The Association Between Quantitative Flow Ratio and Intravascular Imaging-defined Vulnerable Plaque Characteristics in Patients With Stable Angina and Non-ST-segment Elevation Acute Coronary Syndrome.
The Association Between Quantitative Flow Ratio and Intravascular Imaging-defined Vulnerable Plaque Characteristics in Patients With Stable Angina and Non-ST-segment Elevation Acute Coronary Syndrome.
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稳定型心绞痛和非 ST 段抬高急性冠状动脉综合征患者的定量流量比与血管内成像定义的易损斑块特征之间的关联
DOI：
10.3389/fcvm.2021.690262
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发表时间：
2021
影响因子：
3.6
通讯作者：
Ma G
中科院分区：
文献类型：
--
作者：
Zuo W;Sun R;Zhang X;Qu Y;Ji Z;Su Y;Zhang R;Ma G
背景资料：本研究旨在检查定量血流比（QFR）（一种基于血管造影术的血流储备分数计算方法）是否与血管内成像定义的易损斑块特征相关，例如稳定型心绞痛和非ST段抬高型急性冠状动脉综合征患者中的薄帽纤维粥样硬化（TCFA）。研究方法：从两项前瞻性研究中确定了接受光学相干断层扫描（OCT）或血管内超声（IVUS）检查的患者，并使用QFR评估了其询问的血管。OCT队列中的病变分为三分位数：QFR-T1（QFR ≤ 0.85）、QFR-T2（0.85 < QFR ≤ 0.93）和QFR-T3（QFR > 0.93）。IVUS队列中的病变被分为低QFR组或高QFR组。结果：这项事后分析包括来自126名患者的132处病变（OCT 83处，IVUS 49处）。QFR-T1（50%）的OCT-TCFA患病率显著高于QFR-T2（14%）和QFR-T3（19%）（分别为p = 0.003和0.018）。在最大脂质弧、最薄纤维帽厚度和最小管腔面积方面，三分位数之间也观察到总体显著差异（分别为p = 0.017、0.040和<0.001）。血栓在QFR-T1（39%）中的发生率高于QFR-T2（3%）和QFR-T3（12%）（分别为p = 0.001和0.020）。在多变量分析中，无论是否存在NSTE-ACS和低密度脂蛋白胆固醇水平，QFR ≤ 0.80仍然是OCT-TCFA的重要决定因素（校正OR：4.387，95% CI 1.297-14.839，p = 0.017）。QFR在识别OCT-TCFA病变方面的诊断准确性中等（曲线下面积：0.72，95% CI 0.58-0.86，p = 0.003）。在IVUS队列中，两组之间的最小管腔面积和斑块负荷存在显著差异，但虚拟组织学（VH）-TCFA的分布无显著差异（分别为p = 0.025、0.036和1.000）。结论：较低的QFR与OCT定义的血管造影轻度至中度病变的斑块易损性有关。QFR可能是一个有用的工具，可以在不使用任何压力导丝或血管扩张剂的情况下排除高危斑块。
Background: This study aimed to examine whether quantitative flow ratio (QFR), an angiography-based computation of fractional flow reserve, was associated with intravascular imaging-defined vulnerable plaque features, such as thin cap fibroatheroma (TCFA) in patients with stable angina, and non-ST-segment elevation acute coronary syndrome. Methods: Patients undergoing optical coherence tomography (OCT) or intravascular ultrasound (IVUS) examinations were identified from two prospective studies and their interrogated vessels were assessed with QFR. Lesions in the OCT cohort were classified into tertiles: QFR-T1 (QFR ≤ 0.85), QFR-T2 (0.85 < QFR ≤ 0.93), and QFR-T3 (QFR > 0.93). Lesions in the IVUS cohort were classified dichotomously as low or high QFR groups. Results: This post-hoc analysis included 132 lesions (83 for OCT and 49 for IVUS) from 126 patients. The prevalence of OCT-TCFA was significantly higher in QFR-T1 (50%) than in QFR-T2 (14%) and QFR-T3 (19%) (p = 0.003 and 0.018, respectively). Overall significant differences were also observed among tertiles in maximum lipid arc, thinnest fibrous cap thickness, and minimal lumen area (p = 0.017, 0.040, and <0.001, respectively). Thrombus was more prevalent in QFR-T1 (39%) than in QFR-T2 (3%), and QFR-T3 (12%) (p = 0.001 and 0.020, respectively). In the multivariable analysis, QFR ≤ 0.80 remained as a significant determinant of OCT-TCFA regardless of the presence of NSTE-ACS and the level of low-density lipoprotein cholesterol (adjusted OR: 4.387, 95% CI 1.297–14.839, p = 0.017). The diagnostic accuracy of QFR was moderate in identifying lesions with OCT-TCFA (area under the curve: 0.72, 95% CI 0.58–0.86, p = 0.003). In the IVUS cohort, significant differences were found between two groups in minimal lumen area and plaque burden but not in the distribution of virtual histology (VH)-TCFA (p = 0.025, 0.036, and 1.000, respectively). Conclusions: Lower QFR was related to OCT-defined plaque vulnerability in angiographically mild-to-intermediate lesions. The QFR might be a useful tool for ruling out high-risk plaques without using any pressure wire or vasodilator.
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影响因子：
24
作者：
Hakeem, Abdul;Edupuganti, Mohan M.;Uretsky, Barry F.
通讯作者：
Uretsky, Barry F.
DOI：
10.1016/s0735-1097(01)01175-5
发表时间：
2001-04-01
影响因子：
24
作者：
Mintz, GS;Nissen, SE;Yock, PG
通讯作者：
Yock, PG
影响因子：
24
作者：
Jia, Haibo;Abtahian, Farhad;Aguirre, Aaron D.;Lee, Stephen;Chia, Stanley;Lowe, Harry;Kato, Koji;Yonetsu, Taishi;Vergallo, Rocco;Hu, Sining;Tian, Jinwei;Lee, Hang;Park, Seung-Jung;Jang, Yang-Soo;Raffel, Owen C.;Mizuno, Kyoichi;Uemura, Shiro;Itoh, Tomonori;Kakuta, Tsunekazu;Choi, So-Yeon;Dauerman, Harold L.;Prasad, Abhiram;Toma, Catalin;McNulty, Iris;Zhang, Shaosong;Yu, Bo;Fuster, Valentine;Narula, Jagat;Virmani, Renu;Jang, Ik-Kyung
通讯作者：
Jang, Ik-Kyung
影响因子：
7.5
作者：
Brown, Adam J.;Obaid, Daniel R.;Bennett, Martin R.
通讯作者：
Bennett, Martin R.
影响因子：
6.2
作者：
Garcia-Garcia, Hector M.;Mintz, Gary S.;Serruys, Patrick W.
通讯作者：
Serruys, Patrick W.