320排螺旋CT评估升主动脉弹性与冠状动脉狭窄的相关性
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摘要
目的利用320排螺旋CT评估升主动脉弹性指标与冠状动脉狭窄程度的相关性。方法搜集我院拟诊冠心病并行320排螺旋CT冠状动脉造影138例患者(正常组31例,狭窄组107例),其中狭窄组分为轻度狭窄组及中重度狭窄组,比较不同组间升主动脉弹性指标及与Gensini评分的相关性。结果升主动脉弹性指标[膨胀性(Ao D)及僵硬度(Ao S)]在冠状动脉狭窄组与正常组间及不同狭窄程度组间的弹性指标差异均具有统计学意义(P<0.05)。ROC曲线评估Ao D、Ao S预测冠心病的价值,曲线下面积(AUC)分别为0.94、0.89。结论升主动脉弹性与冠状动脉狭窄与否及狭窄程度有密切相关性,有可能可以作为冠心病的独立预测因子。
Objective To evaluate the correlation between the severity of coronary artery stenosis and ascending aortic elasticity by using MDCT. Methods A total of 138 patients with coronary artery disease underwent 320-MDCT coronary angiography. According to the presence of coronary artery stenosis they were divided into coronary stenosis group and no coronary stenosis group, according to the extent of coronary stenosis were divided into mild stenosis and moderate-severe stenosis group; ascending aorta elastic parameters and the Gensini score were compared between different groups. Results The Ao D of Coronary stenosis group was significantly lower than that of no stenosis group. Ao S and the Gensini score were significantly higher than no stenosis group(P<0.05). Mild group Ao D was significantly higher than that of moderate-severe group, Ao S and Gensini score were significantly lower than the moderate-severe group(P<0.05). ROC curve was used to evaluate Ao D, Ao S predicting coronary artery disease and the area under the curve(AUC) was directly 0.94, 0.89. Conclusion The elasticity of ascending aorta is closely related to the extent and extent of coronary stenosis, and may be an independent predictor of coronary artery disease.
Objective To evaluate the correlation between the severity of coronary artery stenosis and ascending aortic elasticity by using MDCT. Methods A total of 138 patients with coronary artery disease underwent 320-MDCT coronary angiography. According to the presence of coronary artery stenosis they were divided into coronary stenosis group and no coronary stenosis group, according to the extent of coronary stenosis were divided into mild stenosis and moderate-severe stenosis group; ascending aorta elastic parameters and the Gensini score were compared between different groups. Results The Ao D of Coronary stenosis group was significantly lower than that of no stenosis group. Ao S and the Gensini score were significantly higher than no stenosis group(P<0.05). Mild group Ao D was significantly higher than that of moderate-severe group, Ao S and Gensini score were significantly lower than the moderate-severe group(P<0.05). ROC curve was used to evaluate Ao D, Ao S predicting coronary artery disease and the area under the curve(AUC) was directly 0.94, 0.89. Conclusion The elasticity of ascending aorta is closely related to the extent and extent of coronary stenosis, and may be an independent predictor of coronary artery disease.
引文
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[2]Oliver JJ,Webb DJ.Noninvasive assessment of arterial stiffness and risk of atherosclerotic events[J].Arterioscler Thromb Vasc Biol,2003,23(4):554-566.
[3]Shechter M,Issachar A,Marai I,et al.Long-term association of brachial artery flowmediated vasodilation and cardiovascular events in middleaged subjects with no apparent heart disease[J].Int J Cardiol,2009,134(1):52-58.
[4]Li N,Beck T,Chen J,et al.Assessment of thoracic aortic elasticity:a preliminary study using electrocardiographically gated dual-source CT[J].Eur Radiol,2011,21(7):1564-1572.
[5]陈义加,查云飞,陈伦刚,等.MDCT评价冠状动脉狭窄程度与升主动脉弹性的相关性[J].放射学实践,2012,27(4):411-416.
[6]尹所,汪春红.冠状动脉双源CT增强及造影在冠脉粥样硬化性狭窄诊断中的对比研究[J].放射学实践,2015,(1):8-10.
[7]Yildiz A,Gur M,Yilmaz R,et al.The association of elasticity indexes of ascending aorta and the presence and the severity of coronary artery disease[J].Coron Artery Dis,2008,19(5):311-317.
[8]刘芳,于晶,曹源,等.双源CT冠状动脉成像对升主动脉弹性与冠状动脉狭窄程度的相关性研究[J].临床放射学杂志,2013,32(10):1436-1439.
[9]Ahmadi N,Nabavi V,Hajsadeghi F,et al.Impaired aortic distensibility measured by computed tomography is associated with the severity of coronary artery disease[J].Int J Cardiovasc Imaging,2011,27(3):459-469.
[10]Kingwell BA,Waddell TK,Medley TL,et al.Large artery stiffness predicts ischemic threshold in patients with coronary artery disease[J].J Am Coll Cardiol,2002,40(4):773-779.