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冠状动脉容积与左心室心肌质量比在检测原发性微血管性心绞痛中的应用:一项针对中国人群的回顾性观察研究

Coronary artery volume to left ventricular myocardial mass ratio in detecting primary microvascular angina: a retrospective observational study in Chinese population.

作者信息

Sun Linlin, Yu Yanli, Li Xincheng, Tong Guoxin, Gao Beibei, Liu Haipeng, Wang Zhen

机构信息

Zhejiang Chinese Medical University, Hangzhou, China.

Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou, China.

出版信息

BMC Cardiovasc Disord. 2025 Jul 28;25(1):552. doi: 10.1186/s12872-025-04978-0.

Abstract

BACKGROUND

The ratio of coronary artery volume to left ventricular myocardial mass (V/M) reflects the hemodynamic association between epicardial coronary arteries and myocardium. Evidence suggests a significant decrease in V/M among patients with primary microvascular angina (PMVA). However, V/M values may be influenced by anatomic and physiological varieties, necessitating independent evaluation in different ethnic groups. We aimed to explore the potential of V/M in predicting PMVA in Chinese population.

METHODS

We conducted a retrospective case-control analysis on 23 PMVA patients and 25 controls matched by age, sex, body mass index, smoking history, hypertension, diabetes, and dyslipidemia. For each patient, the computed tomography (CT) images were three-dimensionally reconstructed to calculate patient-specific V/M and vessel-specific V/M, as well as CT-derived fractional flow reserve (CT-FFR). The results in both groups were compared using t-test or Mann-Whitney U test.

RESULTS

Compared to the control group, the PMVA group had significantly higher total myocardial mass and lower average V/M (P < 0.05 for both). Regarding vessel-specific V/M, PMVA group had significantly lower values of left anterior descending artery and left circumflex artery (P < 0.05 for both), with no significant inter-group difference in right coronary artery (P > 0.05). There was no significant difference between two groups in vessel-specific CT-FFR (P > 0.05 for all).

CONCLUSION

The abnormally decreased V/M value may serve as a potential biomarker of PMVA in Chinese population.

摘要

背景

冠状动脉容积与左心室心肌质量之比(V/M)反映了心外膜冠状动脉与心肌之间的血流动力学关系。有证据表明,原发性微血管性心绞痛(PMVA)患者的V/M显著降低。然而,V/M值可能受解剖学和生理学差异的影响,因此需要在不同种族群体中进行独立评估。我们旨在探讨V/M在中国人群中预测PMVA的潜力。

方法

我们对23例PMVA患者和25例年龄、性别、体重指数、吸烟史、高血压、糖尿病和血脂异常相匹配的对照者进行了回顾性病例对照分析。对每位患者的计算机断层扫描(CT)图像进行三维重建,以计算患者特异性V/M和血管特异性V/M,以及CT衍生的血流储备分数(CT-FFR)。两组结果采用t检验或Mann-Whitney U检验进行比较。

结果

与对照组相比,PMVA组的总心肌质量显著更高,平均V/M更低(两者P均<0.05)。关于血管特异性V/M,PMVA组左前降支和左旋支的值显著更低(两者P均<0.05),右冠状动脉组间差异无统计学意义(P>0.05)。两组间血管特异性CT-FFR无显著差异(所有P>0.05)。

结论

V/M值异常降低可能是中国人群PMVA的潜在生物标志物。

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