Puymirat E, De Bruyne B
Service de cardiologie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, France.
Ann Cardiol Angeiol (Paris). 2011 Jun;60(3):148-53. doi: 10.1016/j.ancard.2010.12.010. Epub 2011 Jan 11.
Most patients undergoing a catheterization did not have any previous non-invasive testing. Therefore, most decisions about revascularization are taken solely on the basis of the angiogram. Nowadays, it is possible to gain reliable functional information during catheterization by measuring fractional flow reserve (FFR). FFR is obtained by simple pressure measurements distal to the stenosis during maximal hyperemia. FFR-guided revascularization provides better clinical outcomes than angiographically-guided decisions. This is especially relevant in patients with multi-vessel disease and mild to moderate coronary plaque burden. FFR is able to determine the hemodynamic significance of each lesion individually and enables therefore guidance of the revascularization treatment. The case of a 62-year-old man with stable angina is reported. He underwent percutaneous coronary intervention of the left anterior descending 10 years ago. Repeat coronary angiogram revealed multi-vessel disease with a moderate stenosis in all main coronary arteries. Non-invasive functional assessment by myocardial perfusion imaging was inconclusive to evaluate presence or absence of ischemia. The use of FFR in this clinical scenario may be very useful to determine treatment strategy.
大多数接受导管插入术的患者此前未进行过任何无创检测。因此，大多数关于血运重建的决策仅基于血管造影。如今，在导管插入术期间通过测量血流储备分数（FFR）能够获得可靠的功能信息。FFR是在最大充血期间通过对狭窄远端进行简单的压力测量而获得的。与血管造影引导的决策相比，FFR引导的血运重建能带来更好的临床结果。这在患有多支血管病变且冠状动脉斑块负荷为轻度至中度的患者中尤为重要。FFR能够单独确定每个病变的血流动力学意义，因此能够指导血运重建治疗。报告了一名62岁稳定型心绞痛男性患者的病例。他10年前接受了左前降支的经皮冠状动脉介入治疗。重复冠状动脉造影显示多支血管病变，所有主要冠状动脉均有中度狭窄。通过心肌灌注成像进行的无创功能评估对于评估是否存在缺血并无定论。在这种临床情况下使用FFR对于确定治疗策略可能非常有用。
