Kalaycı Süleyman, Kalaycı Belma, Şahan Ekrem, Boyacı Asiye Ayça Ayyılmaz
Ankara Training and Research Hospital, Ankara, Turkey, Turkey.
Kardiol Pol. 2017;75(9):877-883. doi: 10.5603/KP.a2017.0089. Epub 2017 Jun 14.
Duke treadmill score (DTS) is an index that provides prognostic information calculated at exercise stress test. Fractional flow reserve (FFR) is an invasive method used to evaluate intermediate coronary stenosis. The direct relation of DTS and FFR has not been studied to date.
The present study aims to investigate the relationship between the DTS and FFR.
The study population consisted of a total of 106 patients with single-vessel disease, as confirmed by coronary angiography performed following EST, and whose FFRs were measured. The patients were separated into three groups according to the DTS values: low risk (DTS ≥ +5), intermediate risk (-10 ≤ DTS ≤ +4), and high risk (DTS ≤ -11). According to the FFR values, the patients were separated into two groups: FFR < 0.80 and FFR ≥ 0.80.
Angina symptoms and chronic heart failure were more frequent in the group with FFR < 0.80 than the group with FFR ≥ 0.80; respectively, 95% vs. 69.8%, p = 0.020 and 15% vs. 3.5%, p = 0.045. The mean DTS value was lower in the group with FFR < 0.80 than the group with FFR ≥ 0.80 (1.60 vs. 5.07; p = 0.011). However, there were no statistically significant differences in the DTS risk groups among the FFR groups (p = 0.070). A weak positive correlation was found between the numerical DTS and FFR values (r = 0.139; p = 0.156). When the patients with high-risk were excluded, a statistically significant relationship was determined between the FFR and in the groups with low- and intermediate-risk in terms of the DTS values (p = 0.029).
In conclusion, our study results showed an association with FFR and in the groups with low and intermediate risk in terms of the DTS values. DTS levels can be useful to determine patients who require invasive management.
杜克运动平板评分（DTS）是一种在运动负荷试验时计算得出的、可提供预后信息的指标。血流储备分数（FFR）是一种用于评估冠状动脉中度狭窄的有创方法。迄今为止，尚未对DTS与FFR之间的直接关系进行研究。
本研究旨在探讨DTS与FFR之间的关系。
研究人群包括经运动负荷试验（EST）后行冠状动脉造影确诊为单支血管病变且测量了FFR的106例患者。根据DTS值将患者分为三组：低风险（DTS≥+5）、中风险（-10≤DTS≤+4）和高风险（DTS≤-11）。根据FFR值，将患者分为两组：FFR<0.80和FFR≥0.80。
FFR<0.80组的心绞痛症状和慢性心力衰竭发生率高于FFR≥0.80组；分别为95%对69.8%，p=0.020；15%对3.5%，p=0.045。FFR<0.80组的平均DTS值低于FFR≥0.80组（1.60对5.07；p=0.011）。然而，FFR组之间的DTS风险组差异无统计学意义（p=0.070）。DTS数值与FFR值之间存在弱正相关（r=0.139；p=0.156）。排除高风险患者后，就DTS值而言，FFR与低风险和中风险组之间存在统计学显著关系（p=0.029）。
总之，我们的研究结果显示FFR与DTS值低风险和中风险组之间存在关联。DTS水平有助于确定需要进行有创治疗的患者。
