Catharina Hospital, Eindhoven, Netherlands.
Eindhoven University of Technology, 5612 AZ Eindhoven, Netherlands.
J Interv Cardiol. 2020 Nov 17;2020:5024971. doi: 10.1155/2020/5024971. eCollection 2020.
During the last two decades, there has been a sharp increase in both interest and knowledge about the coronary microcirculation. Since these small vessels are not visible by the human eye, physiologic measurements should be used to characterize their function. The invasive methods presently used (coronary flow reserve (CFR) and index of microvascular resistance (IMR)) are operator-dependent and mandate the use of adenosine to induce hyperemia. In recent years, a new thermodilution-based method for measurement of absolute coronary blood flow and microvascular resistance has been proposed and initial procedural problems have been overcome. Presently, the technique is easy to perform using the Rayflow infusion catheter and the Coroventis software. The method is accurate, reproducible, and completely operator-independent. This method has been validated noninvasively against the current golden standard for flow assessment: Positron Emission Tomography-Computed Tomography (PET-CT). In addition, absolute flow and resistance measurements have proved to be safe, both periprocedurally and at long-term follow-up. With an increasing number of studies being performed, this method has great potential for better understanding and quantification of microvascular disease.
在过去的二十年中，人们对冠状动脉微循环的兴趣和认识都有了显著的提高。由于这些小血管无法用肉眼观察到，因此应该使用生理测量来描述它们的功能。目前使用的有创方法（冠状动脉血流储备 (CFR) 和微血管阻力指数 (IMR)）依赖于操作者，并且需要使用腺苷来诱导充血。近年来，已经提出了一种新的基于热稀释的绝对冠状动脉血流和微血管阻力测量方法，并克服了初始程序问题。目前，使用 Rayflow 输注导管和 Coroventis 软件很容易执行该技术。该方法准确、可重复且完全独立于操作者。该方法已经通过正电子发射断层扫描-计算机断层扫描 (PET-CT) 对当前的血流评估金标准进行了非侵入性验证。此外，绝对流量和阻力测量在围手术期和长期随访中均被证明是安全的。随着越来越多的研究进行，这种方法对于更好地理解和量化微血管疾病具有很大的潜力。
