基于造影的血流储备分数:开启功能学评估新时代
龚艳君,霍勇
摘要(Abstract):
<正>中国大陆地区经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)无论在数量还是质量上都在稳定发展且不断提升。2019年4月27日,第22届全国介入心脏病学论坛公布了2018年中国大陆地区PCI的总例数为915256例,较2017年增加了21.5%。PCI对于急性冠状动脉综合征尤其急性ST段抬高型心肌梗死患者的临床获益是非常确定的,但对于我国PCI占比50%以上的稳定性冠心病患者的临床获益在学术界一直存在争议。一、造影指导的PCI与药物治疗相比获益不明确从2007年发表的COURAGE研究[1]到2019年底公布的ISCHEMIA研究[2]均提示,对于稳定性冠心病患者常
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基金项目(Foundation):
作者(Author): 龚艳君,霍勇
参考文献(References):
- [1] Boden WE, O’Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med,2007,356(15):1503-1516.
- [2] The ISCHEMIA and ISCHEMIA-CKD Study Results are available. Available at:https://www. ischemiatrial. org/.Accessed November 16,2019.
- [3] Tonino PAL, De Bruyne B, Pijls NHJ, et al. Fractional?ow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med,2009,360(3):213-224.
- [4] De Bruyne B, Pijls NH, Kalesan B, et al. Fractional?ow reserveguided PCI versus medical therapy in stable coronary disease. N Engl J Med,2012,367(11):991-1001.
- [5] Davies JE, Sen S, Dehbi HM, et al. Use of the instantaneous wave-free ratio or fractional?ow reserve in PCI. N Engl J Med,2017,376(19):1824-1834.
- [6] G?tberg M, Christiansen EH, Gudmundsdottir IJ, et al.Instantaneous wave-free ratio versus fractional?ow reserve to guide PCI. N Engl J Med,2017,376(19):1813-1823.
- [7] Papafaklis MI, Muramatsu T, Ishibashi Y, et al. Fast virtual f unctional assessment of intermediate coronary lesions using routine angiographic data and blood?ow simulation in humans:comparison with pressure wire-f ractional f low reserve.EuroIntervention,2014,10(5):574-583.
- [8] Tu S, Westra J, Yang J, et al. Diagnostic accuracy of fast computational approaches to derive fractional?ow reserve from diagnostic coronary angiography:the international multicenter FAVOR pilot study. JACC Cardiovasc Interv, 2016, 9(19):2024-2035.
- [9] Xu B, Tu S, Qiao S, et al. Diagnostic accuracy of angiographybased quantitative?ow ratio measurements for online assessment of coronary stenosis.J Am Coll Cardiol,2017,70(25):3077-3087.
- [10] Li J, Gong Y, Wang W, et al. Accuracy of computational pressure-?uid dynamics applied to coronary angiography to derive fractional?ow reserve:FLASH FFR. Cardiovasc Res, 2019.[Epub ahead of print].