李其勇,杨佼,陶剑虹

• 1:四川省医学科学院四川省人民医院心内科

摘要(Abstract)：

目的通过血流储备分数(FFR)和心脏磁共振(CMR)成像评估冠状动脉慢性完全闭塞(CTO)病变的血运重建适应证。方法选取2018年7月至12月四川省人民医院冠状动脉造影显示至少一支血管存在CTO病变的患者32例,通过CMR测量心肌延迟强化透壁程度和区域性室壁运动积分指数(RWMSI),比较主要供体血管和CTO病变血管在经皮冠状动脉介入治疗(PCI)前后FFR值的变化,并观察3个月随访期间左心室射血分数(LVEF)的变化情况。结果最终19例患者完成所有检查和随访。CTO-PCI后主要供体血管FFR值[(0.88±0.09)比(0.81±0.12),P=0.031]和CTO病变血管FFR值[(0.85±0.10)比(0.41±0.08),P=0.015]均较CTO-PCI前显著增加,差异均有统计学意义;3个月随访时LVEF较CTO-PCI前有所改善,差异有统计学意义[(51.32±11.72)%比(43.82±10.56)%,P=0.038]。但心肌延迟强化透壁程度>75%和RWMSI>2.0的患者CTO-PCI后FFR<0.8,LVEF无改善。结论即使有良好的侧支循环,CTO病变端心肌仍处于缺血状态。CTO-PCI后CTO病变血管和主要供体血管的FFR值均显著升高,并能带来左心功能的改善。

关键词(KeyWords)： 慢性完全闭塞;经皮冠状动脉介入治疗;血流储备分数;心脏磁共振

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生和计划生育委员会资助项目(140094);; 国家青年自然科学基金(81100188)

作者(Author): 李其勇,杨佼,陶剑虹

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