Sun Lulu, Wang Zilong, Xu Tongda, Pan Defeng, Liang Li, Hao Ji, Wang Xiaoping, Li Dongye
Institute of Cardiovascular Disease Research, Xuzhou Medical University, Jiangsu Province-P. R. China.
Anatol J Cardiol. 2018 Jan;19(1):27-33. doi: 10.14744/AnatolJCardiol.2017.8041.
The aim of this study was to evaluate the value of real-time myocardial contrast echocardiography (RT-MCE) for detecting coronary microcirculation (CM) function in coronary artery disease (CAD) patients.
Sixty-five consecutive patients were divided into CAD (n=52) and no-CAD (n=13) groups using coronary angiography (CAG). All patients underwent RT-MCE at rest and CAG within 1 week after RT-MCE. The ventricular segments in CAD patients were divided semi-quantitatively into ischemic and non-ischemic myocardial groups based on RT-MCE images. Myocardial blood volume (A), myocardial blood flow velocity (ß), and mean myocardial blood flow (Axβ) were obtained. The Gensini scores were calculated for CAD patients. The receiver operating characteristic (ROC) curve areas of A, ß, and Axß were calculated to assess CM function in CAD patients.
A total of 798 and 204 segments were investigated in the CAD and non-CAD groups, respectively. In CAD patients, 332 ischemic and 466 non-ischemic segments were identified. The values of A, ß, and Axß were significantly different among non-CAD, CAD, ischemic, and nonischemic groups. ROC curve areas of A, ß, and Axß were 0.85, 0.79, and 0.83, respectively, and significant differences were observed in these values among three Gensini score groups of the CAD patients.
Varying degrees of CM function deterioration was observed in CAD patients both in ischemic and non-ischemic areas, with the deterioration being more sever in the former.
本研究旨在评估实时心肌对比超声心动图(RT-MCE)检测冠状动脉疾病(CAD)患者冠状动脉微循环(CM)功能的价值。
连续纳入65例患者,采用冠状动脉造影(CAG)分为CAD组(n=52)和非CAD组(n=13)。所有患者在静息状态下接受RT-MCE检查,并在RT-MCE检查后1周内接受CAG检查。根据RT-MCE图像将CAD患者的心室节段半定量分为缺血心肌组和非缺血心肌组。获取心肌血容量(A)、心肌血流速度(ß)和平均心肌血流量(Axß)。计算CAD患者的Gensini评分。计算A、ß和Axß的受试者操作特征(ROC)曲线面积,以评估CAD患者的CM功能。
CAD组和非CAD组分别共研究了798个和204个节段。在CAD患者中,识别出332个缺血节段和466个非缺血节段。非CAD组、CAD组、缺血组和非缺血组之间的A、ß和Axß值存在显著差异。A、ß和Axß的ROC曲线面积分别为0.85、0.79和0.83,CAD患者的三个Gensini评分组之间这些值存在显著差异。
CAD患者的缺血和非缺血区域均观察到不同程度的CM功能恶化,前者恶化更严重。