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在接受药物涂层球囊(DCB)与药物洗脱支架(DES)治疗的冠状动脉慢性完全闭塞患者中评估血流储备分数(FFR)和心肺运动试验(CPET)。

Evaluation of FFR and CPET in patients with coronary chronic total occlusion treated with DCB vs. DES.

作者信息

Guo Lingli, Liu Hengdao, Zhao Xi, Liu Ting, Gao Chenyang, Duan Jihao, Wang Dongfeng, Zhao Junwei, Wei Yuzhen, Song Ruipeng, Tao Hailong

机构信息

Gastroscopy Center, The Third People's Hospital of Henan Province, Zhengzhou, Henan, China.

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

出版信息

Front Cardiovasc Med. 2025 Jul 31;12:1584548. doi: 10.3389/fcvm.2025.1584548. eCollection 2025.

Abstract

BACKGROUND

Drug-coated balloon (DCB) is a novel therapeutic strategy for coronary chronic total occlusion (CTO). However, fractional flow reserve (FFR), a key indicator of evaluating coronary function, and cardiopulmonary exercise testing (CPET), an important indicator of cardiopulmonary function, are rarely reported for evaluating the effectiveness of DCB in CTO lesions.

METHODS AND RESULTS

In this retrospective study, 100 patients were enrolled and classified into the DCB group ( = 48) and the drug-eluting stent (DES) group ( = 52). All patients underwent coronary angiography immediately after PCI and during follow-up. Some patients underwent FFR measurement ( = 64) or CPET ( = 56) at follow-up. There was no significant difference in baseline clinical characteristics between the two groups. Compared with the DES group, the DCB group had a significantly smaller late lumen loss (LLL) ( < 0.05). Also, there was no significant difference in the proportion of FFR values ≥0.90 between the two groups at follow-up. Similarly, there was also no statistically significant difference in the CPET parameters between the two groups ( > 0.05). In addition, the incidence of MACE (major adverse cardiovascular events) showed no statistical difference during hospitalization and follow-up between the two groups ( > 0.05).

CONCLUSIONS

DCB treatment for CTO lesions yields FFR and CPET results comparable to DES, with an even smaller LLL. This result provides a new approach for the treatment of CTO lesions.

摘要

背景

药物涂层球囊(DCB)是治疗冠状动脉慢性完全闭塞(CTO)的一种新型治疗策略。然而,用于评估冠状动脉功能的关键指标——血流储备分数(FFR)以及用于评估心肺功能的重要指标——心肺运动试验(CPET),在评估DCB治疗CTO病变有效性方面的报道较少。

方法与结果

在这项回顾性研究中,纳入了100例患者,并将其分为DCB组(n = 48)和药物洗脱支架(DES)组(n = 52)。所有患者在PCI术后即刻及随访期间均接受冠状动脉造影。部分患者在随访时接受了FFR测量(n = 64)或CPET(n = 56)。两组患者的基线临床特征无显著差异。与DES组相比,DCB组的晚期管腔丢失(LLL)显著更小(P < 0.05)。此外,随访时两组间FFR值≥0.90的比例无显著差异。同样,两组间CPET参数也无统计学显著差异(P > 0.05)。另外,两组在住院期间及随访期间的主要不良心血管事件(MACE)发生率无统计学差异(P > 0.05)。

结论

DCB治疗CTO病变所产生的FFR和CPET结果与DES相当,且LLL更小。这一结果为CTO病变的治疗提供了一种新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9be7/12350347/bf99aa1c9441/fcvm-12-1584548-g001.jpg

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