Sahinarslan Asife, Kocaman Sinan Altan, Olgun Hilal, Kunak Tolga, Kiziltunç Emrullah, Ozdemir Murat, Timurkaynak Timur
Department of Cardiology, School of Medicine, Gazi University, Ankara 06500, Turkey.
Coron Artery Dis. 2009 Aug;20(5):317-21. doi: 10.1097/MCA.0b013e32832c8ca3.
Fractional flow reserve (FFR) is an invasive method to assess the functional significance of coronary stenoses. The value of FFR in diabetic patients is controversial because of microvascular dysfunction. The aim of this study is to investigate the effect of diabetes mellitus (DM) on FFR measurements.
One hundred and twenty-one patients with an intermediate lesion who had undergone FFR measurement were included in the study. Lesion severity was determined by quantitative coronary angiography. The patients were divided into groups according to the presence (group 1) or absence (group 2) of DM. The patients were further categorized according to the degree of luminal narrowing caused by the lesion (40-50, 51-60, and >60%) and reference vessel diameter (> or = 2.8 and <2.8 mm). FFR measurements were compared in each category.
There was no difference between the FFR values of diabetic and nondiabetic patients who had coronary lesions with similar degree of luminal narrowing (0.87+/-0.08 vs. 0. 0.85+/-0.07; 0.81+/-0.08 vs. 0.82+/-0.10; 0.81+/-0.10 vs. 0.83+/-0.09, P = 0.957). In the analysis comparing FFR measurements in the categories set according to reference vessel diameter, we did not find a difference either (0.82+/-0.09 vs. 0.83+/-0.09; 0.84+/-0.09 vs. 0.82+/-0.09, P = 0.878). The DeltaFFR value, which is the difference between FFR values before and after adenosine administration, was also similar in diabetic and nondiabetic patients (8.4+/-6.0 vs. 8.4+/-5.5, P = 0.997).
The presence of DM does not have a significant impact on FFR values in coronary stenoses of intermediate severity.
血流储备分数（FFR）是一种评估冠状动脉狭窄功能意义的侵入性方法。由于微血管功能障碍，FFR在糖尿病患者中的价值存在争议。本研究的目的是探讨糖尿病（DM）对FFR测量值的影响。
本研究纳入了121例接受FFR测量的中度病变患者。病变严重程度通过定量冠状动脉造影确定。根据是否患有DM将患者分为两组（1组）或无DM组（2组）。根据病变引起的管腔狭窄程度（40-50%、51-60%和>60%）和参考血管直径（≥2.8和<2.8mm）对患者进一步分类。比较各分类中的FFR测量值。
在管腔狭窄程度相似的冠状动脉病变的糖尿病患者和非糖尿病患者中，FFR值无差异（0.87±0.08对0.85±0.07；0.81±0.08对0.82±0.10；0.81±0.10对0.83±0.09，P = 0.957）。在根据参考血管直径设定的分类中比较FFR测量值的分析中，我们也未发现差异（0.82±0.09对0.83±0.09；0.84±0.09对0.82±0.09，P = 0.878）。糖尿病患者和非糖尿病患者中，腺苷给药前后FFR值的差值DeltaFFR也相似（8.4±6.0对8.4±5.5，P = 0.997）。
DM的存在对中度严重程度冠状动脉狭窄的FFR值无显著影响。
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