Achenbach Stephan, Rudolph Tanja, Rieber Johannes, Eggebrecht Holger, Richardt Gert, Schmitz Thomas, Werner Nikos, Boenner Florian, Möllmann Helge
Department of Cardiology, Friedrich-Alexander University (FAU) Erlangen-Nuremberg, Germany.
Department of Internal Medicine 3, University Hospital, Cologne, Germany.
Interv Cardiol. 2017 Sep;12(2):97-109. doi: 10.15420/icr.2017:13:2.
Fractional flow reserve (FFR) measurements can determine the haemodynamic relevance of coronary artery stenoses. Current guidelines recommend their use in lesions in the absence of non-invasive proof of ischaemia. The prognostic impact of FFR has been evaluated in randomised trials, and it has been shown that revascularisation can be safely deferred if FFR is >0.80, while revascularisation of stenoses with FFR values ≤0.80 results in significantly lower event rates compared to medical treatment. Left main stenoses, aorto-ostial lesions, as well as patients with left ventricular hypertrophy and severely-impaired ejection fraction, have been excluded from large, randomised trials. While FFR measurements are relatively straightforward to perform, uncertainty about procedural logistics, as well as data acquisition and interpretation in specific situations, could explain why they are not widely used in clinical practice. We summarise the clinical data in support of FFR measurements, and provide recommendations for performing and interpreting the procedure.
血流储备分数（FFR）测量可确定冠状动脉狭窄的血流动力学相关性。当前指南建议在缺乏缺血的非侵入性证据时，将其用于病变评估。FFR的预后影响已在随机试验中得到评估，结果表明，如果FFR>0.80，可安全推迟血运重建，而FFR值≤0.80的狭窄病变血运重建与药物治疗相比，事件发生率显著降低。左主干狭窄、主动脉开口病变以及左心室肥厚和射血分数严重受损的患者被排除在大型随机试验之外。虽然FFR测量相对容易进行，但关于操作流程、特定情况下的数据采集和解读的不确定性，可能解释了为何它们在临床实践中未得到广泛应用。我们总结了支持FFR测量的临床数据，并提供了进行该操作及解读结果的建议。
