Chen Cong, Zhao Yang, Li Wei, Zhang Kui, Dang Haiming, Liu Taoshuai, Song Yue, Zheng Jubing, Dong Ran
Center of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2022 Sep 6;9:975759. doi: 10.3389/fcvm.2022.975759. eCollection 2022.
Quantitative flow ratio (QFR) is a new functional index to assess the functional significance of coronary stenosis. While whether there is an association between QFR and transit-time flow measurement (TTFM) parameters of the target coronary artery has not been well addressed.
A total of 89 patients receiving the left internal thoracic artery (LITA) grafts to the left anterior descending artery (LAD), and 19 patients undergoing the saphenous vein grafts (SVG) were enrolled in this retrospective study. The QFR value of the LAD was evaluated preoperatively. According to the QFR values, patients with the LITA to the LAD bypass grafts were divided into two groups (group A1: QFR < 0.75, group A2: QFR ≥ 0.75), and SVG patients were divided into two groups (V1 group: QFR < 0.75, V2 group: QFR ≥ 0.75).
In groups A1 and A2, respectively, median graft flow (Qm) was 44 (34) mL/minute and 26.5 (30.0) ml/minute; median pulsatility index (PI) was 2.00 (1.00) and 2.65 (0.90). Significant differences were observed in Qm ( = 0.034) and PI ( = 0.030). And the correlation coefficients of the TTFM variables with QFR were Qm: = = -0.226, ( = 0.036), PI: = 0.265 ( = 0.012) among the LITA to LAD population.
TTFM variables, especially the PI, of the LITA graft to the LAD during Coronary artery bypass grafting (CABG) are strongly affected by preoperative QFR values. Moreover, in functionally mild coronary stenosis, the chance of competitive flow increases.
定量血流比(QFR)是一种评估冠状动脉狭窄功能意义的新功能指标。然而,QFR与目标冠状动脉的渡越时间血流测量(TTFM)参数之间是否存在关联尚未得到充分探讨。
本回顾性研究共纳入89例行左乳内动脉(LITA)至左前降支(LAD)搭桥术的患者和19例行大隐静脉搭桥术(SVG)的患者。术前评估LAD的QFR值。根据QFR值,将LITA至LAD搭桥术患者分为两组(A1组:QFR < 0.75,A2组:QFR≥0.75),SVG患者分为两组(V1组:QFR < 0.75,V2组:QFR≥0.75)。
A1组和A2组的移植血管平均血流(Qm)分别为44(34)ml/分钟和26.5(30.0)ml/分钟;平均搏动指数(PI)分别为2.00(1.00)和2.65(0.90)。Qm(P = 0.034)和PI(P = 0.030)存在显著差异。在LITA至LAD人群中,TTFM变量与QFR的相关系数为:Qm:r = -0.226,P = 0.036;PI:r = 0.265,P = 0.012。
冠状动脉旁路移植术(CABG)期间LITA至LAD的TTFM变量,尤其是PI,受术前QFR值的强烈影响。此外,在功能上轻度冠状动脉狭窄时,竞争性血流的机会增加。