血流储备分数指导冠状动脉再血管化的相关进展

Relevant Progress of FFR-guided Coronary Revascularization

冠状动脉疾病患者的再血管化应建立在客观的可诱导的心肌缺血证据基础之上,然而在目前冠状动脉疾病患者的治疗决策中,仍以解剖学评估为主导。解剖学评估的狭窄病变是否存在功能性缺血需更多的功能学评价工具来说明。近年来,基于缺血的冠状动脉再血管化策略在临床中已被大多数专家所认可,单纯冠状动脉造影术已远远不能满足临床医师的需求。血流储备分数是目前公认评价心肌缺血最特异性的侵入性指标。现回顾血流储备分数的生理学原理及其临床应用,介绍冠状动脉病变严重程度的解剖学及功能学评价方法及其不一致性,并且详细描述了血流储备分数指导冠状动脉再血管化的相关新进展。

The revascularization of coronary artery disease patients should be based on objective and inducible evidence of myocardial ischemia.However,anatomical evaluation is still the dominant factor in the current treatment decision of coronary artery disease patients.Whether functional ischemia exists in the stenosis of anatomical evaluation needs more functional evaluation tools to explain.In recent years,the strategy of coronary artery revascularization based on ischemia has been accepted by most experts in the clinic,and simple coronary artery angiography cannot satisfy the needs of clinical physicians.Fractional flow reserve(FFR)is the most specific invasive index to evaluate myocardial ischemia.This review aims to illustrate the physiological principle and clinical application of FFR,introduces the anatomy and functional evaluation methods of severity of coronary artery disease and their inconsistencies,and describes the new progress of FFR in guiding coronary artery revascularization in detail.