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基于冠状动脉计算机断层扫描的可视估计 RESOLVE 评分预测经皮分叉介入术中的边支闭塞。

Visually Estimated RESOLVE Score Based on Coronary Computed Tomography to Predict Side Branch Occlusion in Percutaneous Bifurcation Intervention.

机构信息

Departments of Interventional Cardiology and Angiology.

Medical University of Warsaw, Warsaw, Poland.

出版信息

J Thorac Imaging. 2021 May 1;36(3):189-196. doi: 10.1097/RTI.0000000000000570.

Abstract

PURPOSE

The quantitative RESOLVE (Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion) score derived from coronary computed tomography angiography (coronary CTA) was developed as a noninvasive and accurate prediction tool for side branch (SB) occlusion in coronary bifurcation intervention. We aimed to determine the ability of a visually estimated CTA-derived RESOLVE score (V-RESOLVE score) to predict SB occlusion in coronary bifurcation intervention.

MATERIALS AND METHODS

The present study included 363 patients with 400 bifurcation lesions. CTA-derived V-RESOLVE score was derived and compared with the quantitative CTA-derived RESOLVE score. The scoring systems were divided into quartiles, and classified as the high-risk and non-high-risk groups. SB occlusion was defined as any decrease in thrombolysis in myocardial infarction flow grade after main vessel stenting.

RESULTS

In total, 28 SB occlusions (7%) occurred. The concordance between visual and quantitative CTA analysis showed poor to excellent agreement (weighted κ range: 0.099 to 0.867). The area under the receiver operating curve for the prediction of SB occlusion was significantly higher for the CTA-derived V-RESOLVE score than for quantitative CTA-derived RESOLVE score (0.792 vs. 0.709, P=0.049). The total net reclassification index was 42.7% (P=0.006), and CTA-derived V-RESOLVE score showed similar capability to discriminate between high-risk group (18.6% vs. 13.8%, P=0.384) and non-high-risk group (3.8% vs. 4.9%, P=0.510) as compared with quantitative CTA-derived RESOLVE score.

CONCLUSIONS

Visually estimated CTA-derived V-RESOLVE score is an accurate and easy-to-use prediction tool for the stratification of SB occlusion in coronary bifurcation intervention.

摘要

目的

基于冠状动脉计算机断层扫描血管造影(coronary CTA)的定量 RESOLVE(冠状动脉分叉介入术侧支闭塞风险预测)评分是一种用于预测冠状动脉分叉介入术侧支(SB)闭塞的非侵入性和准确的预测工具。我们旨在确定基于视觉评估的 CTA 衍生 RESOLVE 评分(V-RESOLVE 评分)预测冠状动脉分叉介入术 SB 闭塞的能力。

材料和方法

本研究纳入了 363 例 400 处分叉病变患者。推导了 CTA 衍生的 V-RESOLVE 评分,并与定量 CTA 衍生的 RESOLVE 评分进行了比较。评分系统分为四分之一,分为高危和非高危组。SB 闭塞定义为主血管支架置入后心肌梗死溶栓血流分级任何下降。

结果

共有 28 处 SB 闭塞(7%)。视觉和定量 CTA 分析之间的一致性显示出较差到较好的一致性(加权κ范围:0.099 至 0.867)。预测 SB 闭塞的受试者工作特征曲线下面积 V-RESOLVE 评分明显高于定量 CTA 衍生的 RESOLVE 评分(0.792 与 0.709,P=0.049)。总净重新分类指数为 42.7%(P=0.006),V-RESOLVE 评分在区分高危组(18.6%与 13.8%,P=0.384)和非高危组(3.8%与 4.9%,P=0.510)方面与定量 CTA 衍生的 RESOLVE 评分具有相似的能力。

结论

视觉评估的 CTA 衍生的 V-RESOLVE 评分是一种准确且易于使用的预测工具,可用于分层冠状动脉分叉介入术 SB 闭塞。

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