冠状动脉阻抗系统的建立及其稳定性  

Establishment and Reproducibility of a Coronary Arterial Resistance Evaluating System

作　　者：张良惠[1] 葛均波[1] 罗忠池[2] 汪源源[2] 钱菊英[1] 蔡迺绳[1] 王威琪[2] 

机构地区：[1]复旦大学附属中山医院心内科-上海市心血管病研究所,上海200032 [2]复旦大学电子工程系,上海200433

出　　处：《复旦学报（医学版）》2004年第4期331-335,共5页Fudan University Journal of Medical Sciences

基　　金：上海市医学重点发展基金 (2 0 0 0IZD0 0 2 );复旦大学Med-X重点培育基金资助项目

摘　　要：目的　利用计算机和图像、信号采集设备建立冠状动脉阻抗系统 ,并研究冠状动脉阻抗参数的稳定性。方法　与心电信号同步通过腔内超声导管、多普勒导丝和压力导丝 ,获取随心动周期变化的冠状动脉腔内超声图像、流速和压力信号 ;通过自制软件得到随心动周期变化的腔内面积曲线、平均流速曲线、压力曲线和流量 /压力曲线 ;按机电类比方法通过傅立叶变换得到冠脉阻抗参数。采集不同情况下 1 0头小型猪以及 2 1例病人左前降支的基础状态和最大充血状态重复性测量信号分别为 80对。结果　相关分析发现重复性冠脉阻抗参数间有很好的相关性 (P <0 .0 1 ) ;基础状态和充血状态的平均冠脉阻抗和一次谐波冠脉阻抗的决定系数 (r2 )均大于0 .97(P <0 .0 0 1 )。结论　本实验成功建立反映冠脉脉动流阻力的冠脉阻抗系统 。Purpose: The purpose of the present study was to establish the resistance evaluating system of coronary artery based on self-made software and to investigate the reproducibility of coronary resistance (CR) parameters. Methods: Intra-vascular ultrasound (IVUS) images, intracoronary Doppler and pressure signals in the left anterior descending artery (LAD) of 10 pigs and 21 patients were acquired using intracoronary ultrasound imaging catheter, Doppler flow wire and pressure wire separately. The images and signals were respecively sampled into a computer using the image and signal acquistition cards and the corresponding software. A modified active contour model was used to estimate the lumen area of the coronary artery from IVUS images, and a method integrating morphology and dynamic programming were applied to extract the variation of velocity from the Doppler spectrum. With the electrocardiograph as the synchronization, variation of blood volume in a cardiac cycle was calculated as velocity minus area. The curve of volume/ pressure in a cardiac cycle was derived from the curve of volume and pressure. Hereby, the CR parameters for the coronary artery in frequency domain were computed as pressure divided by volume using the Fourier series of blood volume and pressure. A total of 80 pairs of repeated-computer CR parameters were obtained separately in baseline and hyperemia conditions. Results: A highly linear correlation existed between two reproducible CR parameters (P < 0.01). Coefficient of determination of average CR and the first-harmonic CR in baseline and hyperemia conditions were greater than 0.97 (P < 0.001). Conclusions: The curve of volume/pressure in a cardiac cycle and resistance parameters for coronary circulation were established successfully through the software of PC system.

关 键 词：冠状动脉 阻抗系统 建立 稳定性 多普勒 压力 血管内超声 

分 类 号：R540.4[医药卫生—心血管疾病]