To Explore The Risk Factors Of Coronary Microvascular Diseases Based On SPECT Quantitative CFR

Objective:This study aims to use single-photon emission computer tomography(SPECT)to measure coronary flow reserve(CFR)to quantitatively evaluate coronary microcirculation to determine whether there is coronary microvascular disease(CMVD),and then analyze and explore the risk factors of CMVD,and analyze traditional cardiovascular disease risk factors(BMI,history of hypertension,history of diabetes,etc.),inflammation-related indicators(IL-8,leukocyte-related derivative inflammation indicators,Etc.),renal function related indicators(Scr,BUN,Cys-C,GFR,UA)and the correlation of coronary microcirculation function are analyzed and discussed,and the safety of SPECT quantitative measurement of CFR is evaluated.It aims to provide a certain clinical reference for the early detection and prevention of CMVD.Methods:Visited the Department of Cardiovascular Medicine,Shaanxi Provincial People ’ s Hospital from January 2020 to December 2020,with symptoms related to myocardial ischemia,coronary angiography(CAG)or coronary CT angiography(CTA)examination It is suggested that the diameter of each coronary artery stenosis is less than or equal to 50%.64 patients who underwent SPECT quantitative measurement of CFR for coronary microcirculation evaluation were the subjects of study.They were grouped according to CFR,and CFR<2.0 was CMVD group(n=34).CFR≥2.0 is the control group(n=30).General data(age,gender,BMI,history of hypertension,diabetes history,etc.)of the enrolled patients are collected,IL-8,liver and kidney function-related indicators,blood lipid-related indicators,HCY,Fasting blood glucose and other blood test related indicators,calculate the leukocyte-related derivative inflammation indicators,glomerular filtration rate(GFR)through formulas;check the record sheet for the side effects of intravenous adenosine during the CFR measurement by SPECT Register in detail.(1)Compare the general data,blood test indicators,leukocyte-related derivative inflammation indicators,and GFR between the two groups;(2)Perform binary logistic regression analysis on variables with statistically significant differences between the groups(P<0.05)to find possible risks Factors;(3)Perform ROC curve analysis on the possible risk factors found in binary logistic regression analysis to determine their predictive value in CMVD;(4)Perform correlation analysis on CFR and various variables;(5)Statistical SPECT quantitative evaluation of CFR During the process,side effects occurred during intravenous injection of adenosine.Results:1.General data comparison: There was no significant difference between the groups in age,gender,BMI,smoking history,drinking history,history of hypertension,history of diabetes,history of stent implantation(P≥0.05);2.Comparison of blood test related indicators in CMCD group and control group: IL-8(17.67±8.71 VS 12.58±8.09),Scr(74.82±23.13 VS 57.04±19.03),Cys-C(1.07±0.33 VS 0.84±0.24),UA(372.64±113.30 VS 303.47±116.14)The difference between the groups was statistically significant(P<0.05).The leukocyte-related derivative inflammation index LMR(3.49±1.58 VS 4.52±2.24),PLR(174.65±87.67 VS 133.50±50.00)was compared between the groups.The difference was statistically significant(P<0.05),and the difference between the GFR(92.01 ± 32.15 VS 119.71 ±42.47)groups was statistically significant.3.Binary Logistic regression analysis showed that IL-8 was an independent risk factor for CMVD(β=0.089,OR=1.293,95% Cl 1.003-1.192,P<0.05);4.ROC curve analysis showed that the area under the curve(AUC)of IL-8 predicted CMVD was 0.812,the best cutoff value was 13.5pg/ml,the sensitivity was 82.4%,and the specificity was 83.3%;5.The correlation analysis between CFR and each variable showed: BMI(r=-0.268,P=0.032),IL-8(r=-0.471,P=0.000),BUN(r=-0.366,P=0.003),Scr(R=-0.337,P=0.006),Cys-C(r=-0.310,P=0.013),UA(r=-0.269,P=0.032),PLR(r=-0.273,P=0.029)same as CFR All are negatively correlated;6.Statistics of side effects of adenosine injection showed that all 64 patients completed adenosine injection,of which 55 cases(85.9%)had mild transient side effects,and the side effects all resolved spontaneously within 1 min after the completion of adenosine injection.Conclusion:1.Elevated IL-8 is a risk factor for CMVD,which has a certain predictive value for CMVD;2.BMI is negatively correlated with CFR,suggesting that increased BMI has an adverse effect on coronary microcirculation;3.In CMVD patients,IL-8 and PLR related to inflammation are higher,and LMR is lower.IL-8 and PLR are negatively correlated with CFR,suggesting that inflammation has an adverse effect on coronary microcirculation;4.Scr,Cys-C,and UA related to renal function in patients with CMVD are higher,and GFR is lower.BUN,Scr,Cys-C,and UA are negatively correlated with CFR,suggesting that early renal damage is detrimental to coronary microcirculation.influences;5.Injecting adenosine in the process of SPECT quantitative CFR assessment of coronary microcirculation function has good safety.