摘要
目的以血流储备分数(FFR)为金标准,探讨基于国产软件DEEPVESSEL-FFR的冠状动脉CT血流储备分数(CT-FFR,即深脉分数),对冠状动脉(冠脉)临界病变的诊断价值。方法回顾性纳入2019年1月至2020年12月于河南省人民医院阜外华中心血管病医院行侵入性FFR检查的冠状动脉粥样硬化性心脏病(冠心病)患者17例(25支血管,血管直径均超过2.0 mm),入选患者冠脉狭窄程度为50%~80%。采用DEEPVESSEL-FFR软件计算CT-FFR值,当CT-FFR≤0.8时认为狭窄具有血流动力学意义。计算并分析DEEPVESSEL-FFR在患者及血管水平诊断冠脉临界狭窄的准确度、敏感度、特异度、阳性预测值及阴性预测值,同时绘制受试者工作特征曲线(ROC)。结果共纳入17例患者,25支病变血管。以FFR为金标准,DEEPVESSEL-FFR在患者水平的准确度、敏感度、特异度、阳性预测值及阴性预测值分别为84.0%、88.9%、87.5%、88.9%、87.5%。在血管水平的准确度、敏感度、特异度、阳性预测值及阴性预测值分别为88.2%、81.8%、85.7%、81.8%、85.7%。DEEPVESSEL-FFR在患者的ROC曲线下面积为0.903(95%CI:0.661~0.991,P<0.001);在血管水平的曲线下面积为0.903(95%CI:0.717~0.984,P<0.001)。结论以FFR为金标准,DEEPVESSEL-FFR对冠脉临界病变具有较高的诊断价值。
Objective To investigate the diagnostic value of fractional flow reserve derived from coronary computed tomography angiography(CT-FFR)to coronary borderline lesions taken fractional flow reserve(FFR)as a gold standard based on DEEPVESSEL-FFR(a domestic software).Methods The patients with coronary heart disease(CHD,n=17)undergone invasive FFR examination(25 vessels with diameter more than 2.0 mm)were retrospectively chosen from Fuwai Central China Hospital of Cardiovascular Diseases from Jan.2019 to Dec.2020.The stenosis severity of coronary artery was from 50%to 80%.The value of CT-FFR was calculated by using DEEPVESSEL-FFR software,and hemodynamic significance was determined when CT-FFR≤0.8.The accuracy,sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of DEEPVESSEL-FFR in diagnosis of coronary borderline stenosis were calculated and analyzed at the levels of patient and blood vessel,and ROC curves were drawn.Results There were totally 17 patients(25 lesion vessels)included.Taken FFR as the gold standard,the accuracy of DEEPVESSEL-FFR was 84.0%,sensitivity was 88.9%,specificity was 87.5%,PPV was 88.9%and NPV was 87.5%at patient level and accuracy was 88.2%,sensitivity was 81.8%,specificity was 85.7%,PPV was 81.8%and NPV was 85.7%at blood vessel level.The area under ROC curve of DEEPVESSEL-FFR was 0.903(95%CI:0.661~0.991,P<0.001)at patient level,and was 0.903(95%CI:0.717~0.984,P<0.001)at blood vessel level.Conclusion With FFR as the gold standard,DEEPVESSEL-FFR has higher diagnostic value to coronary borderline lesions.
作者
肖亚楠
高传玉
尤世杰
Xiao Yanan;Gao Chuanyu;You Shijie(Heart Center,People's Hospital of Henan Province,Zhengzhou 450003,China.;不详)
出处
《中国循证心血管医学杂志》
2023年第1期50-53,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
国家科技部重点研发专项(2018YFC0114502)。
关键词
血流储备分数
冠状动脉CT血流储备分数
冠状动脉临界病变
Fractional flow reserve
Fractional flow reserve derived from coronary computed tomography angiography
Coronary borderline lesions
