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集成近红外光谱与血管内超声(NIRS-IVUS)系统相对于定量血流比(QFR)的性能

Performance of Integrated Near-Infrared Spectroscopy and Intravascular Ultrasound (NIRS-IVUS) System against Quantitative Flow Ratio (QFR).

作者信息

Dobrolińska Magdalena M, Gąsior Paweł M, Pociask Elżbieta, Smolka Grzegorz, Ochala Andrzej, Wojakowski Wojciech, Roleder Tomasz

机构信息

Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-635 Katowice, Poland.

Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, 30-059 Krakow, Poland.

出版信息

Diagnostics (Basel). 2021 Jun 23;11(7):1148. doi: 10.3390/diagnostics11071148.

Abstract

Quantitative flow ratio (QFR) is a new opportunity to analyze functional stenosis during invasive coronary angiography. Together with a well-known intravascular ultrasound (IVUS) and a new player in the field, near-infrared spectroscopy (NIRS), it is gaining a lot of interest. The aim of the study was to compare QFR results with integrated IVUS-NIRS results acquired simultaneously in the same coronary lesion. We retrospectively enrolled 66 patients in whom 66 coronary lesions were assessed by NIRS-IVUS and QFR. Lesions were divided into two groups based on QFR results as QFR-positive group (QFR ≤ 0.8) or QFR-negative group (QFR > 0.8). Based on ROC curve analysis, the best cut-off values of minimal lumen area (MLA), minimal lumen diameter (MLD) and percent diameter stenosis for predicting QFR ≤ 80 were 2.4 (AUC 0.733, 95%CI 0.61, 0.834), 1.6 (AUC 0.768, 95%CI 0.634, 0.872) and 59.5 (AUC 0.918, 95%CI 0.824, 0.971), respectively. In QFR-positive lesions, the maxLCBI was significantly higher than in QFR-negative lesions (450.12 ± 251.0 vs. 329.47 ± 191.14, = 0.046). The major finding of the present study is that values of IVUS-MLA, IVUS-MLD and percent diameter stenosis show a good efficiency in predicting QFR ≤ 0.80. Moreover, QFR-positive lesions are characterized by higher maxLCBI as compared to the QFR-negative group.

摘要

定量血流比(QFR)是在有创冠状动脉造影期间分析功能性狭窄的新方法。它与广为人知的血管内超声(IVUS)以及该领域的新成员近红外光谱(NIRS)一起,正引起广泛关注。本研究的目的是比较QFR结果与在同一冠状动脉病变中同时获取的IVUS-NIRS综合结果。我们回顾性纳入了66例患者,对其66处冠状动脉病变进行了NIRS-IVUS和QFR评估。根据QFR结果将病变分为两组,即QFR阳性组(QFR≤0.8)和QFR阴性组(QFR>0.8)。基于ROC曲线分析,预测QFR≤80的最小管腔面积(MLA)、最小管腔直径(MLD)和直径狭窄百分比的最佳截断值分别为2.4(AUC 0.733,95%CI 0.61,0.834)、1.6(AUC 0.768,95%CI 0.634,0.872)和59.5(AUC 0.918,95%CI 0.824,0.971)。在QFR阳性病变中,最大脂质核心负担指数(maxLCBI)显著高于QFR阴性病变(450.12±251.0对329.47±191.14,P=0.046)。本研究的主要发现是,IVUS-MLA、IVUS-MLD和直径狭窄百分比的值在预测QFR≤0.80方面显示出良好的效能。此外,与QFR阴性组相比,QFR阳性病变的特征是maxLCBI更高。

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