无创血流储备分数测定对冠心病患者心肌缺血功能评估的临床进展

Clinical application of noninvasive fractional flow reserve in assessment of myocardial ischemic function in patients with coronary artery disease

摘要:

在中度病变的稳定型冠状动脉疾病(CAD)患者中,判断病变是否造成了冠状动脉远端血流动力学的显著改变(即心肌缺血),在制定临床决策中起着至关重要的作用。而在这些临界病变中,血流储备分数(FFR)测定是识别心肌缺血存在与否的金标准。近年来,随着计算机流体动力学(CFD)的发展,基于冠状动脉CT血管造影的无创性FFR(FFRCT)得以发展。本综述旨在通过阐述FFRCT的概念及应用原理,总结目前针对FFRCT技术的几项临床研究,说明其良好的诊断性能、临床实践进展、优点、局限性以及临床应用前景。

Abstract:

For the patients with moderate-grade stable coronary artery disease (CAD), it is crucial to determine whether the lesions have significant influences on distal hemodynamics of the coronary arteries (myocardial ischemia) in the process of clinical decision-making. And in these critical conditions, fractional flow reserve (FFR) is the golden standard for identifying the presence or absence of myocardial ischemia. In recent years, with the development of computational fluid dynamics (CFD), a new technology, namely FFRCT, has been developed to calculate FFR values non-invasively based on coronary CT angiography (CCTA). In this review, we elucidated the concepts and application principles of FFRCT, and summarized several current clinical trials concerning the technique, and indicated its good diagnostic performance, clinical practice, advantages, limitations and clinical application prospects.