Parikh Valay, Agnihotri Kanishk, Kadavath Sabeeda, Patel Nileshkumar J, Abbott J Dawn
Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY, 10305, USA.
Saint Peter's University Hospital, New Brunswick, NJ, USA.
Curr Cardiol Rep. 2016 Apr;18(4):32. doi: 10.1007/s11886-016-0711-3.
Revascularization in stable ischemic heart disease (SIHD) is indicated in patients on optimal medical therapy with angina and/or demonstrable ischemia and a significant stenosis in one or more epicardial coronary arteries. Angiography alone, however, cannot accurately determine the hemodynamic significance of coronary lesions, particularly those of intermediate stenosis severity. A lesion may appear significant on coronary angiogram but may not have functional significance. Percutaneous coronary intervention (PCI) of functionally insignificant coronary artery lesions may have serious consequences; therefore, judicious decision-making in the cardiac catheterization laboratory is indicated. For this reason, it is becoming increasingly important to show that a stenosis is capable to induce myocardial ischemia prior to intervention. Fractional flow reserve (FFR) has emerged as a useful tool for this purpose. In this review, we will briefly discuss the principle of FFR, current evidence and rationale supporting its use, and comparison with other modalities.
对于接受最佳药物治疗仍有心绞痛和/或可证实的心肌缺血且一条或多条心外膜冠状动脉存在明显狭窄的稳定型缺血性心脏病（SIHD）患者，需要进行血运重建。然而，仅靠血管造影不能准确确定冠状动脉病变的血流动力学意义，尤其是中度狭窄的病变。冠状动脉造影上一个病变可能看起来明显，但可能没有功能意义。对无功能意义的冠状动脉病变进行经皮冠状动脉介入治疗（PCI）可能会产生严重后果；因此，在心脏导管室进行明智的决策很有必要。出于这个原因，在干预前证明狭窄能够诱发心肌缺血变得越来越重要。血流储备分数（FFR）已成为实现这一目的的有用工具。在本综述中，我们将简要讨论FFR的原理、支持其应用的现有证据和基本原理，以及与其他方法的比较。
