使用混合RFR-FFR策略用于非ST升高急性冠状动脉综合征的生理指导冠状动脉再血管化
Huanting Liu1,2, Youcheng Wang1,2, Sini Fang1,2
1Department of Cardiology, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, 523326, Guangdong, China.
Scientific reports
|October 21, 2025
概括
使用休息全周期比率 (RFR) 和分量流量储备 (FFR) 的新混合方法可以减少非ST升高急性冠状动脉综合征 (NSTE-ACS) 患者的腺使用,同时保持冠状动脉再血管化决策的高准确性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生理学评估 生理学评估
背景情况:
- 非ST升高急性冠状动脉综合征 (NSTE-ACS) 的管理依赖于对冠状动脉狭窄的准确评估.
- 分流储备 (FFR) 是诊断功能性缺血的黄金标准,但其使用可能是有限的.
- 休息全周期比率 (RFR) 提供了更简单的生理测量,但其诊断准确性需要进一步验证.
研究的目的:
- 开发和评估一种混合RFR-FFR决策策略,用于NSTE-ACS患者的生理指导冠状动脉再血管化.
- 确定混合方法的最佳门,以最大限度地减少腺的使用,同时保持与FFR的高度一致.
- 量化减少腺的管理和评估混合模型的诊断性能.
主要方法:
- 使用探索性分析开发了一种混合RFR-FFR模型,用于定义RFR测量的"灰色区域".
- 分流储备 (FFR) ≤0.80是功能性缺血的参考标准.
- 腺素仅用于定义的RFR灰色区域内的病变,并评估了与FFR单独决定的一致性.
主要成果:
- 混合RFR-FFR模型与FFR单独方法达到了95.31%的一致性.
- 通过混合策略,腺素的使用减少了56.56%,保持了高的正值 (96.28%) 和负值 (93.33%) 的预测值.
- 腺需求区的宽度因协议水平而异,RFR点范围为0.07 (0.87-0.93) 为95.31%的协议.
结论:
- 混合RFR-FFR决策方法有效地减少了NSTE-ACS患者的腺依赖.
- 这种混合策略保持了高的诊断准确性和与FFR单独评估的一致性.
- 开发的混合模型为优化生理学引导的冠状动脉复血管化提供了宝贵的工具.
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