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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 Accuracy of Fractional Flow Reserve Derived From Coronary Angiography Influence of Heart Rate on FFR Measurements: An Experimental and Clinical Validation Study Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve Real-world clinical utility and impact on clinical decision-making of coronary computed tomography angiography-derived fractional flow reserve: lessons from the ADVANCE Registry The Impact of Coronary Physiology on Contemporary Clinical Decision Making Relationship between fractional flow reserve value and the amount of subtended myocardium 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) Physiological Stratification of Patients With Angina Due to Coronary Microvascular Dysfunction New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome An ILUMIEN I Substudy
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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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