Tar Balázs, Ágoston András, Üveges Áron, Szabó Gábor Tamás, Szűk Tibor, Komócsi András, Czuriga Dániel, Csippa Benjamin, Paál György, Kőszegi Zsolt
Kálmán Laki Doctoral School of Biomedical and Clinical Sciences, University of Debrecen, 4032 Debrecen, Hungary.
Szabolcs-Szatmár-Bereg County Hospitals, University Teaching Hospital, 4400 Nyíregyháza, Hungary.
J Pers Med. 2022 May 12;12(5):780. doi: 10.3390/jpm12050780.
Purpose: To develop a method of coronary flow reserve (CFR) calculation derived from three-dimensional (3D) coronary angiographic parameters and intracoronary pressure data during fractional flow reserve (FFR) measurement. Methods: Altogether 19 coronary arteries of 16 native and 3 stented vessels were reconstructed in 3D. The measured distal intracoronary pressures were corrected to the hydrostatic pressure based on the height differences between the levels of the vessel orifice and the sensor position. Classical fluid dynamic equations were applied to calculate the flow during the resting state and vasodilatation based on morphological data and intracoronary pressure values. 3D-derived coronary flow reserve (CFRp-3D) was defined as the ratio between the calculated hyperemic and the resting flow and was compared to the CFR values simultaneously measured by the Doppler sensor (CFRDoppler). Results: Haemodynamic calculations using the distal coronary pressures corrected for hydrostatic pressures showed a strong correlation between the individual CFRp-3D values and the CFRDoppler measurements (r = 0.89, p < 0.0001). Hydrostatic pressure correction increased the specificity of the method from 46.1% to 92.3% for predicting an abnormal CFRDoppler < 2. Conclusions: CFRp-3D calculation with hydrostatic pressure correction during FFR measurement facilitates a comprehensive hemodynamic assessment, supporting the complex evaluation of macro-and microvascular coronary artery disease.
开发一种基于三维（3D）冠状动脉造影参数和血流储备分数（FFR）测量期间的冠状动脉内压力数据来计算冠状动脉血流储备（CFR）的方法。方法：对16条天然血管和3条支架植入血管的共19条冠状动脉进行三维重建。根据血管开口水平与传感器位置之间的高度差，将测量的冠状动脉远端压力校正为静水压力。应用经典流体动力学方程，根据形态学数据和冠状动脉内压力值计算静息状态和血管扩张时的血流。三维衍生冠状动脉血流储备（CFRp-3D）定义为计算的充血血流与静息血流之比，并与多普勒传感器同时测量的CFR值（CFRDoppler）进行比较。结果：使用校正了静水压力的冠状动脉远端压力进行血流动力学计算显示，个体CFRp-3D值与CFRDoppler测量值之间存在强相关性（r = 0.89，p < 0.0001）。对于预测异常的CFRDoppler < 2，静水压力校正将该方法的特异性从46.1%提高到92.3%。结论：在FFR测量期间进行静水压力校正的CFRp-3D计算有助于进行全面的血流动力学评估，支持对冠状动脉大血管和微血管疾病的综合评估。
