Elbadawi Ayman, Sedhom Ramy, Ghoweba Mohamed, Etewa Abdelazeem Mohamed, Kayani Waleed, Rahman Faisal
Division of Cardiology, Christus Good Shepherd, 707 East Marshall Avenue, Longview, TX, 75604, USA.
Department of Internal Medicine, Einstein Medical Centre, Philadelphia, PA, USA.
Cardiol Ther. 2023 Dec;12(4):589-614. doi: 10.1007/s40119-023-00329-2. Epub 2023 Sep 5.
Coronary angiography has a limited ability to predict the functional significance of intermediate coronary lesions. Hence, physiological assessment of coronary lesions, via fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR), has been introduced to determine their functional significance. An accumulating body of evidence has consolidated the role of physiology-guided revascularization, particularly among patients with stable ischemic heart disease. The use of FFR or iFR to guide decision-making in patients with stable ischemic heart disease and intermediate coronary lesions received a class I recommendation from major societal guidelines. Nevertheless, the role of coronary physiology testing is less clear among certain patients' groups, including patients with serial coronary lesions, acute coronary syndromes, aortic stenosis, heart failure, as well as post-percutaneous coronary interventions. In this review, we aimed to discuss the utility and clinical evidence of coronary physiology (mainly FFR and iFR), with emphasis on those specific patient groups.
冠状动脉造影预测中度冠状动脉病变功能意义的能力有限。因此，已引入通过血流储备分数（FFR）或瞬时无波比值（iFR）对冠状动脉病变进行生理评估，以确定其功能意义。越来越多的证据巩固了生理引导下血运重建的作用，尤其是在稳定型缺血性心脏病患者中。使用FFR或iFR指导稳定型缺血性心脏病和中度冠状动脉病变患者的决策获得了主要社会指南的I类推荐。然而，在某些患者群体中，包括患有串联冠状动脉病变、急性冠状动脉综合征、主动脉瓣狭窄、心力衰竭以及经皮冠状动脉介入治疗后的患者，冠状动脉生理测试的作用尚不清楚。在本综述中，我们旨在讨论冠状动脉生理学（主要是FFR和iFR）的效用和临床证据，重点关注那些特定的患者群体。
