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引用次数: 1

摘要

研究狭窄前后患者冠状动脉体内记录的压力曲线Pa(t)、Pd(t)与血流速度Va(t)之间的统计关系,作为计算动态指标FFR、HSR、CFR以及外科实践中普遍接受的其他一些指标的标准临床程序的一部分。结果表明,在不需要手术干预的轻微狭窄的情况下,曲线之间存在相关性,其频谱由三个主要谐波表示。在明显狭窄需要立即支架置入的情况下,Pa(t)和Pd(t)之间的正相关不太明显,与Va(t)曲线呈负相关。曲线的频谱要复杂得多,并且包含高频谐波。对于来自所谓“灰色地带”的患者,可以根据频谱中额外谐波的出现以及Pa(t), Pd(t)和Va(t)曲线之间的负相关关系来做出是否需要支架植入的专家决定。该方法可用于基于机器学习和开发适当数学模型的自动决策。
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Statistical analysis of coronary blood flow monitoring data for hemodynamic assessment of the degree of coronary artery stenosis
Statistical relationships between the pressure curves Pa(t), Pd(t) and blood flow velocity Va(t), recorded in vivo in the coronary arteries of patients before and after stenosis, as part of the standard clinical procedure for calculating dynamic indices FFR, HSR, CFR, and a number of other ones generally accepted in surgical practice are studied. It is shown that in the case of insignificant stenosis that does not require surgical intervention, there is a correlation between the curves, and their spectrum is represented by three main harmonics. In the case of significant stenosis requiring immediate stenting, the positive correlation between Pa(t) and Pd(t) is less pronounced, and there is a negative correlation with the Va(t) curve. The spectrum of the curves is much more complex and contains high-frequency harmonics. For patients from the so-called “gray zone”, an expert decision on the need for stenting can be made based on the appearance of additional harmonics in the spectrum and a negative correlation between the Pa(t), Pd(t) and Va(t) curves. The proposed approach can be used for automatic decision-making based on machine learning and the development of appropriate mathematical models.
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