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无创性分比流量储备值(FFR)在急性胸痛评估中的应用:概念和初步经验。

Non-invasive fractional flow reserve (FFR) in the evaluation of acute chest pain - Concepts and first experiences.

机构信息

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States; Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Facility Mannheim, Heidelberg University, Heidelberg, Germany.

Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States; University Medical Center Groningen, Center for Medical Imaging, Department of Radiology, Groningen, the Netherlands.

出版信息

Eur J Radiol. 2021 May;138:109633. doi: 10.1016/j.ejrad.2021.109633. Epub 2021 Mar 8.

Abstract

OBJECTIVE

To evaluate 30 day rate of major adverse cardiac events (MACE) utilizing cCTA and FFR for evaluation of patients presenting to the Emergency Department (ED) with acute chest pain.

MATERIALS AND METHODS

Patients between the ages of 18-95 years who underwent clinically indicated cCTA and FFR in the evaluation of acute chest pain in the emergency department were retrospectively evaluated for 30 day MACE, repeat presentation/admission for chest pain, revascularization, and additional testing.

RESULTS

A total of 59 patients underwent CCTA and subsequent FFR for the evaluation of acute chest pain in the ED over the enrollment period. 32 out of 59 patients (54 %) had negative FFR (>0.80) out of whom 18 patients (55 %) were discharged from the ED. Out of the 32 patients without functionally significant CAD by FFR, 32 patients (100 %) underwent no revascularization and 32 patients (100 %) had no MACE at the 30-day follow-up period.

CONCLUSION

In this limited retrospective study, patients presenting to the ED with acute chest pain and with CCTA with subsequent FFR of >0.8 had no MACE at 30 days; however, for many of these patients results were not available at time of clinical decision making by the ED physician.

摘要

目的

利用计算机断层扫描血管造影术(cCTA)和血流储备分数(FFR)评估因急性胸痛就诊于急诊科的患者,评估其 30 天主要不良心脏事件(MACE)发生率。

材料与方法

回顾性分析了在急诊科因急性胸痛接受临床有指征的 cCTA 和 FFR 检查的 18-95 岁患者的 30 天 MACE、胸痛再次就诊/入院、血运重建和额外检查情况。

结果

在研究期间,共有 59 例患者因急性胸痛接受 CCTA 和随后的 FFR 检查。59 例患者中有 32 例(54%)FFR 结果为阴性(>0.80),其中 18 例(55%)从急诊科出院。在 FFR 提示不存在功能性显著冠状动脉疾病的 32 例患者中,32 例(100%)未进行血运重建,32 例(100%)在 30 天随访期内无 MACE。

结论

在这项有限的回顾性研究中,因急性胸痛就诊于急诊科且 CCTA 后 FFR>0.8 的患者在 30 天内无 MACE;然而,对于这些患者中的许多人,在急诊科医生进行临床决策时,结果尚不可用。

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