Kong Weifang, Shang Lan, Long Bingzhu, Chen Xinyue, Mou Anna, Pu Hong, Zhang Guojin, Huang Hongyun
Department of Radiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Sci Rep. 2025 Feb 10;15(1):4967. doi: 10.1038/s41598-025-88836-1.
To analyze the correlation between the main perfusion parameters of the left ventricle and various physiological and coronary artery disease (CAD) risk factors or comorbidities using dynamic stress computed tomography myocardial perfusion imaging (CT-MPI) in patients without obstructive coronary stenosis. This retrospective analysis included 119 patients without obstructive coronary artery stenosis in computed tomography angiography (CTA), and without perfusion defects in CT-MPI. Patients were categorized into groups based on the presence or absence of physiological and CAD risk factors or comorbidities. The global myocardial blood flow (MBF), myocardial blood volume (MBV), and perfused capillary blood volume (PCBV) of the left ventricle were compared between groups, and correlations with continuous variables were analyzed. Multivariate linear regression was used to identify independent factors. Perfusion parameters were higher (MBF, 149.41 ± 26.38 vs. 159.20 ± 21.31 ml/100 ml/min, MBV, 17.09 ± 2.37 vs.18.84 ± 1.89, and PCBV, 9.82 ± 2.21 vs. 11.47 ± 1.79 ml/100 ml [all P < 0.05]) in female patients than in male patients. Hypertension and overweight/obesity resulted in lower perfusion parameters (hypertension vs. normotension: MBF, 148.09 ± 21.15 vs. 161.47 ± 25.13 ml/100 ml/min, PCBV, 10.25 ± 2.23 vs. 11.22 ± 1.96 ml/100 ml; overweight/obesity vs. none: MBF, 148.82 ± 20.98 vs. 159.51 ± 25.44 ml/100 ml/min, PCBV, 10.20 ± 1.93 vs. 11.15 ± 2.22 ml/100 ml [all P < 0.05]). Body surface area (BSA), body mass index, stress heart rate (HR), incremental HR, coronary total plaque volume, and stress systolic blood pressure were significantly correlated with perfusion parameters (all P < 0.05). Stress HR, BSA, and hypertension were independent predictors of MBF, stress HR and sex were independent predictors of MBV, and stress HR and BSA were independent predictors of PCBV. Dynamic stress CT-MPI myocardial perfusion is affected by stress HR, sex, and BSA, and can identify early perfusion distribution in hypertension and obesity/overweight.
利用动态负荷计算机断层扫描心肌灌注成像（CT-MPI）分析无阻塞性冠状动脉狭窄患者左心室主要灌注参数与各种生理及冠状动脉疾病（CAD）危险因素或合并症之间的相关性。这项回顾性分析纳入了119例在计算机断层扫描血管造影（CTA）中无阻塞性冠状动脉狭窄且在CT-MPI中无灌注缺损的患者。根据是否存在生理及CAD危险因素或合并症将患者分组。比较各组左心室的整体心肌血流量（MBF）、心肌血容量（MBV）和灌注毛细血管血容量（PCBV），并分析与连续变量的相关性。采用多元线性回归确定独立因素。女性患者的灌注参数较高（MBF，149.41±26.38 vs. 159.20±21.31 ml/100 ml/min；MBV，17.09±2.37 vs.18.84±1.89；PCBV，9.82±2.21 vs. 11.47±1.79 ml/100 ml[所有P<0.05]）。高血压和超重/肥胖导致灌注参数降低（高血压组与正常血压组：MBF，148.09±21.15 vs. 161.47±25.13 ml/100 ml/min，PCBV，10.25±2.23 vs. 11.22±1.96 ml/100 ml；超重/肥胖组与无超重/肥胖组：MBF，148.82±20.98 vs. 159.51±25.44 ml/100 ml/min，PCBV，10.20±1.93 vs. 11.15±2.22 ml/100 ml[所有P<0.05]）。体表面积（BSA）、体重指数、负荷心率（HR）、心率增加值、冠状动脉总斑块体积和负荷收缩压与灌注参数显著相关（所有P<0.05）。负荷HR、BSA和高血压是MBF的独立预测因素，负荷HR和性别是MBV的独立预测因素，负荷HR和BSA是PCBV的独立预测因素。动态负荷CT-MPI心肌灌注受负荷HR、性别和BSA影响，可识别高血压和肥胖/超重患者的早期灌注分布情况。
