Abstract：
Frank\'s sign (named after American pulmonologist Sanders T. Frank) refers to a diagonal skin fold between the tragus and outer edge of the earlobe. Gradation is based on the bilateral presence and/or degree of the earlobe fold. The presence of this sign, referred to as the diagonal earlobe crease (DELC), has been associated with coronary artery disease (CAD), independent of other cardiovascular risk factors. Corresponding studies are predominantly based on clinical or angiographic assessments, and few autopsy studies exist. The association of DELC with CAD, cardiovascular risk factors, and causes of death was investigated via retrospective and prospective evaluations. It was also investigated whether the degree of DELC correlated with the macroscopic severity of coronary heart disease. Furthermore, the influence of age on the appearance of DELC was analyzed and compared using two age groups. Additionally, binomial logistic regression analysis was performed to investigate the influence of age on the presence of higher-grade DELC and CAD. In cases related to a lethal cardiac event, the majority (78%) showed high-grade DELC. The DELC grade correlated significantly with CAD severity (rs = 0.474, p < 0.001) and with the severity of general atherosclerosis (rs = 0.606, p < 0.001) with medium and large effects sizes, respectively. Age was predominantly more suitable than DELC concerning the sensitivity, specificity, and positive prognostic value for preexisting cardiac disease and cardiac-related causes of death. In both DELC and CAD, age has a significant influence on the presence of higher-grade manifestation, but the influence of age in CAD appears to be even more significant than in DELC. The main results of previous autopsy studies and the prognostic value could have been confirmed, but these findings appear to be limited to younger patients.
摘要：
弗兰克的标志（以美国肺科医生桑德斯·T·弗兰克的名字命名）是指耳屏和耳垂外缘之间的对角皮肤褶皱。分级基于耳垂褶皱的双侧存在和/或程度。这个标志的存在，称为对角耳垂折痕(DELC)，与冠状动脉疾病（CAD）有关，独立于其他心血管危险因素。相应的研究主要基于临床或血管造影评估，几乎没有尸检研究。DELC与CAD的关联，心血管危险因素，通过回顾性和前瞻性评估对死亡原因进行了调查.还研究了DELC的程度是否与冠心病的宏观严重程度相关。此外，使用两个年龄组分析并比较了年龄对DELC外观的影响.此外,进行了二项逻辑回归分析,以研究年龄对高级别DELC和CAD存在的影响.在与致命心脏事件有关的情况下，大多数(78%)显示高级DELC。DELC等级与CAD严重程度（rs=0.474，p<0.001）和一般动脉粥样硬化的严重程度（rs=0.606，p<0.001）显着相关，具有中等和大效应大小，分别。在敏感性方面，年龄主要比DELC更合适，特异性，以及对先前存在的心脏病和心脏相关死亡原因的积极预后价值。在DELC和CAD中，年龄对高年级表现的存在有重大影响，但年龄对CAD的影响似乎比DELC更显著。先前尸检研究的主要结果和预后价值可以得到证实，但这些发现似乎仅限于年轻患者。
