Value of Three-dimensional Quantitative Coronary Angiography and μ Quantitative Flow Ratio Methods on the Perfusion Disorder Evaluation of Side Branch in Patience With Side Branch Occlusion:Influencing Factors and Establishment of a Risk Prediction Model
10.3969/j.issn.1000-3614.2023.12.003
- VernacularTitle:基于三维冠状动脉造影定量分析和定量血流分数分析冠状动脉分叉病变分支血流灌注受损的影响因素及其风险预测模型
- Author:
Yubo LONG
1
;
Hu HU
;
Chengcheng HUANG
;
Ting ZHOU
;
Jinwu LIU
;
Zhaofen ZHENG
;
Jingjing RONG
;
Hongwei PAN
Author Information
1. 湖南省人民医院(湖南师范大学附属第一医院) 湖南省心力衰竭临床医学研究中心 心血管内科,长沙 410005
- Keywords:
coronary bifurcation lesion;
side branch blood perfusion;
the Murray's law based quantitative flow ratio;
three-dimensional quantitative coronary angiography;
risk prediction model
- From:
Chinese Circulation Journal
2023;38(12):1246-1253
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:The risk factors affecting the blood perfusion of side branch(SB)in coronary bifurcation lesions were explored by the three-dimensional quantitative coronary angiography(3D-QCA)and the Murray's law based quantitative flow ratio(μQFR),and a risk prediction model affecting SB perfusion disorders was established to provide reference for the percutaneous coronary intervention(PCI)strategies of bifurcation lesions. Methods:From October 2022 to April 2023,393 bifurcation lesions were evaluated by coronary angiography in Hunan Provincial People's Hospital.The general clinical evaluation index of the patient,the anatomical index of coronary bifurcation lesion,and the μQFR representing branch perfusion in bifurcation lesion were collected.All samples were randomly divided into training set and test set at the 8:2 ratio.Univariate logistic regression was used to determine filter variables,and the influencing factors of branch perfusion in bifurcated lesions were evaluated by multivariate logistic regression analysis.A risk prediction model was established,and the accuracy of the model was further verified in the test set. Results:The maximum area stenosis rate,maximum lumen diameter stenosis rate of the bifurcation nucleus,ostia diameter stenosis rate,as well as the branch maximum diameter stenosis rate,and length of the bifurcation lesion are independent predictors of SB perfusion disorders(SB μQFR<0.8),P<0.05.A SB perfusion disorder risk prediction model was established based on the above five independent risk factors.The area under the ROC curve of the model was 0.926(95%CI:0.896-0.958),the sensitivity was 0.864(95%CI:0.818-0.910),and the specificity was 0.850(95%CI:0.780-0.920).This model was applied to the test set,the results showed that the area under the ROC curve of this model was 0.897(95%CI:0.817-0.976),the sensitivity was 0.870(95%CI:0.756-0.936),and the specificity was 0.923(95%CI:0.759-0.986). Conclusions:The blood perfusion of branches in coronary bifurcation lesions is mainly related to multiple anatomical factors of the main branch and SB.Among them,the maximum area stenosis rate,maximum lumen diameter stenosis rate of the bifurcation nucleus,ostia diameter stenosis rate,branch maximum diameter stenosis rate and length of the bifurcation lesion are independent predictors of perfusion disorders in the SB.Future studies are needed to validate the clinical value of the established risk prediction model of the SB perfusion disorders in daily clinical practice.
