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血流储备分数

Abstract

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Diagnostic Performance of Angiogram-Derived Fractional Flow Reserve: A Pooled Analysis of 5 Prospective Cohort Studies Prognostic Implications of Plaque Characteristics and Stenosis Severity in Patients With Coronary Artery Disease Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps) Comparison of Coronary Computed Tomography Angiography, Fractional Flow Reserve, and Perfusion Imaging for Ischemia Diagnosis Coronary Flow Reserve in the Instantaneous Wave-Free Ratio/Fractional Flow Reserve Era: Too Valuable to Be Neglected The Natural History of Nonculprit Lesions in STEMI: An FFR Substudy of the Compare-Acute Trial Anatomical and Functional Computed Tomography for Diagnosing Hemodynamically Significant Coronary Artery Disease: A Meta-Analysis Identification of High-Risk Plaques Destined to Cause Acute Coronary Syndrome Using Coronary Computed Tomographic Angiography and Computational Fluid Dynamics
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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.

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