定量血流分数在冠心病中的临床应用进展

Clinical Application of Quantitative Flow Ratio in Coronary Heart Disease

冠状动脉狭窄的功能学评估在现代临床决策中的作用具有重要意义。冠状动脉血流储备分数(FFR)是目前公认的有创评价冠状动脉狭窄部位血流动力学改变的金标准。然而,在临床实践中FFR技术存在一些技术缺陷,限制其在临床上的广泛应用。定量血流分数(QFR)利用两个常规体位冠状动脉造影影像来计算FFR,简化了评估流程,且弥补了FFR技术的一些不足,具有显著的临床推广优势。最近多项研究已证明QFR在对冠状动脉功能学狭窄诊断上与FFR具有良好的一致性,并发现其在指导临床决策和评估临床预后方面也有很好的价值。QFR有望代替FFR,成为低创和精确地评估冠状动脉生理功能指标的“新标准”,但其在临床上潜在的广泛应用仍待大量研究进一步证实。现阐述QFR技术的基本原理、诊断性能以及临床实践中的最新应用证据,进而为临床医生诊疗疾病及探究冠状动脉功能学提供新的视角。

Functional evaluation of coronary artery stenosis plays an important role in modern clinical decision-making.Fractional flow reserve(FFR)has been considered as the gold standard for invasive evaluation of hemodynamic changes in coronary artery stenosis.However,the limitations of FFR have prevented it from the wide use in clinical practice.Quantitative flow ratio(QFR)is based on two conventional coronary angiography images to calculate functional evaluation of coronary artery stenosis,simplifies the evaluation process,and makes up for some shortcomings of FFR technology,which has significant advantages in clinical promotion.Recently,a number of studies have proved that QFR has good consistency with FFR in the diagnosis of coronary artery functional stenosis,and found that QFR has good value in guiding clinical decision-making and evaluating clinical prognosis.QFR is expected to replace FFR and become a“new standard”for low-invasive and accurate evaluation of coronary artery physiological function,but its potential wide clinical application still needs to be further confirmed by a large number of studies.This paper describes the basic principle,diagnostic performance and the latest application evidence of QFR technology in clinical practice,so as to provide a new perspective for clinicians to diagnose and treat diseases and explore coronary artery function.