in systole or in diastole, and the ratio of LAD-MB were significantly higher in the symptomatic group than in the asymptomatic group, and higher in the AHE group than in the non-AHE group ( P all <0.05). MB thickness, systolic MCA stenosis, and diastolic MCA stenosis were independent variables predicting clinical symptoms ( P < 0.05), with diastolic MCA stenosis having the highest diagnostic performance, when cutting at 24.6%. The corresponding sensitivity and specificity were 87.8% and 90.6%, respectively. Diastolic MCA stenosis independently indicated outcome of AHE (odds ratio, 1.047; P < 0.001). Conclusion Measurements of MB-MCA by CT predict the presence of clinical symptoms and outcomes of AHE, with diastolic MCA stenosis possessing the greatest performance.

摘要

背景 心肌桥(MB)的临床与放射学相关性仍不明确。目的 将MB的临床症状和预后与计算机断层扫描(CT)冠状动脉造影结果相关联。材料与方法 共收集2092例行CT冠状动脉造影的患者。患者被分为有症状组和无症状组、不良心脏事件(AHE)组和非AHE组、MB组和非MB组,以及左前降支(LAD)-MB组和非LAD-MB组。进行统计分析以确定组间差异以及MB或壁冠状动脉(MCA)的临床与放射学相关性。结果 有症状组的MB患病率、MCA收缩期或舒张期狭窄以及LAD-MB比例均显著高于无症状组,AHE组高于非AHE组(P均<0.05)。MB厚度、收缩期MCA狭窄和舒张期MCA狭窄是预测临床症状的独立变量(P<0.05),当截断值为24.6%时,舒张期MCA狭窄具有最高的诊断效能。相应的敏感度和特异度分别为87.8%和90.6%。舒张期MCA狭窄独立提示AHE的预后(比值比,1.047;P<0.001)。结论 CT测量MB-MCA可预测临床症状的存在及AHE的预后,其中舒张期MCA狭窄的效能最大。

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Ann Transl Med. 2020 Mar;8(6):369. doi: 10.21037/atm.2020.02.24.
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Pol J Radiol. 2019 Nov 21;84:e478-e483. doi: 10.5114/pjr.2019.90370. eCollection 2019.
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