Morris Paul D, Silva Soto Daniel Alejandro, Feher Jeroen F A, Rafiroiu Dan, Lungu Angela, Varma Susheel, Lawford Patricia V, Hose D Rodney, Gunn Julian P
Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
Department of Cardiology, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, United Kingdom.
JACC Basic Transl Sci. 2017 Aug 28;2(4):434-446. doi: 10.1016/j.jacbts.2017.04.003. eCollection 2017 Aug.
Fractional flow reserve (FFR)-guided percutaneous intervention is superior to standard assessment but remains underused. The authors have developed a novel "pseudotransient" analysis protocol for computing virtual fractional flow reserve (vFFR) based upon angiographic images and steady-state computational fluid dynamics. This protocol generates vFFR results in 189 s (cf >24 h for transient analysis) using a desktop PC, with <1% error relative to that of full-transient computational fluid dynamics analysis. Sensitivity analysis demonstrated that physiological lesion significance was influenced less by coronary or lesion anatomy (33%) and more by microvascular physiology (59%). If coronary microvascular resistance can be estimated, vFFR can be accurately computed in less time than it takes to make invasive measurements.
血流储备分数（FFR）指导下的经皮介入治疗优于标准评估，但应用仍不充分。作者开发了一种新颖的“伪瞬态”分析方案，用于基于血管造影图像和稳态计算流体动力学计算虚拟血流储备分数（vFFR）。该方案使用台式计算机在189秒内生成vFFR结果（相比之下，瞬态分析>24小时），相对于全瞬态计算流体动力学分析，误差<1%。敏感性分析表明，生理病变的显著性受冠状动脉或病变解剖结构的影响较小（33%），而受微血管生理学的影响较大（59%）。如果能够估计冠状动脉微血管阻力，那么计算vFFR的时间比进行有创测量所需的时间更短，且能准确计算。
