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目的 :通过冠心病患者每心动周期的冠状静脉窦充盈时间与冠脉循环时间的相关性分析,研究使用冠状脉静脉窦充盈时间评估冠脉循环时间的可行性。方法:对照组(54例)和冠心病组(56例)均行经胸超声心动图和冠脉造影检查,分别测得冠状静脉窦充盈时间和冠脉循环时间,对研究结果进行Pearson相关分析和ROC曲线分析。结果:与对照组相比,冠心病组的冠状静脉窦充盈时间[(0.34±0.08)s vs.(0.43±0.10)s,P<0.05]和冠脉循环时间[(4.41±0.82)s vs.(5.42±1.13)s,P<0.05]均明显延长,冠状静脉窦充盈时间和冠脉循环时间呈显著相关(r=0.843,P<0.000 1)。ROC曲线分析结果表明冠状静脉窦充盈时间可作为预测冠脉循环时间(>5 s)延迟的指标,曲线下面积为0.915,敏感性为93.2%,特异性为87.9%;阳性预测值为91.9%,阴性预测值为89.7%,临界值为0.418 s时的准确率为90.5%。结论:每心动周期的冠状静脉窦充盈时间与冠脉循环时间显著相关,且是评估冠脉循环和冠脉瞬时血流测量的重要临床指标。
OBJECTIVE: To investigate the feasibility of using coronary sinus venous filling time to evaluate the coronary circulation time by analyzing the correlation between coronary sinus filling time per coronary cycle and coronary circulation time in patients with coronary heart disease. Methods: The control group (54 cases) and coronary heart disease group (56 cases) underwent transthoracic echocardiography and coronary angiography. Coronary sinus filling time and coronary circulation time were measured respectively. The results were analyzed by Pearson correlation analysis and ROC curve analysis. Results: Compared with the control group, coronary sinus filling time [(0.34 ± 0.08) s vs. (0.43 ± 0.10) s, P <0.05] and coronary circulation time [(4.41 ± 0.82) s vs (5.42 ± 1.13) s, P <0.05]. The filling time of coronary sinus was significantly correlated with coronary circulation time (r = 0.843, P <0.0001). The results of ROC curve analysis showed that the filling time of coronary sinus could be used as an index to predict the delay of coronary circulation (> 5 s). The area under the curve was 0.915 with a sensitivity of 93.2% and a specificity of 87.9%. The positive predictive value was 91.9% , The negative predictive value was 89.7%, the critical value was 0.418 s when the accuracy rate was 90.5%. CONCLUSION: Coronary sinus filling time per cardiac cycle is significantly associated with coronary circulation time and is an important clinical indicator for assessing coronary circulation and transient coronary flow.