Hennigan Barry, Layland Jamie, Fearon William F, Oldroyd Keith G
Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom.
EuroIntervention. 2014 Aug;10 Suppl T:T55-63. doi: 10.4244/EIJV10STA10.
The aim of this article is to review what is currently known about fractional flow reserve (FFR) and related coronary physiological indices in patients with acute coronary syndrome (ACS) including non-ST-elevation (NSTEMI) and ST-elevation myocardial infarction (STEMI) with a view to making recommendations for daily practice.
We explored all relevant publications to date including literature reviews, clinical trials and registries. We identified sufficient data on FFR in the setting of NSTEMI to confirm it to be a reliable and useful tool for lesion-level decision making with certain pitfalls as outlined below. There was limited published literature on FFR in STEMI. However, there is some evidence that, in patients who are stable after culprit lesion intervention, FFR may be of value for assessing the functional significance of non-culprit lesions. When measured in the culprit artery of patients with STEMI, the index of myocardial resistance (IMR) predicts long-term clinical outcomes.
In patients with ACS, there is an increasing evidence base to support the role of FFR to guide revascularisation and of IMR to predict outcome.
本文旨在综述目前已知的关于急性冠脉综合征（ACS）患者，包括非ST段抬高型（NSTEMI）和ST段抬高型心肌梗死（STEMI）患者的血流储备分数（FFR）及相关冠状动脉生理指标，以期为日常临床实践提供建议。
我们检索了截至目前所有相关的出版物，包括文献综述、临床试验和登记资料。我们发现了关于NSTEMI患者FFR的充分数据，证实其是一种可靠且有用的病变水平决策工具，但存在如下所述的某些缺陷。关于STEMI患者FFR的已发表文献有限。然而，有一些证据表明，在罪犯病变干预后病情稳定的患者中，FFR可能对评估非罪犯病变的功能意义有价值。在STEMI患者的罪犯动脉中测量时，心肌阻力指数（IMR）可预测长期临床结局。
在ACS患者中，越来越多的证据支持FFR在指导血运重建方面的作用以及IMR在预测结局方面的作用。
