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血流储备分数

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High-Resolution Cardiac Magnetic Resonance Imaging Techniques for the Identification of Coronary Microvascular Dysfunction Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement Relationship between fractional flow reserve value and the amount of subtended myocardium Impact of Percutaneous Revascularization on Exercise Hemodynamics in Patients With Stable Coronary Disease Meta-Analysis of Death and Myocardial Infarction in the DEFINE-FLAIR and iFR-SWEDEHEART Trials Diagnostic accuracy of fractional flow reserve from anatomic CT angiography Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease
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Original Research2014 Sep 1;84(3):406-13.

JOURNAL：Catheter Cardiovasc Interv. Article Link

Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve

Shiono Y1 Kubo T, Tanaka A et al. Keywords: coronary angiography; fractional flow reserve; ischemic heart disease

ABSTRACT

OBJECTIVES - The aim of this study was to investigate the impact of myocardial area supplied by the coronary artery on fractional flow reserve (FFR).


BACKGROUND - Various factors other than the degree of epicardial stenosis influence the physiological significance of a coronary artery stenosis.

METHODS - A total of 296 coronary lesions in 217 patients were analyzed by quantitative coronary angiography and FFR. Myocardial area supplied by the coronary artery distal to the stenosis was evaluated by angiography using a modified version of the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) score.

RESULTS - Percent diameter stenosis of the coronary lesion was 57 ± 15% (mean ± standard deviation). FFR <0.80 was seen in 132 (45%) lesions. FFR was significantly correlated with minimum lumen diameter (r = 0.584, P <0.001), percent diameter stenosis (r = -0.565, P <0.001), lesion length (r = -0.306, P <0.001), and myocardial supply area (r = -0.504, P <0.001). Multivariate logistic analysis demonstrated that minimum lumen diameter (odds ratio [OR] = 0.031, 95% confidence interval [CI] = 0.013-0.076, P < 0.001), lesion length (OR = 1.038, 95% CI = 1.009-1.069, P = 0.001), and myocardial supply area (OR = 1.113, 95% CI = 1.079-1.147, P <0.001) were independent determinants for FFR <0.80.

CONCLUSIONS - FFR, which is the index of physiological significance of coronary artery stenosis, is influenced by myocardial supply area distal to the stenosis as well as by its own minimal lumen diameter and lesion length.

© 2013 Wiley Periodicals, Inc.
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