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血液流动能识别冠状动脉病变,可能导致未来心肌梗塞
Maurizio Lodi Rizzini1, Alessandro Candreva1,2, Valentina Mazzi1
1PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Turin, Italy.
Annals of biomedical engineering
|September 21, 2023
概括
血流能量转换,特别是运动和旋转能量比率 (KER和RER),有效预测心肌梗塞 (MI) 风险. 这些生物力学因素比定量冠状动脉血管学 (QCA) 等传统方法提供了更强的预测.
科学领域:
- 心血管医学 心血管医学
- 生物医学工程 生物医学工程
- 医疗成像医学成像
背景情况:
- 冠状动脉样硬化病变构成未来心肌梗塞 (MI) 的风险.
- 目前对心脏病发作风险的预测因素通常依赖于解剖狭窄和功能流量储备测量.
- 冠状动脉病变中的生物力学力量仍然是关于斑块不稳定性的进一步研究领域.
研究的目的:
- 研究冠状动脉样硬化病变中的血流能量转换与临床结果之间的联系.
- 将新型血流能量指标的预测能力与已建立的定量冠状动脉血管学 (QCA) 来源预测器进行比较,以预测未来的心脏病发作.
- 探索斑块不稳定导致MI的生物力学贡献.
主要方法:
- 基于血管造影的计算流体动力学 (CFD) 模拟在80个罪祸首病变和108个非罪祸首病变上进行.
- 血流能量转换被量化为动力和旋转能量比率 (KER和RER) 在损伤的收流量段.
- 已建立的QCA指标 (%AS,vFFR,ΔvFFR) 和墙壁剪切应力 (TSVI) 用于比较.
主要成果:
- 在5年内,KER和RER表现出显著的MI预测能力 (AUC分别为0.73和0.76;p<0.0001).
- 对未来MI的KER和RER的预测能力明显强于vFFR,%AS和ΔvFFR (p <0.05).
- 凯尔和RER的预测能力与拓剪切变化指数 (TSVI) 的预测能力相当.
结论:
- 血液流动动力和旋转能量转换是未来心脏病发作的重要预测因素.
- 这些生物力学能量指标与传统的解剖学和功能测量相比,为MI提供了更好的预测价值.
- 这些发现支持在肌痛性心脏病的发病过程中对斑块不稳定和破裂的生物力学作用.
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