川崎病恢复期患儿血管病变的超声研究

目的：探讨川崎病恢复期的肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内一中膜厚度及其之间的关系。方法：共204例受试者纳入试验。包括51例川崎病合并冠状动脉病变者（冠状动脉病变组）,50例川崎病无冠状动脉病变者（冠状动脉正常组）,103名正常儿童（对照组）。观察血压、血脂、肱动脉内皮功能、颈动脉僵硬度指数及颈动脉内-中膜厚度。结果：肱动脉内皮功能冠状动脉病变组（5．2％±1．9％）和冠状动脉正常组（6．8％±2．0％）均显著低于对照组（13．2％±4．1％,均P〈0．01）;颈动脉僵硬度指数在冠状动脉病变组（4．0±0．6）显著高于冠状动脉正常组（3．6±0．6）和对照组（3．4±0．5,P〈0．05和P〈0．01）。同样,冠状动脉病变组颈动脉内-中膜厚度（0．447mm±0．024mm）显著高于冠状动脉正常组（0．426mm±0．016mm）和对照组（0．424mm±0．016mm,均P〈0．01）。多元回归分析显示,年龄和分组是肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度的显著决定因素。相关性检验分析显示,各组在调整年龄后,肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度两两比较均有显著相关性。结论：川崎病恢复期存在血管内皮功能障碍、颈动脉僵硬度增加以及颈动脉内-中膜增厚。综合采用肱动脉内皮功能、颈动脉僵硬度指数和颈动脉内-中膜厚度等超声检测指标可更全面评价川崎病恢复期血管病变的预后。     

血浆不对称二甲基精氨酸水平与冠状动脉硬化关系的研究

目的研究不对称二甲基精氨酸（ADMA）水平是否与冠状动脉粥样硬化的病变范围和严重程度有关。方法110例行冠状动脉造影术的患者根据造影结果分为冠状动脉造影正常的对照组22例,轻度动脉硬化组21例,造影显示冠状动脉内膜不光滑,但无明显的狭窄或狭窄小于50％;单支病变组22例,造影显示1支主要的冠状动脉分支出现明显狭窄（≥50％）;双支病变组22例,两支主要的冠状动脉分支出现明显狭窄;多支病变组23例,两支以上主要的冠状动脉分支出现明显狭窄或伴有左主干病变。血浆ADMA水平的检测采用酶联免疫法。结果除轻度动脉硬化组ADMA水平（1．21μmol／L±0．36μmol／L,P=0．288）偏低外,单支病变组、双支病变组和多支病变组患者的ADMA水平均高于对照组（1．52μmol／L±0．61μmol／L,1．67μmol／L±0．80μmol／L和2．60μmol／L±0．62μmol／L vs 0．79μmol／L±0．54μmol／L,P〈0．01）。经过多元相关与Logstic等级回归分析,ADMA水平与冠状动脉病变程度密切相关。结论血浆ADMA水平升高可以预测冠状动脉粥样硬化的发生,ADMA可能是一种新的冠心病危险因子。     

姑息性肾动脉成形术用于严重冠心病合并肾动脉狭窄老年患者

OBJECTIVE: To investigate the feasibility of palliative percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with serious coronary heart disease and renal arterial stenosis. METHODS: Thirty-four (23 male and 11 female) patients with a mean age of 61.0+/-11.8 years (ranging from 55 to 78 years) with serious coronary heart disease and renal arterial stenosis, who were unwilling or not suitable to undergo percutaneous coronary intervention and coronary artery bypass grafting, were enrolled in this study. All the cases underwent PTRA and were followed up for 17-53 months (average 35.0+/-9.3 months). The patients' renal and cardiac functions and left ventricular ejection fraction (LVEF) were measured in transthoracic echocardiography with the score of SF-36 Health Survey recorded. RESULTS: During the follow-up, the weekly incidence of angina pectoris reduced from 14.0+/-3.9 to 6.5+/-3.3 (P<0.01) and LVEF increased from (40.2+/-10.4)% to (45.3+/-7.8)% (P<0.05). The SF-36 scores were significantly improved from 56.5+/-8.0 to 80.1+/-16.8 (P<0.01), with also significant improvement in the subscales of health and daily activity, self-feeling, and general health. CONCLUSION: Palliative PTRA and stenting is feasible and necessary in elderly patients with serious coronary heart disease and renal arterial stenosis when percutaneous coronary intervention or coronary artery bypass graft therapy is not possible.     

骨质疏松症与冠状动脉病变严重程度的相关性分析

目的 探讨骨质疏松症与冠状动脉病变严重程度的相关性,为早期根据骨质疏松筛查冠心病高危人群提供相关科学依据。方法 选取2015 年1 月-2017 年1 月于江苏省南通市第一人民医院收治的首次行冠状动脉造影并明确为冠心病的300 例患者作为研究对象,回顾性分析骨密度测量结果并将其分为骨质疏松组（n =102）与非骨质疏松组（n =198）,同时分析骨质疏松与反应冠状动脉病变严重程度相关指标（冠状动脉狭窄程度、冠状动脉钙化程度）的相关性。结果 骨质疏松组患者冠状动脉狭窄程度高于非骨质疏松组,差异有统计学意义（P <0.05）;骨质疏松组患者冠脉单支病变比例低于非骨质疏松组,且冠状动脉多支病变比例高于非骨质疏松组（P <0.5）;骨质疏松组患者冠状动脉钙化程度高于非骨质疏松组,差异有统计学意义（P <0.05）;骨质疏松组患者轻度钙化比例低于非骨质疏松组,且冠脉中度钙化、重度钙化比例高于非骨质疏松组（P <0.05）;骨质疏松与冠状动脉狭窄程度、冠状动脉钙化程度均呈正相关（P <0.05）,Logistic 回归分析显示骨质疏松是冠心病存在的独立危险因素。结论 骨质疏松与冠状动脉狭窄程度、冠状动脉钙化程度独立相关,与冠脉病变严重程度联系密切。     

Diagnostic value of dual-source CT in Kawasaki disease

Background Doppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease（KD）.However,the diagnostic accuracy for the whole coronary artery lesions is limited.The purpose of this study was to compare the diagnostic value of dual-source computed tomography （DSCT） and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.Methods Sixteen patients,12 with typical KD and 4 with atypical KD,underwent DSCT and Doppler color echocardiography.The position and internal diameter of each coronary artery lesion was measured.Correlation analysis was used to compare the diagnostic value of the two imaging modalities.Results ln the typical KD group, seven patients did not have any coronary artery Iesion as confirmed by both DSCT scans and Doppler color echocardiography;in four patients proximal coronary artery injuries were identified by both modalities;in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography.In the atypical KD group,three cases showed the same results with both modalities,while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography.There was a good correlation between the two imaging modalities（Kappa value,0.768（≥0.75））.Conclusion DSCT coronary artery angiography is an accurate,non-invasive,and valuable technique for detecting and following up coronary artery lesions in patients with KD.     

丙种球蛋白和阿斯匹林治疗川崎病疗效比较

目的 :评价不同剂量静脉用丙种球蛋白 (IVIG)和阿斯匹林 (ASP)对川崎病 (KD)的治疗效果。方法 :分别采用不同剂量IVIG及阿斯匹林随机治疗 48例例川崎病患儿 ,治疗后监测患儿热程、白细胞计数及冠状动脉改变 ,同时观察IVIG及阿斯匹林的副作用。结果 :静脉滴注IVIGA组、B组治疗后热程、白细胞计数及冠状动脉病变发生率与ASP组比较差异有显著性 (X2 =9 44,P <0 0 5)。但IVIGA组及B组比较无明显差异 (X2 =2 65 ,P >0 0 5)。结论 :对于KD患儿 ,在病程早期应用静脉滴注IVIG可明显缩短热程 ,使冠状动脉瘤发病率明显减低     

经皮腔内冠状动脉成形术30例报告

对３０例严重冠心病患者进行经皮腔内冠状动脉成形术（ＰＴＣＡ），４８支冠状动脉狭窄病变中的４２支进行了有效扩张，平均扩张次数３．６＋／－２．７次／处，扩张时间６８＋／－２３秒／次，扩张压力７．４＋／－２．３ａｔｍ／次，平均狭窄程度由术前９２％减轻至１６％，狭窄完全消失的病变有３６支血管，３例发生急性冠状动脉闭塞，经植入冠状劝脉支架或采用灌注球囊低压扩张而及时获得再通。术后心绞痛、心电图缺血性ＳＴ－Ｔ     

心脏-脚踝血管指数预测老年冠状动脉狭窄程度的价值

目的 观察老年2型糖尿病患者心脏-脚踝血管指数(CAVI)与冠状动脉狭窄程度的相关性,评价CAVI对冠状动脉狭窄程度的预测价值.方法 对60岁以上行冠状动脉造影异常患者,连续人选后进行CAVI测量、病史采集及血液化验检查,并分为A组(CAVI值≥9)及B组(CAVI值<9),观察动脉硬化相关危险因素与CAVI的关系.入选患者分为糖尿病组及非糖尿病组,了解CAVI与血糖增高及冠状动脉病变程度的相关性.结果共入选298例冠心病患者,其中合并糖尿病者135例,无糖尿病者163例.CAVI≥9.0者患糖尿病,多支病变者显著增多,并受年龄、体重指数、低密度脂蛋白等因素的影响.结论 CAVI增高与冠状动脉硬化程度有一定的相关性.CAVI有助于预测冠状动脉硬化程度.     

冠心病患者合并下肢动脉狭窄危险因素分析

目的探讨冠心病患者合并下肢动脉狭窄的危险因素。方法选取2009年6月～2012年6月在第二炮兵总医院心血管内科确诊冠心病患者1421例,均行下肢动脉CT血管成像（CTA）;根据CTA结果,将至少1处病变血管直径狭窄率≥70％定为狭窄组（n=626）,其余为对照组（n=795）。比较两组患者的临床特征。采用二分类变量Logistic回归筛选冠心病患者发生下肢动脉狭窄的危险因素。结果冠心病患者中下肢动脉狭窄的发病率为44．05％（626／1421）。两组性别、收缩压、三酰甘油、心肌梗死病史差异有统计学意义（P〈0．05）,两组年龄、吸烟史、饮酒史比较,差异无统计学意义（P〉0．05）。二分类Logistic回归显示,性别（OR=1．337。95％CI1．039～1．721,P=0．024）、收缩压（OR=1．014,95％CI1．009～1．020,P=0．000）、三酰甘油（OR：1．190,95％CI1．055～1．341,P：0．005）、心肌梗死病史（OR=1．463,95％CI1．088～1．966,P=0．012）均为冠心病合并下肢动脉狭窄发病的独立危险因素。结论冠心病合并下肢动脉狭窄发病与多种独立危险因素有关．采取相应措施可降低冠心病患者合并下肢动脉狭窄发病率。     

桥血管狭窄患者介入治疗影响预后的因素分析

目的：分析冠脉搭桥术后桥血管狭窄成功行介入治疗患者的基线资料特点,探讨原位血管及桥血管介入治疗、支架种类与桥血管狭窄行介入治疗患者预后的关系.方法：对入选的281例桥血管病变患者进行随访,统计基线资料,观察主要不良心血管事件（MACE）的情况,分为MACE组及无MACE组.对可疑影响MACE发生的危险因素行Logistic回归分析,得出影响该类人群预后的独立危险因素,采用Kaplan-Meier生存曲线Log-rank检验原位血管与桥血管介入治疗策略、药物涂层支架与裸支架对生存率的影响及区别.结果：在基线资料方面：年龄、性别、肥胖、高血压病史、吸烟史、高脂血症病史、冠心病家族史、既往心肌梗死病史、心功能情况及冠心病类型方面两组均无统计学差异（P＞0.05）,在血糖、胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平中具有统计学差异（P值分别为0.003、0.02i、0.014及0.014）,糖尿病、HDL-C、支架直径及支架长度与桥血管介入治疗后发生MACE独立相关.原位血管组及桥血管组在发生MACE方面的差异具有统计学意义（P=0.008）,在原位血管及桥血管介入治疗后随访的MACE中,药物洗脱支架（DES）与金属裸支架（BMS）组在MACE发生率中具有统计学差异.结论：糖尿病与支架长度是影响桥血管狭窄介入治疗预后的危险因素;HDL-C及支架直径为预后的保护因素;原位血管与桥血管的介入治疗策略比较中,原位血管的预后优于桥血管.     

74例老年患者的冠状动脉CT造影结果分析

目的了解冠状动脉CT成像在老年患者中的应用价值并探讨其结果与血压、血脂、体质量指数(BMI)等指标的关系。方法收集行64排螺旋CTA检查、年龄≥60岁的74例老年患者进行回顾性分析,按冠状动脉狭窄程度分为正常组、轻度组、中度组和重度组。结果男性组冠状动脉病变率(97.67%)显著高于女性组(80.65%)(P0.05);年龄、BMI、脉压(PP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、空腹血糖(FG)水平在正常组与重度组之间差异有统计学意义(P0.05)。多元回归分析提示TC、冠状动脉病变支数、FG与冠状动脉狭窄程度明显相关(P0.05)。结论 64排螺旋CTA检查对评价老年患者冠状动脉病变有一定的临床价值,积极的调脂及控糖治疗有助于防治冠状动脉病变的进展。     

冠心病患者冠脉狭窄程度的危险因素分析

目的分析冠心病患者冠脉狭窄程度的危险因素。方法按照入院时间和入院人群类别将2018年2月至2019年3月于我院接受治疗的98例冠心病患者为实验组,另选取同期于我院接受体格检查的50例健康者为对照组,对比两组对象ApoE、Hcy及低密度脂蛋白(LDL)水平,不同冠脉病变程度患者ApoE、Hcy及LDL水平,以及对冠心病患者不同冠脉狭窄程度进行单因素分析。结果 (1)实验组ApoE、Hcy及LDL水平均明显高于对照组,差异有统计学意义(P0.05);(2)冠心病患者中ApoE及LDL水平为重度狭窄组中度狭窄组轻度狭窄组无冠脉狭窄组,差异有统计学意义(P0.05);(3)高血压、糖尿病、吸烟、LDL为冠状动脉狭窄程度的单因素影响因素(P0.05),高血压(OR=1.021,95%CI:1.041～1.156)、糖尿病(OR=3.206,95%CI:1.465～7.526)、吸烟(OR=3.625,95%CI:1.563～8.023)、LDL(OR=6.384,95%CI:6.877～21.470)是影响冠心病患者冠脉狭窄程度危险因素(P0.05)。结论ApoE、Hcy、LDL、高血压、糖尿病、吸烟等均为冠心病患者冠脉狭窄程度的危险因素。     

青年和老年急性心肌梗死患者危险因素及冠状动脉造影特点的对比分析

目的 探讨青年与老年人群中急性心肌梗死(AMI)患者危险因素与冠状动脉造影特点.方法 将临床确诊为AMI小于40岁的53例(青年组)与60岁以上的438例(老年组)进行病例对照研究,分析其危险因素、临床检查、以及冠脉病变程度与相关因素的不同特点.结果 青年组与老年组比较,AMI危险因素中吸烟史、阳性家族史明显增高,而合并高血压、糖尿病则低于老年患者.血脂谱分析显示青年患者TG、LDL-C、ApoB显著高于老年患者,而HDL-C则相反.冠脉造影显示青年组单支病变(73.33％)明显多于老年组(25.09％),而双支(11.11％)与多支病变(8.89％)则显著少于老年组(27.49％、47.01％);与之相应的冠脉病变程度用改良的Genisi积分比较,青年组(7.69±5.23)显著低于老年组(16.08±7.81).对多种危险因素进行相关性分析显示LDL-C(r=0.289,P=0.046)与改良的Gensini积分呈明显正相关,HDL-C(r=0.589,v=0.01)、ApoA-Ⅰ(r=-0.395,p=0.023)与改良的Gensini积分呈明显负相关.多元逐步回归分析发现,HDL-C对冠状动脉狭窄严重程度的影响呈现一定的线性负相关.结论 吸烟、代谢紊乱和阳性家族史是40岁以下AMI的主要危险因素;青年AMI患者冠脉病变程度显著低于老年组,HDL-C变化对青年AM／冠状动脉狭窄严重程度具有重要的影响.     

Coronary artery bypass grafting for Kawasaki disease

Background Kawasaki disease （KD） is the leading cause of pediatric ischemic heart disease. The incidence of serious coronary sequelae is low and about 2%-3% of patients with KD, but once myocardial infarction occurs in children, the mortality is quite high and 22% at the first infarction.This study aimed to evaluate the efficacy of coronary artery bypass grafting （CABG） in patients with KD. Methods Eight patients with a history of KD underwent CABG between October 1997 and July 2005. The number of bypass grafts placed was 2 to 4 per patient （mean 2.5±0.8）. Various bypass grafts were used in patients, i.e. the left internal mammary artery （LIMA） in 3 patients, bilateral internal mammary artery （IMA） in 2 patients, LIMA plus gastroepiploic artery （GEA） in 1 patient and total saphenous vein grafts （SVGs） in 2 patients. The combined procedures included ventricular aneurysmectomy in 1 patient, mitral valve plasty in 1 and right coronary aneurysmectomy in 1. One patient was not able to wean from cardiopulmonary bypass （CPB）, after being supported with intra-aortic balloon pump （IABP）, the patient was weaned from CPB successfully. Results One patient died of low cardiac output syndrome and acute renal failure 19 days after operation. Other patients recovered and were discharged uneventfully. During the follow-up that ranged from 3 to 57 months （mean 27 months）, clincal angina disappeared or improved. Cardiac function was in Class I-II （NYHA）.Conclusion CABG is a safe and effective procedure for Kawasaki coronary artery disease. However long-term results need to be followed up.     

冠心病患者血浆尾加压素Ⅱ的临床研究

OBJECTIVE: To investigate the changes in plasma urotensin II(U II) expression levels in patients with coronary heart disease (CHD). METHODS: Plasma U II levels in 50 CHD patients with coronary stenosis indicated by coronary angiography and 20 healthy subjects were determined by radio immunoassay. RESULTS: Venous plasma U II levels were significantly lowered in CHD patients in comparison with the healthy subjects (1.61+/-1.02 pg/ml vs 3.70+/-1.30 pg/ml, P=0.000). In the CHD patient group, significantly differences were noted in the U II levels between patients with stable angina (2.62+/-1.20 pg/ml), unstable angina (1.39+/-0.80 pg/ml) and acute myocardial infarction (AMI, 1.04+/-0.45 pg/ml, P=0.004). CHD patients with coronary artery occlusion and those with only coronary stenosis had comparable venous plasma U II levels (1.29+/-1.02 pg/ml vs 1.76+/-1.00 pg/ml, P=0.131), whereas the patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA) had higher U II levels than the other subjects in the CHD patient group (2.28+/-0.94 pg/ml vs 1.40+/-0.96 pg/ml, P=0.008), and the femoral plasma U II levels were significantly elevated after PTCT, increasing from 1.18+/-1.14 pg/ml to a postoperative level of 2.22+/-1.77 pg/ml (P=0.001). CONCLUSION: U II might play a role in the pathophysiological process of CHD and can be involved in the restenosis after angioplasty.     

胰腺脂肪浸润对2型糖尿病患者冠状动脉粥样硬化严重程度的预测价值

目的 探讨2型糖尿病患者胰腺脂肪浸润与冠状动脉粥样硬化的关系。方法 连续性纳入2016年1月至2019年2月因胸痛于首都医科大学附属北京世纪坛医院行冠状动脉CT血管成像(CCTA)检查的2型糖尿病患者。根据CCTA结果将患者分为冠状动脉正常组、轻中度狭窄组及重度狭窄组。在腹部CT平扫图像上测量胰腺及脾脏的CT 值,并计算CT密度指数[胰腺与脾脏的密度差值(P-S)和胰腺与脾脏密度比值(P/S)]。应用方差分析、Kruskal-Wallis秩和检验比较各组患者的差异。应用Logistic回归分析冠状动脉重度狭窄的相关因素。应用受试者工作特征曲线分析P/S预测冠状动脉重度狭窄的准确性。结果 共纳入173例2型糖尿病患者,其中冠状动脉正常组27例(15.6%)、轻中度狭窄组124例(71.7%)、重度狭窄组22例(12.7%)。3组胰腺CT值(Z=11.543,P=0.003)、P-S(Z=11.152,P=0.004)及P/S(Z=11.327,P=0.004)差异均有统计学意义。冠状动脉狭窄患者胰头、胰体及胰尾CT值差异有统计学意义(Z=14.737,P=0.001)。校正混杂因素后,多因素Logistic回归显示P/S(OR=0.062,95%CI=0.008~0.487,P=0.008)与冠状动脉重度狭窄仍具有相关性。P/S预测冠状动脉重度狭窄的受试者工作特征曲线下面积为0.701,最佳截断点为0.660。结论 2型糖尿病患者胰腺CT值、CT密度指数与冠状动脉狭窄程度有相关性,提示胰腺脂肪浸润可作为冠状动脉重度狭窄的预测因子之一。     

经桡动脉冠状动脉介入术后桡动脉狭窄及闭塞的危险因素分析

目的探讨经桡动脉途径冠状动脉介入术后桡动脉狭窄及闭塞的危险因素。方法观察323例经桡动脉人路成功行冠状动脉介入术的患者,应用彩色多普勒超声评价患者是否发生桡动脉狭窄及闭塞,据此将观察病例分为正常组（n=256）和桡动脉狭窄及闭塞组（n=67）。比较两组患者的临床特征,通过多因素Logistic回归分析探索引起术后桡动脉狭窄及闭塞的危险因素。结果67例（20．74％）患者术后发生桡动脉狭窄甚至闭塞。单因素分析显示,桡动脉狭窄及闭塞组女性、糖尿病、既往TRI或TRA史、反复穿刺、留置鞘管患者的比例高于正常组,鞘管留置时间、压迫止血时间大于正常组;而桡动脉内径与鞘管外径的比值（RAID／SOD）及术中肝素用量小于正常组,差异有统计学意义（P〈0．05）。多因素Logistic回归分析显示糖尿病、RAID／SOD、术中肝素用量、鞘管留置时间及压迫止血时间是桡动脉狭窄及闭塞的独立危险因素。结论选择与桡动脉内径匹配的动脉鞘管、足够强度的抗凝治疗、减少鞘管留置的时间及压迫止血的时间,有利于减少术后桡动脉狭窄及闭塞的发生,对糖尿病患者及桡动脉内径较小的患者更应注意采取预防措施。     

108例川崎病并冠状动脉损害的临床观察与随访

目的：为临床诊断和治疗川崎病（Kawasaki disease,KD）并发冠状动脉损害提供参考。方法：回顾性分析186例KD患儿的临床资料,并对不完全KD的特点进行分析。结果：186例KD经1～2次二维超声心动图检查发现冠状动脉损害108例,发生率58．1％,不完全KD更易并发冠状动脉损害。其中轻度冠状动脉扩张60例（55．6％）,中度36例（33,3％）,重度12例（11．1％）。108例病例经过1～3年的随访,轻度冠状动脉扩张者均在6个月内恢复正常,而中度、重度扩张者除3例巨瘤并发冠状动脉血栓形成、冠脉狭窄发生心肌梗死、心肌病外,余在6个月内均有改善,其中1年内消失30例,2年内消失8例,3年内消失7例;急性期未发现冠状动脉损害者随访1～2年均未发现异常。结论：不完全KD易并发冠状动脉病变且冠状动脉瘤预后较差,对可疑KD病例应尽早作二维超声心动图检查以提高对不完全KD的早期诊断及治疗。     

Assessment of coronary artery disease with second harmonic myocardial perfusion contrast echocardiography

Objectives To assess the relationship between myocardial regional perfusion using second harmonic myocardial contrast echocardiography (MCE) by venous injection of Levovist and coronary artery stenosis detected by coronary angiography to determine whether MCE can be used to detect coronary artery disease (CAD) and its sensitivity and specificity for detecting CAD.Methods Thirty-six patients who underwent coronary artery angiography and MCE formed the study groups.Ten myocardial segments (5 each in the apical two- and four-chamber views) from the images were scored for detecting myocardial perfusion as follows: 1, normal perfusion; 2, decreased perfusion; and 3, perfusion defect.The arteries were classified as normal or diseased.The diseased arteries were classified into three groups according to the perfusion scores.Results There were significant differences in coronary diameter stenosis among the different perfusion score groups (P&lt;0.001).There were 10 total occluded arteries, and the myocardial perfusion scores were different because of different collateral circulation.In the normal perfusion group (Group A), the coronary diameter stenosis was 65%±12%, and the myocardial perfusion score index was 1±0.00.In the decreased perfusion group (Group B), the average coronary diameter stenosis was 82%±8%, and the myocardial perfusion score was 1.93±0.16.The diameter stenosis was less than 85% in 63 % of the coronary arteries (including diameter stenosis ≤75% in 12% of the vessels).The diameter stenosis was 85%-90% in 22% of the coronary arteries and &gt;90% in 15% of the arteries.In the perfusion defect group (Group C), the average diameter stenosis was 90%±6%, and the myocardial perfusion score index was 2.89±0.24.The diameter stenosis was　≥85% in 94% of the coronary arteries, and the diameter stenosis was &lt;85% and &gt;75% only in 6% of the coronary arteries.The overall sensitivity and specificity of MCE in identifying angiographic coronary diameter stenosis was 67% and 100%, respectively.The false negative rate was 32.6% for the 108 coronary arteries.Further subdivided analysis showed the sensitivities in Groups A, B and C were 0, 100%, and 100%, respectively.The sensitivity increased with increased lumen diameter stenosis of coronary arteries.Conclusions There is a close relationship between coronary artery stenosis and MCE perfusion scores.MCE with venous injection of new generation contrast can define the presence of CAD and lesion graded classifications.Some disagreements between perfusion score and coronary diameter of stenosis may indicate other factors such as different collateral circulation, which should be further investigated.As artery stenosis increases, the sensitivity of MCE is increased.