CT Scan Of Adenosine Triphosphate Loaded Myocardial Perfusion Was Used To Assess Myocardial Blood Flow And Analyze The Influence Of Cardiovascular Risk Factors On Myocardial Blood Flow

Objective:More and more people in China suffer from coronary heart disease,which has a high mortality rate and seriously affects the life and health of Chinese residents.At present,there are many methods to diagnose coronary heart disease which include two economic and effective methods: these two methods can only respond to the anatomical structure of coronary artery disease,cannot provide with the function of coronary artery information,and cannot load myocardial perfusion computed tomography（CT）.In recent years,computed tomography myocardial perfusion（computed tomography myocardial perfusion,CTP）imaging and dual-source coronary CT one-stop inspection technology were born which can also provide the function of coronary artery learning information.It is carried out by acquiring quantitative parameters: the relationship between stenosis and myocardial blood supply is based on myocardial blood flow MBF,myocardial blood volume MBV,This article analyzes the MBF obtained by CTP combined with CCTA to explore the diagnostic value of MBF in coronary microcirculation diseases and the influence of cardiovascular risk factors on MBF.Methods: From June 2018 to August 2019,69 patients who were clinically suspected of coronary atherosclerotic heart disease were selected at Jiangsu Province People’s Hospital.These patients were mainly outpatients a nd inpatients from the Department of Cardiology,including 43 Cases of male patients and 26 case of female patients,where they had to provide information about their clinical symptoms,past medical history,history of smoking and drinking,medications,etc.coronary CT imaging and CT adenosine triphophate-loaded myocardial perfusion after 4 hours of fasting Imaging examination.Obtain the MBF value through examination,Fasting biochemical and blood routine tests were performed within 1 week before CTP examination.Blood lipid,fasting blood glucose,creatinine clearance rate,white blood cell count,hemoglobin,platelet count and other indicators were collected for study.Results: 1.According to the exclusion criteria,a total of 69 people were included in the study,including 43 males and 26 females.According to the gender grouping,it was found that the drinking history,smoking history and hemoglobin level of the two groups were statistically different,while the comparison of other indicators was comparable.Among the 69 patients,32 were diagnosed with coronary heart disease according to CCTA results,and 37 were non-coronary heart disease.Statistical analysis of indicators in the two groups showed that: Age（t = 3.063,P < 0.05）,diabetes（X₂= 11.74,P < 0.05）,apolipoprotein A（P < 0.05）,glucose（P < 0.05）,creatinine clearance（t = 2.381,P < 0.05）,platelet count（t = 2.831,P < 0.05）,the gensini score（P < 0.05）and MBF（P < 0.05）,and other indexes between the two groups compare statistical differences.Gensini score is the sum of all coronary artery lesions in narrow integral,the variable gensini score line spearman correlation analysis found that the gensini score and apolipoprotein A（r = 0.27,P < 0.05）,glucose were positively correlated（r = 0.297,P < 0.05）,the MBF（r = 0.45,P < 0.05）,platelet count（r = 0.316,P < 0.05）,creatinine clearance（r = 0.263,P < 0.05）and negatively correlated with gensini score.2.According to the median of MBF value,divide into three groups（group A:MBF≤88ml/min/100 ml,group B: 88 < MBF≤121ml/min/100 ml,group C: MBF >121ml/min/100ml）.Drinking history between groups（X₂=4.188,P < 0.05）,prevalence of hypertension（X₂=4.188,P<0.05）,prevalence of diabetes（X₂=17.75,P< 0.05）,high-density cholesterol（t =4.397,P < 0.05）,creatinine clearance rate（t=5.825,P<0.05）,gensini score（P<0.05）and MBF（P<0.05）were statistically different.Spearman correlation analysis showed that MBF was positively correlated with heart rate after adenosine injection（r=0.296,P<0.05）,platelet count（r=0.283,P<0.05）,and high-density cholesterol（r=0.282,P<0.05）,And the gensini score（r=-0.450,P<0.05）was negatively correlated.A multiple linear regression analysis model with MBF as the dependent variable,HDL-C,heart rate after adenosine injection,and gensini score as independent variables was established.The results show that the three have a linear regression relationship with MBF.Conclusion: This study suggests that high-density cholesterol,blood platelet count,and heart rate after adenosine injection may be protective factors for myocardial blood flow,while apolipoprotein A,fasting glucose,gensini score,etc.may be risk factors for MBF,The higher the Gensini score was,the lower the MBF value was,indicating insufficient myocardial perfusion and myocardial ischemia,and the presence of myocardial perfusion defects in non-CHD patients,suggesting that MBF value can be used for the determination of coronary microvascular lesions.