基于冠状动脉 CT 血管造影的血流储备分数 对高原高海拔环境下冠心病的诊断价值.

To investigate the diagnostic value of fractional flow reserve (FFR) of coronary CT angiography (CCTA) in coronary heart disease (CHD) in high altitude environment of plateau. 54 patients who underwent CCTA examination and guidewire measurement of FFR in Qinghai Provincial Cardiovascular and Cerebrovascular Disease Specialized Hospital from January 2022 to May 2023 were selected as the research objects. The data were collected by Flash dual-source spiral CT, CCTA-based FFR (CT-FFR) was simulated calculation by fluid mechanics principle based on CCTA images. FFR as the gold standard, positive predictive value, negative predictive value, sensitivity, accuracy and specificity of CT-FFR in the diagnosis of coronary heart disease and coronary artery lesions were analyzed, the diagnostic efficacy of CT-FFR in coronary heart disease and coronary artery lesions were analyzed by receiver operating characteristic (ROC) curve. The consistency between CT-FFR and FFR were analyzed by Bland-Altman plot. The positive predictive value of CT-FFR in the diagnosis of coronary heart disease was 73.08%, negative predictive value was 89.29%, sensitivity was 86.36%, accuracy was 81.48%, sensitivity was 78.13%. The area under the curve (AUC) of CT-FFR in the diagnosis of coronary heart disease was 0.854, and 95%CI was 0.747~0.962. The positive predictive value of CT-FFR in the diagnosis of coronary artery lesions was 71.05%, negative predictive value was 91.84%, sensitivity was 87.10%, accuracy was 82.76%, sensitivity was 80.36%. The AUC of CT-FFR in the diagnosis of coronary artery lesions was 0.921, and 95%CI was 0.865~0.978. Whether the diagnosis of coronary heart disease or diagnosis of coronary artery lesions, CT-FFR and FFR had good consistency. CT-FFR has high accuracy and sensitivity in the diagnosis of coronary heart disease in high altitude environment, and the detection efficiency is ideal, which has good consistency with FFR. [ABSTRACT FROM AUTHOR]