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基于血管内超声的血流储备分数用于预测经皮冠状动脉介入治疗后的预后

Intravascular Ultrasound-Based Fractional Flow Reserve for Predicting Prognosis after Percutaneous Coronary Intervention.

作者信息

Huang Jianzhen, Yang Xinyi, Hu Yumeng, Li Huibin, Leng Xiaochang, Xiang Jianping, Wei Wenjuan

机构信息

Department of Cardiology, The First People's Hospital of Xiaoshan District, Hangzhou, China.

ArteryFlow Technology Co., Ltd., Hangzhou, China.

出版信息

J Cardiovasc Transl Res. 2023 Dec;16(6):1417-1424. doi: 10.1007/s12265-023-10409-2. Epub 2023 Jul 13.

Abstract

AccuFFRivus is an alternative to fractional flow reserve (FFR) based on intravascular ultrasound (IVUS) images for functional assessment of coronary stenosis. However, its prognostic impact in patients undergoing percutaneous coronary intervention (PCI) is still unclear. This retrospective study aimed to investigate the capability of AccuFFRivus in predicting prognosis. AccuFFRivus was calculated based on postoperative angiographic and IVUS images. Vessel-oriented clinical events (VOCE) at 2 years were recorded and analyzed. A total of 131 participants with 131 vessels were included in the study. VOCE occurred in 15 patients during 2-year follow-up. AccuFFRivus after PCI (post-AccuFFRivus) was significantly higher in the non-VOCE group than in the VOCE group (0.95 ± 0.03 vs. 0.91 ± 0.02, p < 0.001). Multivariate Cox regression showed that AccuFFRivus ≤ 0.94 was a strong independent predictor of VOCE during 2-year follow-up (hazard ratio 23.76, 95% confidence interval: 3.04-185.81, p < 0.001). The left panel displays the Receiver operating characteristics (ROC) curves of postoperative parameters (post-AccuFFRivus and post-MLA) versus vessel-oriented clinical events (VOCE) occurrence within 2-year follow-up. The right panel demonstrates Kaplan-Meier curves of VOCE stratified by the optimal cut-off of post-AccuFFRivus.

摘要

AccuFFRivus是一种基于血管内超声(IVUS)图像的冠状动脉狭窄功能评估方法,可替代血流储备分数(FFR)。然而,其在接受经皮冠状动脉介入治疗(PCI)患者中的预后影响仍不明确。这项回顾性研究旨在探讨AccuFFRivus预测预后的能力。AccuFFRivus是根据术后血管造影和IVUS图像计算得出的。记录并分析了2年时的血管定向临床事件(VOCE)。该研究共纳入了131名参与者的131条血管。在2年随访期间,15名患者发生了VOCE。非VOCE组PCI术后的AccuFFRivus(术后AccuFFRivus)显著高于VOCE组(0.95±0.03对0.91±0.02,p<0.001)。多变量Cox回归显示,AccuFFRivus≤0.94是2年随访期间VOCE的强独立预测因子(风险比23.76,95%置信区间:3.04-185.81,p<0.001)。左图显示了术后参数(术后AccuFFRivus和术后最小管腔面积)与2年随访期间血管定向临床事件(VOCE)发生情况的受试者工作特征(ROC)曲线。右图展示了根据术后AccuFFRivus的最佳临界值分层的VOCE的Kaplan-Meier曲线。

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