Seike Fumiyasu, Uetani Teruyoshi, Nishimura Kazuhisa, Kawakami Hiroshi, Higashi Haruhiko, Aono Jun, Nagai Takayuki, Inoue Katsuji, Suzuki Jun, Kawakami Hideo, Okura Takafumi, Yasuda Kazunori, Higaki Jitsuo, Ikeda Shuntaro
Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
Am J Cardiol. 2017 Nov 15;120(10):1772-1779. doi: 10.1016/j.amjcard.2017.07.083. Epub 2017 Aug 8.
Fractional flow reserve (FFR) is widely used for the assessment of myocardial ischemia. Optical coherence tomography (OCT) provides accurate visualization of coronary artery morphology. The aim of this study was to investigate the relation between FFR and OCT-derived FFR. We retrospectively analyzed 31 lesions (25 left anterior descending arteries, 2 left circumflex arteries, and 4 right coronary arteries) in 31 patients with moderate-to-severe coronary stenosis, who underwent OCT and FFR measurements simultaneously. OCT-derived FFR was calculated by the original algorithm, which was calculated using the following equation based on fluid dynamics: ΔP = FV + SV, where V is the flow velocity, F is the coefficient of pressure loss because of viscous friction (Poiseuille resistance), and S is the coefficient of local pressure loss because of abrupt enhancement (flow separation). Mean values of % diameter stenosis by quantitative coronary angiography and FFR were 55.2 ± 14.0% and 0.70 ± 0.14, respectively. OCT-derived FFR showed a stronger linear correlation with FFR measurements (r = 0.89, p <0.001; root mean square error = 0.062 FFR units) than quantitative coronary angiography % diameter stenosis (r = -0.65, p <0.001), OCT measurements of minimum lumen area (r = 0.68, p <0.001), and % area stenosis (r = -0.70, p <0.001). OCT-derived FFR has the potential to become an alternative method for the assessment of functional myocardial ischemia, and may elucidate the relation between coronary morphology and FFR.
血流储备分数（FFR）被广泛用于评估心肌缺血。光学相干断层扫描（OCT）能提供冠状动脉形态的精确可视化。本研究的目的是探讨FFR与OCT衍生的FFR之间的关系。我们回顾性分析了31例中重度冠状动脉狭窄患者的31处病变（25处左前降支、2处左旋支和4处右冠状动脉），这些患者同时接受了OCT和FFR测量。OCT衍生的FFR通过原始算法计算，该算法基于流体动力学使用以下公式计算：ΔP = FV + SV，其中V是流速，F是由于粘性摩擦导致的压力损失系数（泊肃叶阻力），S是由于突然增强（血流分离）导致的局部压力损失系数。定量冠状动脉造影显示的平均直径狭窄百分比和FFR分别为55.2±14.0%和0.70±0.14。与定量冠状动脉造影直径狭窄百分比（r = -0.65，p <0.001）、OCT测量的最小管腔面积（r = 0.68，p <0.001）和面积狭窄百分比（r = -0.70，p <0.001）相比，OCT衍生的FFR与FFR测量值显示出更强的线性相关性（r = 0.89，p <0.001；均方根误差 = 0.062 FFR单位）。OCT衍生的FFR有可能成为评估功能性心肌缺血的替代方法，并可能阐明冠状动脉形态与FFR之间的关系。
