Relationship of Stress Test Findings to Anatomic or Functional Extent of Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve.
Relationship of Stress Test Findings to Anatomic or Functional Extent of Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve.
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DOI：
10.1155/2021/6674144
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发表时间：
2021
影响因子：
--
通讯作者：
Rabbat MG
中科院分区：
文献类型：
--
作者：
Doukas D;Allen S;Wozniak A;Kunchakarra S;Verma R;Marot J;Lopez JJ;Nieman K;Pontone G;Leipsic J;Bax J;Rabbat MG
在美国，功能压力测试是疑似冠状动脉疾病（CAD）的稳定症状患者的主要成像方式。冠状动脉ct血管造影（CTA）在鉴别解剖性冠状动脉疾病（CAD）方面具有卓越的价值。计算流体动力学在冠状动脉CTA中的应用，可以无创地计算血流储备分数（FFR）。在现实世界的临床实践中，无创应激测试与冠状动脉CTA和FFRCT的关系尚未得到研究。我们评估了芝加哥洛约拉大学206例疑似CAD的连续患者，他们接受了无创压力测试，并在有指示时进行了冠状动脉CTA和FFRCT。根据压力测试结果（阳性、阴性、不确定和模棱两可）对患者进行分类。分析Duke跑步机评分（DTS）、METS、运动持续时间和运动引起的胸痛。冠脉CTA检查认为病变狭窄≥50%为阳性。FFRCT < 0.80为缺血诊断。206例患者进行了配对的无创压力测试和冠状动脉CTA/FFRCT结果。从压力测试到冠状动脉CTA的中位时间为49天。患者平均年龄60.3岁，男性占42%。206例压力测试中，75%为运动测试（超声心动图70%，核测试26%，心电图4%）。压力测试结果与CAD > 50%或FFRCT < 0.80无关联（p = 0.927和p = 0.910）。在那些压力测试呈阳性的患者中，只有30%（3/10）的CAD bb0达到50%，只有50%（5/10）的FFRCT < 0.80。运动引起的胸痛与冠心病bb0 50%或FFRCT < 0.80无关（分别为p = 0.66和p = 0.12）。met、DTS或运动时间与FFRCT之间无显著相关性（r = 0.093, p = 0.274; r = 0.012, p = 0.883; r = 0.034, p = 0.680）。使用冠状动脉CTA和FFRCT诊断策略，无创压力测试、功能能力、运动胸痛和DTS与解剖或功能性CAD无关。
In the United States, functional stress testing is the primary imaging modality for patients with stable symptoms suspected to represent coronary artery disease (CAD). Coronary computed tomography angiography (CTA) is excellent at identifying anatomic coronary artery disease (CAD). The application of computational fluid dynamics to coronary CTA allows fractional flow reserve (FFR) to be calculated noninvasively (FFRCT). The relationship of noninvasive stress testing to coronary CTA and FFRCT in real-world clinical practice has not been studied. We evaluated 206 consecutive patients at Loyola University Chicago with suspected CAD who underwent noninvasive stress testing followed by coronary CTA and FFRCT when indicated. Patients were categorized by stress test results (positive, negative, indeterminate, and equivocal). Duke treadmill score (DTS), METS, exercise duration, and chest pain with exercise were analyzed. Lesions ≥ 50%stenosis were considered positive by coronary CTA. FFRCT < 0.80 was considered diagnostic of ischemia. Two hundred and six patients had paired noninvasive stress test and coronary CTA/FFRCT results. The median time from stress test to coronary CTA was 49 days. Average patient age was 60.3 years, and 42% were male. Of the 206 stress tests, 75% were exercise (70% echocardiographic, 26% nuclear, and 4% EKG). There were no associations of stress test results with CAD > 50% or FFRCT < 0.80 (p = 0.927 and p = 0.910, respectively). Of those with a positive stress test, only 30% (3/10) had CAD > 50% and only 50% (5/10) had FFRCT < 0.80. Chest pain with exercise did not correlate with CAD > 50% or FFRCT < 0.80 (p = 0.66 and p = 0.12, respectively). There were no significant correlations between METS, DTS, or exercise duration and FFRCT (r = 0.093, p = 0.274; r = 0.012, p = 0.883; and r = 0.034, p = 0.680; respectively). Noninvasive stress testing, functional capacity, chest pain with exercise, and DTS are not associated with anatomic or functional CAD using a diagnostic strategy of coronary CTA and FFRCT.
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影响因子：
--
作者：
Ball C;Pontone G;Rabbat M
通讯作者：
Rabbat M
影响因子：
158.5
作者：
MARK, DB;SHAW, L;PRYOR, DB
通讯作者：
PRYOR, DB
影响因子：
24
作者：
Hlatky, Mark A.;De Bruyne, Bernard;Douglas, Pamela S.
通讯作者：
Douglas, Pamela S.
影响因子：
158.5
作者：
KANNEL, WB;ABBOTT, RD
通讯作者：
ABBOTT, RD
影响因子：
158.5
作者：
Maron, David J.;Hochman, Judith S.;Rosenberg, Yves
通讯作者：
Rosenberg, Yves