Zijlstra F, Fioretti P, Reiber J H, Serruys P W
Thoraxcenter, Erasmus University, Rotterdam, the Netherlands.
Int J Card Imaging. 1988;3(2-3):133-9. doi: 10.1007/BF01814886.
The goal of this investigation was to establish which anatomical parameters of stenotic lesions correlate best with its functional severity. Therefore, thirty-eight patients with single vessel disease underwent coronary cineangiography and exercise/redistribution thallium-201 scintigraphy. Cross-sectional area at the site of obstruction (OA), percentage diameter stenosis (DS), the calculated pressuredrop over the stenosis (PD), as well as coronary flow reserve (CFR) derived from myocardial contrast appearance time and density were determined. The relations between CFR and the 3 anatomical parameters were described by the following equations: CFR = 4.6 - 0.053 DS, r = 0.82, SEE: 0.79, p less than 0.001 CFR = 0.5 + 0.75 OA, r = 0.87, SEE: 0.68, p less than 0.001 CFR = 3.6 - 1.5 log PD, r = 0.90, SEE: 0.62, p less than 0.001 The calculated pressuredrop was highly predictive of the thallium scintigraphic results with a sensitivity of 94% and a specificity of 90%. Therefore, the calculated pressuredrop is a better anatomical parameter for assessing the functional importance of a stenosis than percentage diameter stenosis or obstruction area. However, the 95% confidence limits of the relation between pressuredrop and coronary flow reserve are wide, making measurement of CFR a valuable addition to quantitative angiography, especially when determining the functional importance of moderately severe coronary artery lesions.
本研究的目的是确定狭窄病变的哪些解剖学参数与其功能严重程度最相关。因此，38名单支血管疾病患者接受了冠状动脉造影和运动/再分布铊-201闪烁扫描。测定了梗阻部位的横截面积（OA）、直径狭窄百分比（DS）、计算得出的狭窄压力阶差（PD）以及由心肌对比剂出现时间和密度得出的冠状动脉血流储备（CFR）。CFR与这三个解剖学参数之间的关系由以下方程描述：CFR = 4.6 - 0.053 DS，r = 0.82，标准误：0.79，p < 0.001；CFR = 0.5 + 0.75 OA，r = 0.87，标准误：0.68，p < 0.001；CFR = 3.6 - 1.5 log PD，r = 0.90，标准误：0.62，p < 0.001。计算得出的压力阶差对铊闪烁扫描结果具有高度预测性，敏感性为94%，特异性为90%。因此，与直径狭窄百分比或梗阻面积相比，计算得出的压力阶差是评估狭窄功能重要性的更好解剖学参数。然而，压力阶差与冠状动脉血流储备之间关系的95%置信区间较宽，这使得测量CFR成为定量血管造影的一项有价值补充，尤其是在确定中度严重冠状动脉病变的功能重要性时。
