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血流储备分数

Abstract

Recommended Article

Meta-Analysis of Death and Myocardial Infarction in the DEFINE-FLAIR and iFR-SWEDEHEART Trials Impact of Percutaneous Revascularization on Exercise Hemodynamics in Patients With Stable Coronary Disease 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 Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms. Results from the prospective multicenter DISCOVER-FLOW Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI

Original Research2018 Jan 16. [Epub ahead of print]

JOURNAL:EuroIntervention. Article Link

Clinical Significance of Concordance or Discordance Between Fractional Flow Reserve and Coronary Flow Reserve for Coronary Physiological Indices, Microvascular Resistance, and Prognosis After Elective Percutaneous Coronary Intervention

Usui E, Murai T, Kanaji Y et al. Keywords: fractional flow reserve; QCA; clinical research; Other technique

ABSTRACT


AIMS - We aimed to investigate the impact of concordance or discordance of fractional flow reserve (FFR) and coronary flow reserve (CFR) on coronary flow profiles and microvascular resistance after percutaneous coronary intervention (PCI), and the prognostic impact of the periprocedural physiological indices.


METHODS AND RESULTS - Totally, 249 de novo physiologically significant coronary lesions from 231 patients who underwent FFR, CFR, and index of microcirculatory resistance (IMR) examinations before and after PCI were included. Baseline characteristics and physiological indices were compared between the concordant (FFR≤0.80 and CFR<2.0, n=114) and discordant groups (FFR≤0.80 and CFR≥2.0, n=135). Follow-up data were collected to determine predictors of cardiac events. Shortening of the mean transit time, CFR improvement, and decrease in the hyperemic IMR were all significantly greater in the concordant territories. Cox proportional hazards analysis showed that a lower pre-PCI CFR was an independent predictor of adverse events at a median follow-up of 26.5 months, whereas neither the pre- nor post-PCI FFR was predictive of events. Event-free survival was significantly worse in patients with a lower pre-PCI CFR.


CONCLUSIONS - FFR/CFR concordantly abnormal territories provide a favorable benefit as assessed by coronary physiological indices after elective PCI. The pre-PCI CFR may predict adverse cardiac events.