Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920, USA.
Rev Cardiovasc Med. 2022 Feb 18;23(2):70. doi: 10.31083/j.rcm2302070.
The diagnostic accuracy and clinical benefits of instantaneous wave-free ratio (iFR) compared to fractional flow reserve (FFR) have been well-established in the literature. Despite the advantages of non-hyperemic pressure indices, approximately 20% of iFR and FFR measurements are discordant. Efforts have been made to establish the mechanisms as well as identify causative factors that lead to such a discordance. Recent studies have identified many factors of discordance including sex differences, age differences, bradycardia, coronary artery stenosis location, elevated left ventricular end-diastolic pressure, and diastolic dysfunction. Additionally, discordance secondary to coronary artery microcirculation dysfunction, as seen in diabetics and patients on hemodialysis, has sparked interest amongst experts. As more interventional cardiologists are utilizing iFR independent of FFR to guide percutaneous coronary intervention an emphasis has been placed on identifying factors leading to discordance. The aim of this review is to outline recent studies that have identified factors of FFR and iFR discordance.
瞬时无波比（iFR）与血流储备分数（FFR）的诊断准确性和临床获益在文献中已有充分证实。尽管非充血压力指数具有优势，但大约 20%的 iFR 和 FFR 测量结果存在不相符。人们已经努力确定导致这种不相符的机制和原因。最近的研究确定了许多导致不相符的因素，包括性别差异、年龄差异、心动过缓、冠状动脉狭窄位置、左心室舒张末期压升高和舒张功能障碍。此外，在糖尿病患者和血液透析患者中可见到的冠状动脉微循环功能障碍导致的不相符也引起了专家的关注。随着越来越多的介入心脏病学家使用 iFR 独立于 FFR 来指导经皮冠状动脉介入治疗，人们越来越关注导致不相符的因素。本综述的目的是概述最近确定 FFR 和 iFR 不相符因素的研究。
