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血流储备分数

Abstract

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Fractional Flow Reserve-Guided Complete Revascularization Improves the Prognosis in Patients With ST-Segment-Elevation Myocardial Infarction and Severe Nonculprit Disease: A DANAMI 3-PRIMULTI Substudy (Primary PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: Treatment Relationship between fractional flow reserve value and the amount of subtended myocardium Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve 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) Real-world clinical utility and impact on clinical decision-making of coronary computed tomography angiography-derived fractional flow reserve: lessons from the ADVANCE Registry New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome An ILUMIEN I Substudy Coronary Microcirculation Downstream Non-Infarct-Related Arteries in the Subacute Phase of Myocardial Infarction: Implications for Physiology-Guided Revascularization
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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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