血管内超声对中等程度冠状动脉病变功能的预测价值。

Predictive value of intravascular ultrasound for the function of intermediate coronary lesions.

机构信息

Department of Cardiology, Shanghai General Hospital of Nanjing Medical University, No.100, Haining Rd, Hongkou District, Shanghai, 200080, China.

Department of Cardiology, Shanghai General Hospital of Shanghai Jiao Tong University School of Medicine, No.100, Haining Rd, Hongkou District, Shanghai, 200080, China.

出版信息

BMC Cardiovasc Disord. 2023 Sep 14;23(1):457. doi: 10.1186/s12872-023-03489-0.

BACKGROUND

Intravascular ultrasound (IVUS) can provide detailed coronary anatomic parameters. The purpose of our study was to evaluate the parameters measured by IVUS for the prediction of intermediate coronary lesions function by referencing quantitative fraction ratio (QFR) ≤ 0.80 (vs. > 0.80).

METHODS

Eighty four cases with 92 intermediate coronary lesions in vessels with a diameter ≥ 2.50 mm were enrolled. Paired assessment of IVUS and cQFR was available, and vessels with cQFR ≤ 0.8 were considered the positive reference standard. Logistic regression was used to select model variables by a maximum partial likelihood estimation test and receiver operating characteristic curve (ROC) analysis to evaluate the diagnostic value of different indices.

RESULTS

Plaque burden (PB) and lesion length (LL) of IVUS were independent risk factors for the function of coronary lesions. The predictive probability P was derived from the combined PB and LL model. The area under the curve (AUC) of PB, (minimum lumen area) MLA, and LL and the predicted probability P are 0.789,0.732,0731, and 0.863, respectively (P < 0.01). The AUC of the predicted probability P was the biggest among them; the prediction accuracy of cQFR ≤ 0.8 was 84.8%, and the sensitivity of the diagnostic model was 0.826, specificity was 0. 725, and P < 0.01.

CONCLUSION

PB and LL of IVUS were independent risk factors influencing the function of intermediate coronary lesions. The model combining the PB and LL may predict coronary artery function better than any other single parameter.

背景

血管内超声（IVUS）可提供详细的冠状动脉解剖学参数。本研究旨在评估 IVUS 测量的参数对定量血流分数比（QFR）≤0.80（vs. >0.80）的中等冠状动脉病变功能的预测价值。

方法

纳入 84 例血管直径≥2.50mm 的 92 处中等冠状动脉病变患者。可进行 IVUS 和 cQFR 配对评估，将 cQFR≤0.8 的血管视为阳性参考标准。采用最大似然估计检验和受试者工作特征曲线（ROC）分析对逻辑回归选择模型变量，并评价不同指标的诊断价值。

结果

IVUS 的斑块负荷（PB）和病变长度（LL）是冠状动脉病变功能的独立危险因素。联合 PB 和 LL 模型得出预测概率 P。PB、最小管腔面积（MLA）、LL 和预测概率 P 的曲线下面积（AUC）分别为 0.789、0.732、0.731 和 0.863（P<0.01）。其中预测概率 P 的 AUC 最大；cQFR≤0.8 的预测准确率为 84.8%，诊断模型的灵敏度为 0.826，特异度为 0.725，P<0.01。