Derivation of a 17 myocardial segment angiographic scoring system and its validation
首发时间:2017-09-15
Abstract:The Syntax Score has been devised to characterize the number of lesions, and their functional impact, location, and complexity in terms of coronary artery trees. An obvious fallacy is that the Syntax Score system over simply divided coronary artery circulation system into right or left dominant coronary artery circulation, which fails to reflect the great variability of coronary artery trees. Furthermore, the Syntax Score is in essence blood vessel-based rather than blood vessel importance-based. Finally, the scores assigned for the lesion characteristics, such as calcification, tortuosity, angulation, and thrombosis, etc, are largely arbitrary in the Syntax score. In the current study, we have aimed to devise a new scoring system, the 17 myocardial segment based coronary scoring system, to accurately describe the anatomical characteristics of the native coronary artery trees, to grade the complexity of the acquired coronary artery diseases according to the importance of a blood vessel, and to collect the treatment information on lesions. We have successfully completed a program to realize the above-mentioned aims based on the following preexisting or initiated classifications or rules: 54 coronary artery circulations; a 17 myocardial segment model; the 3 areas delineated by 3 anatomical landmarks on the left heart surface; law of competitive myocardial blood supply for the 3 areas; and blood flow for parent vessels equals the summation of blood flow for daughter vessels. The utility of the 17 myocardial segment based coronary scoring system for prediction of outcomes will be investigated prospectively in the conduct of the trial: in acute myocardial infarction patients undergoing emergency percutaneous coronary intervention trial (AMI-EPCI trial). Once validated and standardized, the 17 myocardial segment based coronary scoring system will be available online.
keywords: 17 myocardial segment model angiographic scoring system coronary artery disease
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基于17节段心肌节段模型的冠脉评分系统及其验证
摘要:本研究旨在设计一种新的基于17节段模型原理的冠脉评分系统,以便评分冠脉系统病变的复杂性,并充分考虑冠脉变异。我们依据下列原理或以已有模型,17节段心肌节段模型,竞争性供血原理及子血管权重之和等于母血管权重等。我们据上述原理成功设计出一崭新冠脉评分系统(Catlet系统),克服Syntax之缺点。我们认为CatLet系统可能是一个有用的评价冠脉病变复杂性,收集治疗信息的工具。其有效性将在急诊PCI患者进行验证。一旦验证成功并完成标准化,该评分系统将公布上网。
关键词: 17节段心肌节段模型 冠脉评分系统 冠心病
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