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血流储备分数

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Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW Retrospective Comparison of Long-Term Clinical Outcomes Between Percutaneous Coronary Intervention and Medical Therapy in Stable Coronary Artery Disease With Gray Zone Fractional Flow Reserve - COMFORTABLE Retrospective Study Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI Fractional Flow Reserve–Guided PCI for Stable Coronary Artery Disease Physiological Stratification of Patients With Angina Due to Coronary Microvascular Dysfunction Accuracy of Fractional Flow Reserve Derived From Coronary Angiography Lesion-Specific and Vessel-Related Determinants of Fractional Flow Reserve Beyond Coronary Artery Stenosis The Impact of Coronary Physiology on Contemporary Clinical Decision Making Randomized Comparison of FFR-Guided and Angiography-Guided Provisional Stenting of True Coronary Bifurcation Lesions: The DKCRUSH-VI Trial (Double Kissing Crush Versus Provisional Stenting Technique for Treatment of Coronary Bifurcation Lesions VI) Coronary Microcirculation Downstream Non-Infarct-Related Arteries in the Subacute Phase of Myocardial Infarction: Implications for Physiology-Guided Revascularization
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Original Research30 December 2019

JOURNAL：European Heart Journal Article Link

Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation

SX Tu, J Westra, J Adjedj et al. Keywords: coronary angiography; fractional coronary flow reserve; intravascular ultrasonography; bone wires; catheterization; constriction; pathologic diagnosis; diagnostic imaging; physiology; revascularization

ABSTRACT

Fractional flow reserve (FFR) and instantaneous wave-free ratio are the present standard diagnostic methods for invasive assessment of the functional significance of epicardial coronary stenosis. Despite the overall trend towards more physiology-guided revascularization, there remains a gap between guideline recommendations and the clinical adoption of functional evaluation of stenosis severity. A number of image-based approaches have been proposed to compute FFR without the use of pressure wire and induced hyperaemia. In order to better understand these emerging technologies, we sought to highlight the principles, diagnostic performance, clinical applications, practical aspects, and current challenges of computational physiology in the catheterization laboratory. Computational FFR has the potential to expand and facilitate the use of physiology for diagnosis, procedural guidance, and evaluation of therapies, with anticipated impact on resource utilization and patient outcomes.

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