Ischemia/reperfusion (I/R) injury is a key driver in cardiomyocyte loss and cardiac dysfunction in ischemic heart disease. Here, we uncover a previously unrecognized gut microbiota-mediated mechanism that contributes to myocardial I/R injury. Using murine I/R models and fecal microbiota transplantation, we demonstrate that the gut microbiota mediates cardiac damage through selective enrichment of Bacteroides acidifaciens (B. acidifaciens) following I/R-induced intestinal hypoxia and elevated luminal lactate levels. B. acidifaciens produces dipeptidyl peptidase 4 (BaDPP4), which degrades cardioprotective peptides (e.g., glucagon-like peptide-1 [GLP-1]) in the plasma, amplifying myocardial injury. Pharmacological inhibition of BaDPP4 with daurisoline, a microbial DPP4-specific inhibitor, mitigates cardiac dysfunction. In acute myocardial infarction patients with I/R injury, B. acidifaciens abundance and BaDPP4 levels correlate with clinical markers of cardiac damage. Together, these findings reveal a gut-heart axis whereby microbial-derived DPP4 exacerbates cardiac I/R injury and highlight the hypoxia-lactate-BaDPP4 axis as a promising target for microbiota-based cardioprotection.

Objective:The aim of this study was to investigate the quantitative flow ratio (QFR) outcomes in the left circumflex artery (LCX) following the placement of a crossover stent from the left main coronary artery (LM) to the left anterior descending artery (LAD) in LM bifurcation lesions. In addition, we sought to assess the relationship between these QFR results and clinical prognoses. Background:The treatment approach for LM bifurcation lesions remains a topic of debate, with the LM-LAD single-stent technique being one possible option. QFR, a fractional flow reserve calculation method derived from angiography that does not require pressure guide wires, could serve as an alternative functional assessment of the LCX. This study aims to evaluate the clinical outcomes of postoperative LCX by utilizing QFR measurements, addressing a current gap in the relevant literature on this topic. Methods:This study was a retrospective, single-center analysis of patients with LM bifurcation lesions who underwent percutaneous coronary intervention (PCI) guided by intravascular ultrasound. QFR values were derived from angiographies. The primary endpoint was the 1-year rate of major adverse cardiac events, defined as a composite of cardiovascular death, target bifurcation-related myocardial infarction (MI), or target bifurcation revascularization. The secondary clinical endpoint was defined as the persistence or recurrence of angina pectoris after PCI. Results:We analyzed 91 patients from a total of 180 who were screened for LM bifurcation lesions. All patients completed the 1-year follow-up. The pre- and post-PCI QFR values were 0.89 ± 0.09 and 0.86 ± 0.11, respectively. Subgroup analysis showed that 74 patients were in the postoperative QFR ≥0.80 group, whereas 17 patients were in the QFR <0.80 group. In addition, 32 patients had a ΔQFR ≥0, and 58 patients had a ΔQFR <0. Nine patients (9.9%) achieved the primary endpoint, including one patient with non-ST elevation myocardial infarction who received revascularization in both the LM-LAD and LCX arteries. In addition, nine patients (9.9%) reported no substantial improvement in their chest pain symptoms. Post-LCX-QFR <0.8 was associated with a higher 1-year incidence of cardiovascular death or MI (P = 0.036). ΔQFR proved to be a robust predictor of the 1-year incidence of the primary endpoint, with an incidence of 15.3% in the ΔQFR ≥0 group compared to 0% in the ΔQFR <0 group (area under the curve: 0.822; 95% CI: 0.728-0.895, P < 0.001), especially when ΔQFR ≤-0.03. Conclusions:After the LM-LAD single-stent strategy for LM bifurcation lesions, a ΔQFR of LCX ≤-0.03 was associated with a higher risk of 1-year main adverse cardiac events, indicating the superior prognostic value of the post-PCI physiological assessment.

Background:Quantitative flow ratio (QFR) based lesion selection for percutaneous coronary intervention (PCI) treatment has shown clinical benefits in terms of reduced risk for myocardial infarction and repeat revascularization. Whether this benefit is consistent across different age groups still needs further investigation. Methods:In this prespecified subgroup study of FAVOR III China trial, we compared long-term clinical outcomes between QFR-guided and angiography-guided PCI among different age groups among 3825 enrolled subjects. The primary endpoint was major adverse cardiac events (MACEs), a composite of all-cause death, myocardial infarction, and ischemia-driven revascularization. Results:Of the 3825 patients, 1717 (44.9%) were aged ≥ 65 years. At baseline, patients ≥ 65 had higher rates of hypertension, hyperlipidaemia, stroke history (P < 0.0001), and peripheral vascular disease (P = 0.024) and had higher SYNTAX scores (P = 0.0095). Compared with standard angiography guidance, the QFR-guided strategy consistently reduced the 1-year (≥ 65 years, 6.04% vs. 9.19%, HR = 0.65, 95% CI: 0.46-0.92; < 65 years, 5.53% vs. 8.43%, HR = 0.65, 95% CI: 0.47-0.91) and 3-year MACE rates in both age groups (≥ 65 years, 11.8% vs. 15.2%, HR: 0.75, 95% CI: 0.58-0.98; < 65 years, 9.5% vs. 14.6%, HR = 0.63; 95% CI: 0.49-0.81), without a significant interaction (P interaction = 0.99). Within the QFR-guided group, the 3-year MACE rate in patients with deferred vessels was numerically greater in patients aged ≥ 65 years than in those aged < 65 years (8.3% vs. 3.0%, P = 0.10). Conclusions:Although with higher rate of comorbidities and more complex coronary anatomy, the long-term benefit of the QFR-guided PCI strategy remained consistent in patients ≥ 65 years, compared with those < 65 years.

OBJECTIVES:To analyze sex and age distribution of global disease burden of calcific aortic valve disease (CAVD) from 1990 to 2021. METHODS:CAVD data during 1990-2021 were obtained from the IHME website for Global Burden of Disease (GBD). The prevalence, mortality, years lived with disability (YLDs), and disability-adjusted life years (DALYs) were analyzed by gender and age groups. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC). RESULTS:In 2021, there were 13.32 million CAVD patients and 142 000 deaths caused by CAVD globally. Age-standardized prevalence was higher in males (193.2/105) than that in females (128.9/105). Patients in 65-<85 age group accounted for 64.0% of total cases, while those ≥85 years old accounted for 16.1%. From 1990 to 2021, prevalence increased in both sexes with an AAPC of 0.72% for males and 0.57% for females, respectively. Prevalence grew fastest from 2000 to 2010, slowed thereafter, and declined from 2015 to 2021. In <65 years old, the mortality of males was 2.4 times higher than that of females, while in ≥85 years old, mortality of females (117.3/105) exceeded that of males (99.1/105). YLD rates increased with age, and were higher in males for all age groups. DALY rates decreased overall but increased in ≥85 years old, with a greater increase in females. CONCLUSIONS:There are significant gender and age disparities in global disease burden of CAVD, with the elderly, especially super-elderly females deserving particular attention. It is recommended to develop personalized intervention strategies for these populations.

>Kounis syndrome （KS） is a rare but clinically significant condition characterized by the simultaneous occurrence of acute coronary syndrome （ACS） and allergic reactions,which can develop in patients with either normal or diseased coronary arteries. [1,2] The condition is typically triggered by various allergens including medications （particularly contrast media）,environmental factors,or food exposures,with symptom onset usually occurring within one hour of exposure. [3,4] KS classifies into three distinct subtypes:type Ⅰ involves acute coronary vasospasm in angiographically normal arteries that may progress to myocardial infarction if sustained,type Ⅱ features allergen-mediated plaque destabilization leading to thrombosis or rupture in pre-existing atherosclerotic lesions,and type Ⅲ presents as stent thrombosis with characteristic eosinophilic and mast cell infiltration at the thrombus site. [5] Diagnostic challenges frequently arise as KS may mimic conventional ACS or isolated allergic reactions,especially in type Ⅰ variant where coronary angiography appears normal.Accurate diagnosis therefore requires careful integration of clinical history,documentation of allergen exposure,and laboratory evidence of mast cell activation and immunoglobulin E-mediated hypersensitivity.Here,we report two clinically confirmed cases of KS:a type Ⅰ variant precipitated by contrast media-induced anaphylaxis and a type Ⅱ variant featuring optical coherence tomography （OCT）-documented plaque rupture following flour allergy exposure.

Currently, precise stent manipulation and placement in percutaneous coronary intervention remain compromised. Intravascular imaging techniques are often limited by either spatial resolution or depth of penetration. A hybrid intravascular ultrasound (IVUS)-optical coherence tomography (OCT) system would be a better choice for interventional cardiologists. To validate the image quality and safety of the novel IVUS-OCT system for guiding coronary intervention in Chinese patients, a total of 114 cases were included. The proportion of clear imaging length was 96.21% ± 10.16%. Device success rate was 99.1%, technical success rate was 98.2%, and excellent image rate was 96.5%. No catheter-related adverse events occurred, and the incidence of device defects was 0.9%. This study preliminarily verified the image quality and safety of the novel Hybrid IVUS and OCT imaging system. (The StUdy to Evaluate the Performance and safEty of the Novasight HybRid System Using Objective PeRformance Criteria [SUPERIOR]; NCT04617899).

Cardiac computed tomography angiography (CTA) is the preferred modality for preoperative planning in aortic valve stenosis. However, it cannot provide essential functional hemodynamic data, specifically the mean transvalvular pressure gradient (MPG). This study aims to introduce a computational fluid dynamics (CFD) approach for MPG quantification using cardiac CTA, enhancing its diagnostic value. Twenty patients underwent echocardiography, cardiac CTA, and invasive catheterization for pressure measurements. Cardiac CTA employed retrospective electrocardiographic gating to capture multi-phase data throughout the cardiac cycle. We segmented the region of interest based on mid-systolic phase cardiac CTA images. Then, we computed the average flow velocity into the aorta as the inlet boundary condition, using variations in end-diastolic and end-systolic left ventricular volume. Finally, we conducted CFD simulations using a steady-state model to obtain pressure distribution within the computational domain, allowing for the derivation of MPG. The mean value of MPG, measured via invasive catheterization (MPGInv), echocardiography (MPGEcho), and cardiac CTA (MPGCT), were 51.3 ± 28.4 mmHg, 44.8 ± 19.5 mmHg, and 55.8 ± 25.6 mmHg, respectively. In comparison to MPGInv, MPGCT exhibited a higher correlation of 0.91, surpassing that of MPGEcho, which was 0.82. Moreover, the limits of agreement for MPGCT ranged from −27.7 to 18.7, outperforming MPGEcho, which ranged from −40.1 to 18.0. The proposed method based on cardiac CTA enables the evaluation of MPG for aortic valve stenosis patients. In future clinical practice, a single cardiac CTA examination can comprehensively assess both the anatomical and functional hemodynamic aspects of aortic valve disease.

重度主动脉瓣狭窄是常见的心脏瓣膜疾病,外科主动脉瓣置换术是其传统的治疗方法.随着技术的不断发展,经导管主动脉瓣置换术已成为无法行外科手术或手术风险较高的严重症状性主动脉瓣狭窄患者的有效治疗手段,其适应证也在不断扩大.该文阐述经导管主动脉瓣置换术在不同人群的适应证选择、手术入路、人工瓣膜类型选择、术后治疗和康复等进展,为主动脉瓣狭窄患者的治疗提供参考.

Background and objectives: Intravascular optical coherence tomography (IVOCT) is capable of delineating periluminal region, including thin fibrous cap, calcium, lipid and thrombus. The segmentation result of these plaques is needed when calculating some useful diagnostic indicators, such as the minimum fiber cap thickness or the maximum Plaque Structural Stress (PSS), to help the diagnosis of vulnerable plaque. Since only some images contain plaques, in order to simplify the network architecture, we designed a three-step framework with single task for each step in this paper to realize the machine learning based pixel-level semantic segmentation of plaque in IVOCT.Methods: A three-step framework is designed: lumen segmentation, image classification and plaque semantic segmentation. Firstly, the lumen of IVOCT is segmented using U-Net. Then the patches are cropped along the lumen boundary, and the plaques in the patches are classified and merged to get whether the original image contains calcium or lipid plaque. In the classification procedure, a self-attention module is introduced into ResNet to form the improved self-attention ResNet. Finally, the selected images with plaque are segmented to get the pixel-level segmentation results of each plaque component, which is realized by an combined network composed by convolutional auto encoder and U-Net.Results and conclusions: In the lumen segmentation step, the Dice coefficient is greater than 95%. In the classification step, the classification precision, sensitivity and specificity of calcium plaque are all 100%; and that of lipid plaque are 97%, 100% and 94% respectively. In the final segmentation step, the Dice coefficient of calcium plaque is 71.8% and that of lipid plaque is 60.5%; the sensitivity of calcium plaque is 78.4% and that of lipid plaque is 80.2%. The experiments show that compared to some commonly used networks the proposed method achieves better performance.

Objective To analyze the influence factors of new-onset complete left bundle branch block（CLBBB） after transcatheter aortic valve replacement（TAVR） in patients with aortic stenosis（AS）, and to explore the impact of CLBBB on postoperative cardiac remodeling reversal. Methods Totally 55 patients with AS who underwent TAVR were enrolled. Among them, new-onset CLBBB after TAVR and lasted for at least 1 month was observed in 16 patients（CLBBB group）,while 31 patients did not develop new CLBBB after operation and 8 patients developed new CLBBB within 1 day after operation but CLBBB disappeared within 1 month were included in NO-CLBBB group. The hemoglobin（Hb）, N-terminal pro-brain natriuretic peptide（NT-proBNP）, creatinine（Cr）, creatine kinase-MB（CK-MB） and troponin（cTn） before and 1 day after TAVR were compared between groups. Echocardiographic parameters, as well as NYHA cardiac function classification before and 1 month after TAVR were also compared between groups. Results Serum cTn at 1 day after TAVR was significantly higher than that before in both groups（both P＜0.05）, and there was no significant difference between groups（both P＞0.05）. The interventricular septum thickness at end-diastole（IVSD）, aortic valve peak pressure gradient（PPG） and aortic valve mean pressure gradient（MPG） of CLBBB group were significantly higher than those of NO-CLBBB group before TAVR（all P＜0.05）. In NO-CLBBB group, 1 month after TAVR, the left ventricular mass（LVM）, IVSD, left ventricular posterior wall thickness at end-diastole（LVPWD）, pulmonary artery systolic pressure（PASP）, PPG and MPG decreased, while aortic valve orifice area（AVA） increased compared with those before operation（all P＜0.01）. In CLBBB group, IVSd, PPG and MPG decreased 1 month after TAVR, while AVA increased compared with those before operation（all P＜0.01）. There was no significant difference of the other indexes between and within groups（all P＞0.05）. Conclusion After TAVR for treating AS, PPG, MPG and IVSD were impact factors of new CLBBB. New-onset CLBBB affected postoperative cardiac remodeling reversal.

本研究探讨在新型冠状病毒肺炎疫情期间,采用情景教学法,将教师标准化病人(teacher standardized patient,TSP)与案例教学相结合,由教师扮演标准化病人,模拟临床真实情景,将实际临床问题准确表现在物理诊断学课程中,并进行线上教学效果评估.结果显示,应用TSP结合案例教学法使教学效果得到提升,医学生的理论考试成绩得到明显提高,在问诊、内科常见疾病阳性体征、病历书写、医患沟通、人文关怀等方面教学满意度较高.全身体格检查手法有待学生返校后,进行强化培训和考核.

BACKGROUND: The predictive scoring systems for early stent thrombosis (EST) remains blank in China. The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population. METHODS: EST was defined as thrombosis that occurs within the first 30 days after primary percutaneous coronary intervention (PCI). Patients from ten Chinese hospitals diagnosed as stent thrombosis (ST) from January 2010 to December 2016 were retrospectively included as the study group. A control group (1 case:2 controls) was created by including patients without ST, major adverse cardiovascular events, or cerebrovascular events during follow-up. The present study evaluated 426 patients with single-vessel lesions and ultimately included 40 patients with EST and 80 control patients, who were included to identify factors that predicted EST and to develop a prediction scoring system. The other 171 patients without integrated 1:2 pair were used for external validation. RESULTS: EST was independently associated with a low hemoglobin concentration (adjusted odds ratio [OR] 0.946, 95% confidence interval [95% CI] 0.901-0.993, P=0.026), a high pre-PCI Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (OR 1.166, 95% CI 1.049-1.297, P=0.004), and a DAPT (DAPT) duration of <30 days (OR 28.033, 95% CI 5.302-272.834, P<0.001). The simple EST prediction score provided an area under the curve (AUC) of 0.854 (95% CI 0.777- 0.932, P<0.001) with 70.0% sensitivity and 90.0% specifi city, and 0.742 (95% CI 0.649-0.835, P<0.001) with 54.5% sensitivity and 81.0% specificity for external validation dataset. CONCLUSIONS: EST may be independently associated with DAPT discontinuation within 30 days, a low hemoglobin concentration, and a high SYNTAX score. The scoring system also has a good ability to predict the risk of EST and may be useful in the clinical setting.

随着健康理念的普及,越来越多的人开始有意识地关注自身健康问题,不少家庭都会常备一台血压计,很多高血压患者也会坚持每天在家自测血压.有监测血压的意识是好事,可大多数人在没有经过医生指导的情况下,仍存在很多误区,造成测量结果不准确,下面我们就一起来看看,在家到底如何测血压才能准确有效.

目的 评价瞬时无波形比值(iFR)与血流储备分数(FFR)的相关性及影响诊断一致性的因素.方法 回顾性收集北京大学第三医院2015年5月至2019年4月接受iFR和FFR检测的冠心病患者,探讨二者的相关性及影响其诊断一致性的因素.结果 收集60例患者80支冠状动脉的109组FFR和iFR数据,FFR和iFR中位数分别为0.80(0.74,0.85)和0.90(0.87,0.94),二者呈线性相关(r=0.780,P<0.001).iFR预测FFR≤0.80的受试者工作特征曲线下面积为0.870,最佳临界值为iFR≤0.90,诊断一致率为77.1％.iFR"灰区"为0.88～0.94,可使44.0％的功能学评价免予使用腺苷.体重指数是二者诊断不一致的独立影响因素,与iFR≤0.89且FFR≤0.80组相比,iFR>0.89且FFR≤0.80组的参考血管直径[(3.06±0.75)mm比(2.54±0.67)mm]、最小管腔直径[1.84(1.42,2.21)mm比1.35(1.17,1.52)mm]和最小管腔面积[2.65(1.58,3.83)mm2比1.42(1.08,1.83)mm2]均较大(均P<0.05).结论 iFR与FFR具有良好的相关性,病变局部解剖特点可能对二者的诊断一致性产生一定影响.

提起高脂血症,大家并不陌生,无论是医院检查还是体检中,为了明确您的血脂是否正常,均需化验血脂.血脂升高是心血管疾病重要的危险因素,积极控制血脂可以显著降低心血管病的发病率和死亡率,意义重大.

Aims: The progression of myocardial infarction (MI) involves multiple metabolic disorders. Bile acid metabolites have been increasingly recognized as pleiotropic signaling molecules that regulate multiple cardiovascular functions. G protein-coupled bile acid receptor (TGR5) is one of the receptors sensing bile acids to mediate their biological functions. In this study, we aimed to elucidate the effects of bile acids-TGR5 signaling pathways in myocardial infarction (MI). Methods and results: Blood samples of AMI patients or control subjects were collected and plasma was used for bile acid metabolism analysis. We discovered that bile acid levels were altered and deoxycholic acid (DCA) was substantially reduced in the plasma of AMI patients. Mice underwent either the LAD ligation model of MI or sham operation. Both MI and sham mice were gavaged with 10 mg/kg/d DCA or vehicle control since 3-day before the operation. Cardiac function was assessed by ultrasound echocardiography, infarct area was evaluated by TTC staining and Masson trichrome staining. Administration of DCA improved cardiac function and reduced ischemic injury at the 7th-day post-MI. The effects of DCA were dependent on binding to its receptor TGR5. Tgr5(-/-) mice underwent the same MI model. Cardiac function deteriorated and infarct size was increased at the 7th-day post-MI, which were not savaged by DCA administration. Moreover, DCA inhibited interleukin (IL)-1 beta expression in the infarcted hearts, and ameliorated IL-1 beta activation at 1-day post-MI. DCA inhibited NF-kappa B signaling and further IL-1 beta expression in cultured neonatal mouse cardiomyocytes under hypoxia as well as cardio-fibroblasts with the treatment of LPS. Conclusions: DCA-TGR5 signaling pathway activation decreases inflammation and ameliorates heart function post-infarction. Strategies that control bile acid metabolism and TGR5 signaling to ameliorate the inflammatory responses may provide beneficial effects in patients with myocardial infarction.

Heart failure (HF) is a major clinical concern owing to its high prevalence and high mortality. Metabolomics, an effective approach to predict diagnostic biomarkers and to explore the altered metabolic pathways in pathogenesis, has been extensively applied in evaluating the course of diseases. In this study, we used this approach to analyse the abundance of metabolites, with liquid chromatograph-mass spectrometer, in plasma samples from rats with transverse aortic constriction (TAC) and patients at different stages of HF. We compared the metabolic parameters within and between TAC rats and patients. An apparent metabolic shift was observed in rats, from compensated hypertrophy stage to decompensated hypertrophy stage, and in patients with HF, from stage A to stage B and subsequently stage C. Diagnostic biomarkers were predicted by comparing the variable importance in the projection scores and fold change analysis within and between rats and patients. Enrichment pathway analysis and network analysis provided an overview of the largely disturbed metabolic pathways, and those interfered at different stages and across species were confirmed. The significantly changed metabolites and pathways revealed the underlying mechanisms of HF pathogenesis, hinted at novel potential biomarkers, and provided potential therapeutic intervention targets for HF.

1 临床资料 患者男性,53岁,因"胸痛11 h"于2017年12月8日入院.患者入院前11 h出现剑突下锐痛,约一掌大小,程度较重但尚可忍受,无放射,疼痛持续不缓解,无心悸、咳嗽、咳痰、反酸、烧心等症状.考虑"急性冠状动脉综合征".既往高血压、高脂血症病史,否认烟酒史.入院查体:体温:36.2℃,脉搏 62 次/min,呼吸: 16 次/min,血压: 110/60 mmHg.双肺未闻及干、湿啰音,心律齐,未闻及杂音,双下肢无水肿.入院后查肌酸激酶(CK)1 130 U/L(↑),肌酸激酶同工酶( CK-MB ) 139 U/L (↑),肌钙蛋白 T ( cTnT ) 1.64 ng/ml(↑), N 末端 B 型利钠肽原( NT-proBNP) 172 pg/ml,血常规、肝功能、肾功能、凝血功能、甲状腺功能正常.动态观察心电图V2 ~V6 导联ST-T演变(图1),超声心动图提示左室侧后壁、基底段节段性运动异常,左室射血分数(LVEF)55% (2-D).入院诊断:冠心病、急性非ST段抬高型心肌梗死、KillipⅠ级.予阿司匹林、氯吡格雷口服双联抗血小板治疗,低分子肝素皮下注射抗凝治疗,辅以雷贝拉唑口服保护胃黏膜;受血压及心率限制,未加用血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂类药物及β受体阻滞剂.入院后24 h内因患者反复发作心绞痛,行急诊经皮冠状动脉介入(PCI)治疗.冠状动脉造影示前降支( LAD)发出S1后

急性心肌梗死(AMI)是心源性休克最常见的原因,AMI合并心源性休克病死率高达50％～ 60％.其现代治疗策略主要包括早期血运重建、血管活性药物应用、机械循环支持、团队管理4个方面,推荐在团队协作下,及早、完全血运重建,合理使用多巴胺、去甲肾上腺素和经皮机械循环支持保障循环稳定,实现成功救治.

目的:应用微循环阻力指数(IMR)评价非心肌梗死冠状动脉性心脏病(冠心病)患者的心肌微循环状态,并分析影响IMR的相关因素.方法:连续纳入101例非心肌梗死冠心病患者,在血流储备分数(FFR)排除功能性病变或行经皮冠状动脉介入治疗(PCI)后即刻进行IMR检测.以IMR≥25 U定义为冠状动脉微血管疾病,分析IMR异常的发生率和影响因素.结果:共在116支冠状动脉靶血管中测量了IMR,IMR为14.2(11.4,19.9)U,17例(16.8％)患者IMR≥25 U.高血压、服用钙拮抗剂(CCB)的患者IMR较高(P均<0.05);服用他汀类药物和左心室舒张末期内径(LVEDD)增大的患者IMR较低(P均<0.05).IMR与空腹血糖、高密度脂蛋白胆固醇、FFR呈正相关(r=0.203、0.203、0.207,P均<0.05),而与左心室质量指数(LVMI)呈负相关(r=-0.205,P<0.05).多重线性回归分析提示,空腹血糖、LVEDD、他汀类药物、CCB为IMR的独立相关因素(β=1.177,P=0.003;β=-7.015,P=0.002;β=-8.568,P<0.001;β=3.250,P=0.017).结论:近17％的非心肌梗死冠心病患者存在IMR反映的冠状动脉微血管疾病;空腹血糖、LVEDD、应用他汀类药物及CCB可能是影响IMR的独立相关因素.