静息全周期比值与冠状动脉血流储备分数评价冠状动脉狭窄关系

Relationship between resting full-cycle ratio and fractional flow reserve in assessments of coronary stenosis

目的:确定静息全周期比值(resting full-cycle ratio, RFR)与冠状动脉(冠脉)血流储备分数(fractional flow reserve, FFR)之间一致性的预后价值,并确定测量的RFR的稳定性。方法:纳入2021年9月—2022年10月在我院接受侵入性生理学检查的患者。RFR≤0.89作为界值,FFR≤0.80作为界值,分高RFR和高FFR组(高RFR/高FFR),高RFR和低FFR组(高RFR/低FFR),低RFR和高FFR组(低RFR/高FFR),低RFR和低FFR组(低RFR/低FFR)。比较RFR与FFR总的关系及各分支血管的关系,并探讨引起不一致的相关因素。结果:本研究共纳入151例患者,共205支血管。各组比例分布为高RFR和高FFR组59.5%(122/205),高RFR和低FFR组10.7%(22/205),低RFR和高FFR组7.3%(15/205),低RFR和低FFR组22.4%(46/205)。RFR与FFR一致性为82.0%,并具有统计学意义(R~2=0.683,P<0.001)。RFR>0.89/FFR≤0.8不一致的预测指标中,年龄对不一致的影响具有统计学意义(OR=0.944,95%CI 0.891~0.999,P=0.047)。RFR≤0.89/FFR>0.8不一致预测指标中,女性对不一致的影响具有统计学意义(OR=5.98,95%CI 1.16~30.80,P=0.032);LAD对不一致的影响具有统计学意义(OR=10.75,95%CI 1.38~83.70,P=0.023)。结论:RFR与FFR有很好的一致性。RFR>0.89/FFR≤0.8不一致的预测指标中,年龄对不一致的影响具有统计学意义。RFR≤0.89/FFR>0.8不一致的预测指标中,女性、LAD病变对不一致的影响具有统计学意义。

Objective: To identify the prognostic value of concordance between resting full-cycle ratio(RFR) and fractional flow reserve(FFR) and determine the stability of measured RFR. Methods: The study included patients from September 2021 to October 2022 in our hospital and undergoing invasive physiology check and classified the data using known cutoffs for FFR(≤0.80) and RFR(≤0.89) into groups, high RFR and high FFR(high RFR/high FFR), high RFR and low FFR(high RFR/low FFR), low RFR and high FFR(low RFR/high FFR), low RFR and low FFR(low RFR/low FFR) group. The relationship between RFR and FFR and between branch vessels was compared. Results: A total of 205 lesions were evaluated in 151 patients. The concordance rates in in the high RFR and high FFR group 59.5%(122/205), high RFR and low FFR group 10.7%(22/205), low RFR and high FFR group were 7.3%(15/205), low RFR and low FFR group 22.4%(46/205). The concordance between FFR and RFR was 82.0%,(R~2=0.683, P<0.001). Among the predictors of RFR0.89/FFR≤0.8 inconsistency, age was statistically significant(OR=0.944, 95%CI 0.891-0.999, P=0.047). Among the predictors of RFR≤0.89/FFR0.8 in consistency, female was statistically significant(OR=5.98, 95%CI 1.16-30.80, P=0.032);LAD was statistically significant(OR=10.75, 95%CI 1.38-83.70, P=0.023). Conclusion: The RFR and FFR values consistently agreed. Age may be related to the difference of discordance between high RFR/low FFR. Female, LAD may be related to the difference of discordance between low RFR/high FFR.