Maitre-Ballesteros Laura, Riou Laurent, Marliere Stephanie, Canu Marjorie, Vautrin Estelle, Piliero Nicola, Ormezzano Oliviez, Bouvaist Helene, Broisat Alexis, Ghezzi Catherine, Fagret Daniel, Vanzetto Gérald, Djaïleb Loïc, Barone-Rochette Gilles
Department of Cardiology, University Hospital, 38000 Grenoble Alpes, France.
Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, 38000 Grenoble, France.
Rev Cardiovasc Med. 2022 Apr 27;23(5):158. doi: 10.31083/j.rcm2305158. eCollection 2022 May.
Coronary physiological assessment is now widely used to assess epicardial coronary lesions in cath lab. Based on clinical evidence, fractional flow reserve (FFR) is the gold standard method to select whether epicardial coronary lesions need revascularization. While additional epicardial indexes, such as instantaneous wave-free ratio (iFR), are also used for revascularization decision-making, several indexes are now also available to explore the coronary microcirculation. Therefore, coronary physiological assessment now allows to explore the entire coronary tree and offer the potential of precision medicine for patients affected by coronary artery disease (CAD). This paper will provide review of the epicardial and microvascular indexes available for the assessment of coronary physiology. More specifically, the already demonstrated contributions of these indexes in the management of CAD and the role they could play in precision medicine will be reviewed with special emphasis on chronic coronary syndrome.
冠状动脉生理评估目前在导管室中被广泛用于评估心外膜冠状动脉病变。基于临床证据，血流储备分数（FFR）是选择心外膜冠状动脉病变是否需要血运重建的金标准方法。虽然其他心外膜指标，如瞬时无波比值（iFR），也用于血运重建决策，但现在也有一些指标可用于探索冠状动脉微循环。因此，冠状动脉生理评估现在能够探索整个冠状动脉树，并为冠心病（CAD）患者提供精准医疗的潜力。本文将对可用于评估冠状动脉生理的心外膜和微血管指标进行综述。更具体地说，将回顾这些指标在CAD管理中已证实的贡献以及它们在精准医疗中可能发挥的作用，特别强调慢性冠状动脉综合征。
