Yang Cathevine, Wong Christopher, Teradaa Kosei, Tremmel Jennifer A
Stanford University, Department of Medicine, Division of Cardiovascular Medicine, Stanford, CA, USA.
Stanford University, Department of Medicine, Division of Cardiovascular Medicine, Stanford, CA, USA.
Cardiovasc Revasc Med. 2025 Feb;71:16-21. doi: 10.1016/j.carrev.2024.12.011. Epub 2024 Dec 28.
In this review article, we provide an overview of the definition and application of fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), coronary flow reserve (CFR), and index of microvascular resistance (IMR) in the diagnosis, prognosis, and management of coronary microvascular dysfunction. We discuss their respective limitations as it relates to microvascular dysfunction. In each section, we review the most recent evidence supporting their use in microvascular and epicardial coronary artery disease. We also highlight specific clinical conditions with emerging indications for the use of these indices, including in the setting of microvascular dysfunction due to acute myocardial infarction, heart failure with preserved ejection fraction, and post-cardiac transplant.
在这篇综述文章中，我们概述了血流储备分数（FFR）、瞬时无波比值（iFR）、冠状动脉血流储备（CFR）和微血管阻力指数（IMR）在冠状动脉微血管功能障碍的诊断、预后及管理中的定义和应用。我们讨论了它们与微血管功能障碍相关的各自局限性。在每个部分，我们回顾了支持它们用于微血管和心外膜冠状动脉疾病的最新证据。我们还强调了这些指标有新应用指征的特定临床情况，包括急性心肌梗死所致微血管功能障碍、射血分数保留的心力衰竭以及心脏移植后。
