Quantitative relationship between the extent and morphology of coronary atherosclerotic plaque and downstream myocardial perfusion.
Quantitative relationship between the extent and morphology of coronary atherosclerotic plaque and downstream myocardial perfusion.
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DOI：
10.1016/j.jacc.2011.06.051
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发表时间：
2011-10-18
影响因子：
24
通讯作者：
Di Carli, Marcelo F.
中科院分区：
文献类型：
--
作者：
Naya, Masanao;Murthy, Venkatesh L.;Blankstein, Ron;Sitek, Arkadiusz;Hainer, Jon;Foster, Courtney;Gaber, Mariya;Fantony, Jolene M.;Dorbala, Sharmila;Di Carli, Marcelo F.
关键词：
本研究的目的是量化冠状动脉粥样硬化的形态和程度对心肌血流储备（MFR）的影响。虽然冠状动脉狭窄和心肌灌注之间的关系已经很好地建立起来，但关于动脉粥样硬化负荷的其他解剖学描述符对这种关系的贡献知之甚少。我们评价了73例连续接受铷-82正电子发射断层扫描和冠状动脉计算机断层扫描血管造影的患者的动脉粥样硬化斑块负荷、形态和组成与局部MFR（MFRregional）之间的关系，以评价已知或疑似冠状动脉疾病。73例患者中有51例出现动脉粥样硬化，209支可评估的冠状动脉中有107支出现动脉粥样硬化。在每支血管的基础上，直径狭窄百分比（p = 0.02）或狭窄评分总和（p = 0.002），整合狭窄系列，是区域MFR的最佳预测因子。重要的是，在每种冠状动脉狭窄类别中，MFR区域差异很大，即使在非阻塞性斑块的血管中（n = 169），38%的血管具有异常的MFR区域（<2.0）。总斑块长度、成分和重塑指数与较低的MFR无关。在每个患者的基础上，改良的杜克CAD（冠状动脉疾病）指数（p = 0.04）和混合斑块的节段数量（p = 0.01）是低MFR的最佳预测因子。动脉粥样硬化的计算机断层扫描血管造影描述符对下游MFR只有适度的影响。在每个患者的基础上，动脉粥样硬化的范围和严重程度（通过改良的杜克CAD指数评估）和混合斑块的冠状动脉节段数量与MFR降低相关。
The purpose of this study was to quantify the effects of coronary atherosclerosis morphology and extent on myocardial flow reserve (MFR). Although the relationship between coronary stenosis and myocardial perfusion is well established, little is known about the contribution of other anatomic descriptors of atherosclerosis burden to this relationship. We evaluated the relationship between atherosclerosis plaque burden, morphology, and composition and regional MFR (MFRregional) in 73 consecutive patients undergoing Rubidium-82 positron emission tomography and coronary computed tomography angiography for the evaluation of known or suspected coronary artery disease. Atherosclerosis was seen in 51 of 73 patients and in 107 of 209 assessable coronary arteries. On a per-vessel basis, the percentage diameter stenosis (p = 0.02) or summed stenosis score (p = 0.002), integrating stenoses in series, was the best predictor of MFRregional. Importantly, MFRregional varied widely within each coronary stenosis category, even in vessels with nonobstructive plaques (n = 169), 38% of which had abnormal MFRregional (<2.0). Total plaque length, composition, and remodeling index were not associated with lower MFR. On a per-patient basis, the modified Duke CAD (coronary artery disease) index (p = 0.04) and the number of segments with mixed plaque (p = 0.01) were the best predictors of low MFRglobal. Computed tomography angiography descriptors of atherosclerosis had only a modest effect on downstream MFR. On a per-patient basis, the extent and severity of atherosclerosis as assessed by the modified Duke CAD index and the number of coronary segments with mixed plaque were associated with decreased MFR.
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DOI：
10.2967/jnumed.104.007831
发表时间：
2009-07
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
El Fakhri G;Kardan A;Sitek A;Dorbala S;Abi-Hatem N;Lahoud Y;Fischman A;Coughlan M;Yasuda T;Di Carli MF
通讯作者：
Di Carli MF
影响因子：
2.4
作者：
Parkash, R;DeKemp, RA;Beanlands, RSB
通讯作者：
Beanlands, RSB
影响因子：
5.3
作者：
Lin, Fay;Shaw, Leslee J.;Min, James K.
通讯作者：
Min, James K.
影响因子：
37.8
作者：
De Bruyne, B;Hersbach, F;Wijns, W
通讯作者：
Wijns, W
影响因子：
37.8
作者：
Giri, S;Shaw, LJ;Heller, GV
通讯作者：
Heller, GV