量化流量比率与视觉估计之间的不一致性在重血管化指导中的预测作用
Dimitrios Terentes-Printzios1, Dimitrios Oikonomou1, Konstantia-Paraskevi Gkini1
1First Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration Hospital, 114 Vassilisis Sofias St, 11527 Athens, Greece.
European heart journal open
|January 4, 2024
概括
在冠状动脉复血管化中,定量流量比率 (QFR) 和视觉评估之间的差异会增加不良心血管事件. 适当选择患者进行干预对于更好的长期结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗成像医学成像
背景情况:
- 功能性严重性评估比视觉指导改善了重血管化结果.
- 定量流量比 (QFR) 提供可靠的,基于血管造影的功能评估.
研究的目的:
- 评估QFR和视觉估计之间的异常在指导冠状动脉再血管化的预后意义.
- 为了确定差异是否会影响长期的心血管结果.
主要方法:
- 在接受冠状动脉血管造影的患者中进行了离线QFR分析.
- 根据QFR结果和穿皮冠状动脉干预 (PCI) 决策,患者被分为一致性和不一致性组.
- 主要终点包括心血管死亡,心肌梗塞和缺血驱动的再血管.
主要成果:
- 在26.2%的患者中发现了QFR和视觉估计之间的不一致.
- 不一致组在2.5年后显示出复合结果的显著更高率 (HR:3.34,P <0.001).
- 与不同意的两组 (PCI+,QFR>0.8和PCI-,QFR ≤0.8) 与同意组相比,心血管风险增加.
结论:
- 在重血管化指导中,QFR和视觉估计之间的不一致与更糟糕的长期预后有关.
- 准确的患者选择干预,以全面的功能评估为指导,是必不可少的.
- 避免基于仅视觉评估的不必要的支架植入非常重要.
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