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冠状动脉微循环功能的周围程序评估,以预测可选PCI后的临床结果

ChenGuang Li, You Zhou, Danbo Lu¹

¹Shanghai Geriatric Medical Center, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, China; State Key Laboratory of Cardiovascular Diseases, Zhongshan Hospital, Fudan University; NHC Key Laboratory of Ischemic Heart Diseases; Key Laboratory of Viral Heart Diseases Chinese Academy of Medical Sciences; National Clinical Research Center for Interventional Medicine Shanghai China.

Journal of the American Heart Association

|September 2, 2025

概括

穿皮冠状动脉干预 (PCI) 后微循环阻力 (IMR) 指数的变化预测主要心脏不良事件 (MACE). 增加周围手术血管IMR识别了接受选择性PCI的高风险患者.

科学领域:

心脏病学
干预心脏病学
微循环研究

背景情况:

穿皮冠状动脉干预 (PCI) 恢复了心上血流,但微循环功能对结果至关重要.
血管学衍生微循环阻力指数 (angio-IMR) 量化微循环功能.
在选择性PCI中,外流动性血管IMR的预后价值尚不清楚.

研究的目的:

在PCI前后评估血管IMR.
在接受选择性PCI的患者中,确定外流动性血管IMR变化与长期预后的联系.

主要方法:

分析了接受选择性PCI的1,768名冠状动脉疾病患者的数据.
主要终点:主要心脏不良事件 (MACE),包括死亡和非致命心肌梗塞.
在PCI前后评估血管-IMR,以及改变 (Δangio-IMR).

主要成果:

在PCI后,血管IMR的中位数显著从11. 3增加到17. 0 (p < 0. 001).
在20个月的随访期间,3. 0%的患者出现了MACE.
与单独进行PCI后的血管IMR相比,dangio- IMR对MACE的预测能力更强.
Δangio- IMR > 10 独立地与MACE风险增加有关 (aHR,2. 43;p=0. 004).
在预测MACE (AUC0. 681对0. 635) 方面,Dangio- IMR> 10提供了额外的预后值.

结论:

在接受选择性PCI的稳定CAD患者中,血管IMR (Δangio-IMR) 的周围过程变化预测MACE.
将dangio-IMR纳入风险评估可以改善高风险患者的识别.

关键词:

血管学衍生的微循环阻力指数冠状动脉微血管功能通过皮肤进行冠状动脉干预预后情况

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