心肌运动定量技术评估冠心病患者冠状动脉狭窄程度及预测预后的效能  

The efficacy of the quantitative cardiac motion quantification technique in assessing the degree of coronary artery stenosis and predicting prognosis in patients with coronary heart disease

作　　者：胡海 万青 王铮 HU Hai;WAN Qing;WANG Zheng(Department of Ultrasound,Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou,450002,China)

机构地区：[1]河南省中医院,河南中医药大学第二附属医院超声科,郑州450002

出　　处：《临床心血管病杂志》2025年第3期201-206,共6页Journal of Clinical Cardiology

基　　金：2024年度河南省中医药科学研究专项课题(No:2023ZY3056)。

摘　　要：目的:探讨心肌运动定量(CMQ)技术在冠心病冠状动脉(冠脉)狭窄程度中的评估价值及预测预后效能。方法:选取2018年12月——2020年12月本院收治的100例冠心病患者,所有患者均在入院后实施CMQ检查及传统冠脉造影(CAG)检查。并以CAG检查结果为金标准,分析CMQ技术对冠脉狭窄程度的诊断价值。随访1年,根据预后情况将患者分为预后良好组(70例)及预后不良组(30例)。比较两组CMQ相关参数。采用Spearman相关性检验分析CMQ相关参数与预后的相关性。绘制受试者工作曲线(ROC)检验CMQ参数评估患者预后的价值。结果:经CAG确诊,100例冠心病患者中Ⅲ级狭窄30例(30.00%),Ⅳ级狭窄70例(70.00%),CMQ技术评估冠脉狭窄程度的准确度为96.00%(96/100)。Kappa检验显示,CMQ评估的冠脉狭窄程度结果与CAG一致性较好(κ=0.903,P<0.001)。预后不良组LVGLS、AP2LS、AP3LS及AP4LS绝对值均低于预后良好组(均P<0.05)。Spearman检验显示,LVGLS、AP2LS、AP3LS、AP4LS与预后呈负相关(r=-0.412、-0.501、-0.375、-0.382,均P<0.05)。ROC曲线显示,LVGLS、AP2LS、AP3LS、AP4LS单独及联合预测冠心病患者不良预后风险的AUC分别为0.773、0.787、0.783、0.766、0.910,其中联合预测的效能最高。结论:CMQ技术能准确评估冠心病患者冠脉狭窄程度,与CAG检查结果有较好的一致性,且CMQ相关参数LVGLS、AP2LS、AP3LS、AP4LS与冠心病患者预后关系密切,联合测定能很好地预测预后。Objective To explore the evaluation value of cardiac motion quantification(CMQ)technique in the degree of coronary artery stenosis and the prognostic efficacy in patients with coronary heart disease.Methods One-hundred patients with coronary heart disease who were admitted to our hospital from December 2018 to December 2020 were included.All patients were underwent CMQ and angiography(CAG)examination.Taking the results of CAG examination as the gold standard,the diagnostic value of CMQ for coronary artery stenosis was analyzed.Follow-up for one year,patients were divided into the good prognosis group(n=70)and the poor prognosis group(n=30)based on their prognosis.The related parameters of CMQ were compared between the two groups.Spearman correlation test was used to analyse the relationship between the related parameters of CMQ and the prognosis.Receiver operating characteristic(ROC)analysis was used to test the value of CMQ parameters in evaluating the prognosis.Results CAG confirmed that there were 30 patients(30.00%)with gradeⅢstenosis,and 70 cases(70.00%)of gradeⅣstenosis.The accuracy of CMQ in evaluating the degree of coronary artery stenosis was 96.00%(96/100).The consistent Kappa measurement showed that the results of CMQ in evaluating the degree of coronary artery stenosis were consistent with CAG examination(κ=0.903,P<0.001).The absolute values of left ventricular global systolic longitudinal peak strain(LVGLS),two-chamber longitudinal peak strain(AP2LS),three-chamber longitudinal peak strain(AP3LS),and four-chamber longitudinal peak strain(AP4LS)in the poor prognosis group were lower than those in the poor prognosis group(all P<0.05).Spearman test showed that LVGLS,AP2LS,AP3LS,and AP4LS were negatively correlated with the prognosis,respectively(r=-0.412,-0.501,-0.375,-0.382,all P<0.05).The ROC curve showed that the AUC of LVGLS,AP2LS,AP3LS,and AP4LS alone and in combination for predicting the risk of poor prognosis were 0.773,0.787,0.783,0.766,and 0.910,respectively,with the highest efficacy observ

关 键 词：心肌运动定量技术 冠心病 冠状动脉狭窄 预后 预测效能 

分 类 号：R541.4[医药卫生—心血管疾病]