经胸负荷超声冠脉血流储备对冠心病诊断价值的研究进展

Diagnostic value of coronary flow reserve assessed by stress transthoracic echocardiography for coronary artery disease

冠脉血流储备(coronary flow reserve,CFR)的评估方法较多,经胸多普勒超声心动图(transthoracic Doppler echocardiography,TDE)是一种非常实用的方法。TDE-CFR有助于冠脉中度狭窄的功能评估,可用于急性冠脉综合征和心肌梗死的评估,以及血管重建后再狭窄的检测;而在无心外膜血管狭窄时,CFR可以评估冠脉微循环功能。CFR联合室壁运动分析可明显提高诊断冠脉微循环病变的敏感性。TDE-CFR在前降支的应用较为广泛,随着技术的进步,在回旋支和右冠的检测成功率越来越高。

Several methods have been established for measuring coronary flow reserve（CFR）. Transthoracic Doppler echocardiography（TDE）is a very useful method. TDE-CFR measurement is helpful in functional assessment of moderate stenosis,and can be used for assessment of acute coronary syndrome and myocardial infarction,as well as for monitoring of restenosis after revascularization.While in the absence of stenosis in the epicardial coronary artery,CFR can assess coronary microcirculation. Combined assessment of CFR and wall motion analysis can significantly improve the diagnosis values of coronary microcirculation disease. TDE-CFR is widely used in anterior descending artery. With the advances of the technology,the success rate of detection in circumflex and right coronary artery is increasing.