Predictive value of CT-FFR combined with plaque quantification for reperfusion injury in patients with myocardial ischemia(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2023年第1期
- Page:
- 66-70
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Predictive value of CT-FFR combined with plaque quantification for reperfusion injury in patients with myocardial ischemia
- Author(s):
- WANG Shengnan; BU Rongsheng; DU Jingru; WANG Yaoguo; WU Chunchun
- Department of Cardiology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China
- Keywords:
- Keywords: coronary artery myocardial ischemia reperfusion injury fractional flow reserve plaque quantification CT angiography
- PACS:
- R541；R814.42
- DOI:
- DOI:10.3969/j.issn.1005-202X.2023.01.011
- Abstract:
- Abstract: Objective To analyze the value of CT-based fractional flow reserve (CT-FFR) combined with plaque quantification for predicting the reperfusion injury in patients with myocardial ischemia. Methods The clinical data of 126 patients with coronary heart disease (CHD) who were scheduled for percutaneous coronary intervention (PCI) were retrospectively analyzed. All patients underwent coronary CT angiography before PCI, and received cardiac magnetic resonance or optical coherence tomography within 8 d after PCI to assess the reperfusion injury. Those with myocardial microvascular obstruction (MVO) and/or intramyocardial hemorrhage (IMH) were included in reperfusion injury group, and those without MVO and IMH were enrolled as non-reperfusion injury group. The baseline data, such as gender, age, etc, and differences in CT-FFR and plaque quantitative parameters before PCI were compared between two groups. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of CT-FFR and plaque quantitative parameters for reperfusion injury in CHD patients. Results The multivessel lesion rate in reperfusion injury group were significantly higher than that in non-reperfusion injury group (P<0.05), while the rate of TIMI grade 3 flow after PCI was lower than that in non-reperfusion injury group (P<0.05). The differences between two groups in the minimum lumen area, calcified plaque volume, remodeling index and eccentricity index were trivial (P>0.05). Compared with non-reperfusion injury group, reperfusion injury group had lower CT-FFR, but higher degree of stenosis, longer plaque length, larger non-calcified plaque volume and total plaque volume (P<0.05). ROC curve analysis showed that CT-FFR, stenosis degree, plaque length, non-calcified plaque volume and total plaque volume had high predictive value for reperfusion injury in CHD patients (AUC=0.758, 0.943, 0.865, 0.928, 0.891 P<0.05), with the Cut-off values of 0.671, 75.44%, 38.61 mm, 186.08 mm3, and 305.04 mm3, respectively, and the predictive value of the combination of the 5 items was the highest (AUC=0.999, P<0.05). Conclusion CT-FFR and plaque quantitative parameters play a role in predicting reperfusion injury in CHD patients, and can provide a reference for the clinical diagnosis and treatment of CHD.
Last Update: 2023-01-07