摘要
目的:基于定量血流分数(QFR)评估探讨不同低密度脂蛋白胆固醇(LDL-C)水平对冠状动脉临界病变的影响以及导致冠状动脉临界病变进展的相关危险因素。方法:连续收集2020年1月至2021年2月于阜外华中心血管病医院行冠状动脉造影检查提示存在临界病变,并至少于11个月后行冠状动脉造影复查的219例患者,行离线QFR分析。根据随访时LDL-C水平将患者分为LDL-C达标组(LDL-C<1.8 mmol/L,148例患者191支血管)与LDL-C不达标组(LDL-C≥1.8 mmol/L,71例患者98支血管),比较两组间冠状动脉血管QFR和解剖相关指标如最小管腔直径、最小管腔面积、最大直径狭窄百分比、最大面积狭窄百分比等的不同,进一步分析导致冠状动脉血管QFR改变的影响因素。结果:LDL-C达标组患者的血管QFR值与基线相比差异无统计学意义(P>0.05),LDL-C未达标组患者QFR值较基线下降(P<0.05)。LDL-C达标组患者最大直径狭窄百分比和最大面积狭窄百分比更低,最小管腔直径和最小管腔面积更高(P均<0.05)。多因素Logistic回归分析发现体重指数>28 kg/m2、随访时LDL-C≥1.8 mmol/L、既往曾发生过心肌梗死是导致血管QFR下降的独立危险因素(P均<0.05)。结论:LDL-C达标组较LDL-C未达标组患者冠状动脉血管QFR、最小管腔直径和最小管腔面积更高,最大直径狭窄百分比和最大面积狭窄百分比更低。
Objectives:This study aims to investigate the impact of different Low-Density Lipoprotein cholesterol(LDL-C)levels on progression of intermediate coronary stenosis,and the associated risk factors leading to the progression of such lesions.Methods:Data were collected on 219 consecutive patients admitted at the Fuwai Central China Vascular Hospital from January 2020 to February 2021,underwent angiographic examinations and diagnosed with intermediate coronary stenosis,with at least one follow-up angiography after 11 months.Offline quantitative flow ratio(QFR)analysis was performed on these cases.Patients were divided into two groups:LDL-C controlled group(LDL-C<1.8 mmol/L,148 patients with 191 vessels)and LDL-C uncontrolled group(LDL-C≥1.8 mmol/L,71 patients with 98 vessels).Coronary artery QFR and anatomical indicators such as minimal lumen diameter,minimal lumen area,percentage diameter stenosis,percentage area stenosis were compared within and between the groups.Further analysis was performed to identify influencing factors leading to changes in coronary physiological parameters derived from QFR.Results:Within the LDL-C controlled group,there was no significant difference in the QFR values of the vessels compared to baseline(P>0.05),whereas in the LDL-C uncontrolled group(P<0.05),a notable decline in QFR was observed.Patients in the LDL-C controlled group had lower rates of maximum diameter and area stenosis and higher minimum lumen diameter and area(all P<0.05).Through multifactorial Logistic regression analysis,it was found that a body mass index>28 kg/m²,LDL-C≥1.8 mmol/L,and a history of myocardial infarction were independent risk factors leading to the decline in QFR(all P<0.05).Conclusions:It was found that patients in the LDL-C controlled group had higher coronary artery QFR,minimum lumen diameter and area,lower rates of maximum diameter and area stenosis.
作者
崔启
张传奇
袁晓鹏
王潇
吕纳强
李爽
郭鹏召
张静
高传玉
党爱民
CUI Qi;ZHANG Chuanqi;YUAN Xiaopeng;WANG Xiao;LYU Naqiang;LI Shuang;GUO Pengzhao;ZHANG Jing;GAO Chuanyu;DANG Aimin(Department of Cardiology,Zhengzhou University,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,China;Emergency Department,Zhengzhou University,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,China;Special Medical Center,Zhengzhou University,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,China;Department of Cardiology,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Coronary Heart Disease Intensive Care Unit,Zhengzhou University,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,China;Coronary Heart Disease Ward One,Zhengzhou University,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,China)
出处
《中国循环杂志》
CSCD
北大核心
2024年第1期54-60,共7页
Chinese Circulation Journal
基金
国家重点研发计划项目(2022YFC3602400,2022YFC3602405)。
