分量流量储备和定量流量比率之间的差异的临床意义
Takashi Mineo1, Mirei Setoguchi1, Yoshihisa Kanaji1
1Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital.
概括
定量流量比率 (QFR) 和分量流量储备 (FFR) 之间的差异,称为delta QFR-FFR,可以预测皮肤冠状动脉干预 (PCI) 后的主要不良心血管事件 (MACE). 较低的三角形QFR-FFR值表明MACE的风险更高.
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 生理学 生理学
背景情况:
- 定量流量比 (QFR) 是一种基于血管造影的指数,用于评估冠状动脉功能狭窄,与分数流量储备 (FFR) 有良好的相关性.
- 在接受FFR导向皮肤冠状动脉干预 (PCI) 的患者中,研究了QFR和FFR (delta QFR-FFR) 之间的差异的临床意义.
- 了解三角形QFR-FFR可能会为冠状动脉微血管功能和扩散性疾病提供见解.
研究的目的:
- 研究在接受FFR指导选择性PCI的患者中delta QFR-FFR的临床意义.
- 评估三角形QFR-FFR作为主要不良心血管事件 (MACE) 的预测指标.
主要方法:
- 对301名患有慢性冠状动脉综合征的患者进行了回顾性分析,这些患者接受了FFR引导的PCI和QFR评估.
- 根据PCI前的QFR-FFR,患者被分为三层.
- 临床特征,生理参数和MACE在三角动物之间进行了比较;三角 QFR-FFR被分析为MACE的预测因子.
主要成果:
- 较低的三角形QFR-FFR与微血管功能受损有关,包括较低的QFR回调压力梯度,更高的微循环阻力指数,以及PCI后冠状动脉流量储备的减少.
- 在delta QFR-FFR小于-0.060 (日志排名P=0.006) 的患者中,MACE发生的频率显著增加.
- 考克斯回归确定了较低的三角形QFR-FFR作为MACE的独立预测因素.
结论:
- 前PCI三角形QFR-FFR与微血管功能障碍和扩散性冠状动脉疾病有关.
- 较低的三角形QFR-FFR值预测在FFR引导的再血管化后,MACE的风险增加.
- 德尔塔QFR-FFR显示出作为PCI患者风险分层的有价值工具的潜力.
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