RESUMO
Background: Pressure wire fractional flow reserve (FFR) and its derivatives, such as quantitative flow ratio (QFR), computational pressure flow-derived FFR (caFFR), coronary angiography-derived FFR (FFRangio), and computed tomography-derived FFR (FFRCT), have been validated for identifying functionally significant stenosis and guiding revascularization strategy. The limitations of using these methods include the side effects of hyperemia-induced agents, additional costs, and vulnerability to microvascular resistance. FFR is related both to the degree of a stenotic coronary artery and to its subtended myocardial territory. Coronary Artery Tree Description and Lesion Evaluation (CatLet) score (also known as Hexu) is a product of the degree of a stenosis and the weighting of the affected coronary artery (myocardial territory). Hence, we hypothesized that the CatLet score could predict hemodynamically significant coronary stenosis. Methods: We retrospectively enrolled consecutive patients with stable coronary artery disease. They attended Sichuan Science City Hospital with at least one lesion of 50-90% diameter stenosis in a coronary artery of 2 mm or larger. FFR measurement was obtained during invasive coronary angiography. The CatLet score was obtained by multiplying a fixed value of 2.0 (for non-occlusive lesions) and the weight of the affected coronary artery. The primary endpoint was the CatLet score's diagnostic accuracy in identifying hemodynamically significant coronary stenosis, with a pressure wire FFR of ≤0.80 being used as reference. Results: We analyzed the FFR and CatLet scores from 206 vessels in 175 patients with stable coronary disease and intermediate coronary lesions. The per-vessel analysis revealed an overall good correlation between the CatLet score and the FFR [r=-0.61; 95% confidence interval (95% CI): -0.69 to -0.52; P<0.01]. We also noted a significant CatLet score-FFR correlation for each of the left anterior descending artery (LAD), left circumflex (LCX), and right coronary artery (RCA). With a CatLet score ≥10 as a predictor of FFR ≤0.80, the overall diagnostic accuracy included a sensitivity of 78.80% (95% CI: 67.00-87.90%), a specificity of 85.00% (95% CI: 78.00-90.50%), a positive likelihood ratio of 5.25, a negative likelihood ratio of 0.25, and an area under the curve of 0.90 (95% CI: 0.85-0.94). Equivalent vessel-specific results were also achieved for each of the LAD, LCX, and RCA. Conclusions: The CatLet score, solely based on visual estimation of the results of coronary angiography, demonstrated good diagnostic performance with respect to myocardial ischemia. Its clinical values in guiding revascularization warrant further investigation.
RESUMO
As an important inter-unit of lignin, guaiacylglycerol-ß-guaiacyl (GG) ether has been synthesized, and characterized using terahertz time-domain spectroscopy in the frequency range of 5-85 cm(-1). Seven absorption peaks have been observed. Among these peaks, the 49.8 cm(-1) and 57.6 cm(-1) vibrations are propose to be characteristic absorption peaks of GG ether. Raman spectra were also measured in the range of 50-3500 cm(-1). The vibrations of the two lowest energy forms, i.e., erythro 1r4s and threo 1s4s, were calculated using density functional theory at the B3LYP/6-311G∗∗ level and assigned according to potential energy distribution. In addition, the contents of erythro and threo forms in GG sample could be estimated by comparing the waveform similarities between theoretical and observed curves in the 33.0-80.0 cm(-1) range. Results showed that the observed curve of GG sample is a combination of erythro 1s4r and threo 1s4s. The four absorption vibrations below 33.0 cm(-1) could be assigned to phonon, inter-molecular modes and/or hydrogen bond vibrations. Terahertz spectra and Raman spectra, together with theoretical calculations, could be powerful methods for predicting contents of different isomers in sample.