Guo Lijun

CORRELATION BETWEEN FRACTIONAL FLOW RESERVE AND QUANTITATIVE CORONARY ANGIOGRAPHY PARAMETERS IN INTERMEDIATE CORONARY ARTERY STENOSIS

Objectives To clarify the relationship between quantitative coronary angiography (QCA) parameters and fractional flow reserve (FFR) for screening out ideal angiographic parameters to predict myocardial ischaemia. Methods The study included 121 lesions with QCA and FFR datas from 106 patients. The lesions were grouped into FFR>0.75 group and FFR≤0.75 group. Assessed parameters by QCA included percentage diameter stenosis, minimum luminal diameter (MLD), percentage area stenosis, minimum luminal area (MLA), reference vessel diameter (RVD) and lesion length (LL). Correlation analysis was used to identify the relationship between QCA parameters and FFR value, and receiver operating characteristic (ROC) curve was used to determine predictors of FFR≤0.75. Results When compared to FFR>0.75 group, FFR≤0.75 group had higher LL (14.8±7.9 mm vs 10.7±5.4 mm, p=0.024), lower MLD (1.47±0.31 mm vs 1.82±0.51 mm, p=0.028), lower RVD (2.30±0. 50 mm vs 2.81±0.64 mm, p=0.036), and lower MLA (2.30±1.50 mm2 vs 3.60±2.30 mm2, p=0.038). By correlation analysis, significant negative correlation between QCA parameters and FFR included LL (r=−0.209, p=0.040), significant positive correlation included MLD (r=0.414, p=0.040), RVD (r=0.303, p=0.000) and MLA (r=0.315, p=0.002). By using a ROC, we identified MLD≥1.6 mm to be the best cut-off value to fit with a FFR>0.75 with sensitivity 63%, specificity 82%, and positive predictive value 96%. Conclusions Anatomic parameters of intermediate coronary lesions by QCA show a moderate correlation to FFR value. MLD by QCA may be used as an alternative to FFR when assessing the need for intervention in intermediate coronary lesions.

Changes and significance of Serum Angiopoietin-1 and Angiopoietin-2 levels in Patients with coronary heart disease

Objective Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) are the members of angiopoietin families. The regulation between Ang-1 and Ang-2 plays an important role in accommodating endothelial cell function and inflammation. Several recent studies have demonstrated that Ang-1, Ang-2 levels and ratio can strongly predict the condition and prognosis in several inflammatory related diseases. However, there were a little study on the changes and clinical significance of Ang-1 and Ang-2 in the patients with coronary heart disease and whether they may be used to predict disease severity are still unknown. The aim of our study is to investigate the Ang-1, Ang-2 levels and ratio changes and some conceivably influential factors in different type of patients with CHD, explore the predictive value for disease severity and plaque stability. Methods We studied 166 patients admitted to the ward of Cardiology Department in Peking University Third Hospital between September 2010 and April 2011. They were divided into five groups: 35 STEMI, 26 NSTEMI, 40 UA, 40 SA patients and 25 controls. The serum samples were collected before coronary arteriography. Serum concentrations of Ang-1 and Ang-2 were tested by ELISA. Results (1) The serum levels of Ang-1 Ang-2 and Ang-2/Ang-1 ratio in patients with SA, UA, NSTEMI and STEMI were significantly higher than those in the controls (p<0.001). (2) Ang-1 and Ang-2 levels in patients with SA, UA, NSTEMI and STEMI increased gradually with significant difference between each two groups (p<0.001). Ang-2/Ang-1 ratio was significantly different in each two groups (p<0.05), but not SA and UA groups (p>0.05). (3) Compared with SA group, the levels of Ang-1, Ang-2 and Ang-2/Ang-1 ratio were significantly higher in ACS group (p<0.001). (4) By correlation analysis, Ang-1, Ang-2 and Ang-2/Ang-1 ratio in patients with CHD were positively related to Gensini scores (p<0.01). (5) Ang-1 was positively correlative to Neu (p<0.05), WBC, Neu%, hs-CRP, LDL-c, Glu and Fib (p<0.01), but was negatively correlative to LVEF (p<0.01). Ang-2 was positively related to hypertension, Neu, LDL-c (p<0.05), WBC, Neu%, hs-CRP, Glu and Fib (p<0.01), but was negatively related to LVEF (p<0.01). Ang-2/Ang-1 ratio had positive relationship with Hypertension, hs-CRP, Fib (p<0.05), WBC, Neu% and Glu (p<0.01), but had negative relationship with LVEF (p<0.01). (6) In AMI patients, Ang-1, Ang-2 and Ang-2/Ang-1 ratio were significant positive correlation to peak CK, CKMB and TnT levels (p<0.01). Conclusion The serum levels of Ang-1, Ang-2 and Ang-2/Ang-1 ratio change significantly in different type of coronary heart disease, which could be used to evaluate the disease severity. Moreover, they may become important biomarkers to predict the stability of coronary plaque.