张祥凝,谢昊泰,高澜,范芳芳,龚艳君,张岩

• 1:北京大学第一医院心血管内科
• 2:北京大学第一医院心血管病研究所
• 3:北京大学血管稳态与重构国家重点实验室
• 4:国家卫生健康委员会心血管分子生物学与调节肽重点实验室

摘要(Abstract)：

目的 探讨心内膜下心肌活力率（SEVR）与冠状动脉狭窄及其严重程度的关联，以及其对冠状动脉疾病（CAD）及中重度CAD的初步诊断价值。方法 连续性选取2024年1—7月于北京大学第一医院因疑似或确诊CAD入院并接受冠状动脉造影的患者，利用无创经皮压力传感器获取颈动脉脉搏波并计算SEVR，按SEVR三等分为T1组（SEVR<144%）、T2组（144%≤SEVR<167%）和T3组（SEVR≥167%）。根据冠状动脉造影结果判定有无CAD、主要血管狭窄程度，并计算SYNTAX评分，SYNTAX评分≥23分确诊为中重度CAD。结果 最终纳入337例患者，平均年龄（63.92±9.60）岁，男237例（70.3%）；其中286例（84.9%）为CAD。随着SEVR升高，CAD患病率及SYNTAX评分均降低[SEVR由低到高的三等分组，CAD患病率分别为91.1%、86.4%、77.4%;SYNTAX评分分别为（16.8±12.3）分、（13.1±11.0）分、（12.4±11.1）分，差异均有统计学意义（均P<0.05）]。在调整混杂因素后，SEVR与CAD、中重度CAD均呈独立负相关（SEVR每增加10%,CAD:OR 0.86,95%CI 0.76～0.96；中重度CAD:OR 0.89,95%CI 0.81～0.98）。限制立方样条分析示，随着SEVR升高，CAD及中重度CAD患病可能性均降低，且无显著非线性关联（非线性均P>0.05）。受试者工作特征曲线分析显示，SEVR对CAD及中重度CAD的诊断曲线下面积分别为0.605(0.520,0.690)与0.589(0.512,0.666)。结论 SEVR与冠状动脉狭窄及疾病严重程度相关。较低的SEVR提示更高的CAD患病可能和更严重的冠状动脉病变程度。

关键词(KeyWords)： 心血管病;心内膜下心肌活力率;心肌缺血;冠状动脉疾病

Abstract:

Keywords:

基金项目(Foundation): 北京市自然科学基金项目（L246054、7252190）;; 国家自然科学基金项目（82170452）;; 国家重点研发计划项目（2021YFC2500503）

作者(Author): 张祥凝,谢昊泰,高澜,范芳芳,龚艳君,张岩

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