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通过基于血管造影的微循环阻力指数评估心血管炎的微血管功能:一个元分析

Wei Wen¹, Yi Chi², Mingwang Liu¹

¹Cardiovascular Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, 100091 Beijing, China.

Reviews in cardiovascular medicine

|September 10, 2025

概括

基于血管造影的IMR (Angio-IMR) 是一种可靠的,非侵入性的方法,用于诊断心脏病患者的冠状动脉微血管功能障碍 (CMD). 它显示出高精度,特别是在高血压条件下,使其成为一种有价值的临床工具.

科学领域:

心脏病学心脏病学
医疗成像医学成像
诊断工具诊断工具

背景情况:

冠状动脉微血管功能障碍 (CMD) 诊断依赖于微循环阻力 (IMR) 的侵入性指数,由于复杂性和成本,临床应用有限.
基于血管造影的IMR (Angio-IMR) 为CMD评估提供了一个有希望的,不那么侵入性的替代方案.
这项研究旨在评估Angio-IMR在患有胸痛 (AP) 的患者中用于CMD检测的诊断疗效.

研究的目的:

评估Angio-IMR用于检测冠状动脉微血管功能障碍 (CMD) 在患有胸痛 (AP) 的患者的诊断性能.
为了比较Angio-IMR的诊断准确性与现有方法,在不同的生理条件下 (高血压与休息).

主要方法:

在主要数据库 (PubMed,Embase,Scopus,Cochrane图书馆) 进行了系统的文献审查.
包括评估AP群体Angio-IMR诊断性能的研究.
分析的关键结果包括聚合灵敏度,特异性,正预测值 (PPV),负预测值 (NPV) 和ROC曲线下的面积 (AUC).

主要成果:

有927名患者的11项研究证实了Angio-IMR强大的诊断性能:灵敏度86%,特异性90%,PPV 82%,NPV 91%,AUC 0.91.
诊断准确度在阻塞性和非阻塞性冠状动脉疾病的子组中保持一致.
与静止状态评估相比,高血压血管-IMR显示出更高的灵敏度和特异性,并表现出优于量化流量比率 (QFR).

结论:

血管-IMR是一种可靠的,非侵入性的诊断工具,用于识别心血管疾病在患有胸痛的患者.
它的诊断一致性,特别是在高血压条件下,支持广泛的临床适用性.
血管IMR为CMD诊断提供了侵入性IMR的可行替代方案.

关键词:

胸痛是一种心痛.基于血管图的微循环阻力指数.冠状动脉疾病是一种冠状动脉疾病.冠状动脉微血管功能障碍微循环阻力指数的微循环阻力指数

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