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休息期生理指数的生理和临床评估
Joo Myung Lee1, Ki Hong Choi1, Jonghanne Park2,3,4
1Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (J.M.L., K.H.C., Y.B.S., J.-Y.H.).
Circulation
|December 28, 2018
概括
休息压力衍生指数如休息全周期比率 (RFR) 和透气压比率 (dPR) 与即时无波比率 (iFR) 具有很高的一致性,并预测冠状动脉疾病的结果. 这些方法可以指导患者的治疗策略.
科学领域:
- 心脏病学
- 干预心脏病学
- 生理学
背景情况:
- 新的静止压力衍生指数,包括静止全周期比率 (RFR) 和透气压比率 (dPR),正在出现以评估冠状动脉狭窄的功能意义.
- 之前的研究集中在即时无波比 (iFR) 和分流储备 (FFR) 上,用于评估冠状动脉疾病.
- 需要进一步研究RFR和dPR与已确定的指数的临床实用性和一致性.
研究的目的:
- 调查RFR和dPR与iFR和FFR的协议.
- 评估RFR和dPR的敏感性,以确定解剖学和血液动力学狭窄的严重程度.
- 将RFR和dPR与iFR在预测心血管不良事件中的预后影响进行比较.
主要方法:
- 从435名患者的1024个血管的静止压力追踪结果计算出RFR和dPR.
- 分析了与iFR和FFR的一致性和相关性.
- 在115名患者中,使用13N-氨正子发射断层扫描来评估诊断性能.
- 通过分析与864艘延期船只的2年船舶导向复合结果的关联来评估预测值.
主要成果:
- RFR和dPR与iFR具有很高的相关性和一致性 (R=0. 979,C指数=0. 987对于RFR;R=0. 985,C指数=0. 993对于dPR),超过与FFR的相关性.
- 在预测心肌缺血时,iFR,RFR和dPR的诊断性能相似.
- 所有休息期生理指数 (iFR,RFR,dPR) 都与2年血管导向组合结果的风险显著降低有关.
结论:
- 休息压力指数,包括RFR和dPR,与iFR非常一致.
- 这些指数对狭窄的严重程度敏感,对心肌缺血的诊断性能相似.
- 与iFR一起,RFR和dPR是指导冠状动脉疾病治疗策略的有价值的侵入性工具.
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