Mangiacapra F, Di Serafino L, Barbato E
Cardiovascular Center, OLV Hospital, Aalst, Belgium.
Minerva Cardioangiol. 2011 Feb;59(1):39-48.
In routine clinical practice, a sizeable proportion of patients with suspected coronary artery disease (CAD) undergo coronary angiography without prior non-invasive functional evaluation. In this situation, the decision wheter to perform revascularization is taken solely on the basis of angiographic parameters, which are often limited in assessing the lesions that are functionally significant and ultimately responsible for patients' symptoms. Fractional flow reserve (FFR) is a validated method for assessing hemodynamic significance of coronary stenoses based on the use of pressure wires and assessment of hyperemic pressure gradients across coronary lesions. FFR can guide clinical decision making in several anatomical settings: e.g. intermediate stenosis, left main stenoses, multivessel disease, bifurcation lesions. Treatment strategies guided by FFR have been shown to be equally safe and more efficacious than angiography-guided PCI. FFR is readily available in the catheterization laboratory, and can be easily measured during coronary angiography. FFR represents a unique tool for interventional cardiologists to combine anatomical and functional information, allowing the selection of optimal revascularization strategy in patients with CAD.
在常规临床实践中，相当一部分疑似冠心病（CAD）患者在未进行无创功能评估的情况下就接受了冠状动脉造影。在这种情况下，是否进行血运重建的决定完全基于血管造影参数，而这些参数在评估具有功能意义且最终导致患者症状的病变时往往存在局限性。血流储备分数（FFR）是一种基于使用压力导丝和评估冠状动脉病变处充血压力梯度来评估冠状动脉狭窄血流动力学意义的有效方法。FFR可在多种解剖情况下指导临床决策：例如中度狭窄、左主干狭窄、多支血管病变、分叉病变。由FFR指导的治疗策略已被证明与血管造影指导的经皮冠状动脉介入治疗（PCI）同样安全且更有效。FFR在导管室很容易获得，并且在冠状动脉造影期间可以轻松测量。FFR是介入心脏病学家结合解剖和功能信息的独特工具，可帮助为CAD患者选择最佳的血运重建策略。
