冠状动脉多支血管病变血运重建功能性评价的新进展
刘广忠,李悦,李为民
摘要(Abstract):
<正>冠状动脉多支血管病变(multi-vessel disease,MVD)指两支或以上心外膜的冠状动脉(前降支/回旋支/右冠状动脉或其主分支,和/或左主干干部)在冠状动脉造影中存在>50%的狭窄或显著狭窄。目前针对冠状动脉MVD治疗,可采用的治疗策略包括药物治疗、经皮冠状动脉介入治疗(PCI)及冠状动脉旁路移植术(CABG)等,血运重建策略的抉择是临床医师需要思考的问题。先前研究认为,MVD治疗目标是实现解剖性完全血运重建,可显著改善临床患者的预后。但新近研究显示,实现
关键词(KeyWords):
基金项目(Foundation): 哈尔滨市科技攻关计划项目(2007AA3CS082)
作者(Author): 刘广忠,李悦,李为民
参考文献(References):
- [1]Pijls NH,van Schaardenburgh P,Manoharan G,et al.Percutaneous coronary intervention of functionally nonsignificant stenosis:5-year follow-up of the DEFER Study.J Am Coll Cardiol,2007,49:2105-2111.
- [2]Tonino PA,Fearon WF,De Bruyne B,et al.Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation.J Am Coll Cardiol,2010,55:2816-2821.
- [3]Pijls NH,Fearon WF,Tonino PA,et al.Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease:2-year followup of the FAME(Fractional Flow Reserve Versus Angiography for Multivessel Evaluation)study.J Am Coll Cardiol,2010,56:177-184.
- [4]De Bruyne B,Pijls NH,Kalesan B,et al.Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease.N Engl J Med,2012,367:991-1001.
- [5]Carrick D,Behan M,Foo F,et al.Usefulness of fractional flow reserve to improve diagnostic efficiency in patients with non-ST elevation myocardial infarction.Am J Cardiol,2013,111:45-50.
- [6]Angkananard T,Wongpraparut N,Tresukosol D,et al.Fractional flow reserve guided coronary revascularization in drugeluting era in Thai patients with borderline multi-vessel coronary stenoses.J Med Assoc Thai,2011,94(Suppl 1):S25-S32.
- [7]Li J,Elrashidi MY,Flammer AJ,et al.Long-term outcomes of fractional flow reserve-guided vs.angiography-guided percutaneous coronary intervention in contemporary practice.Eur Heart J,2013,34:1375-1383.
- [8]Muller O,Mangiacapra F,Ntalianis A,et al.Long-term followup after fractional flow reserve-guided treatment strategy in patients with an isolated proximal left anterior descending coronary artery stenosis.JACC Cardiovasc Interv,2011,4:1175-1182.
- [9]Toth G,De Bruyne B,Casselman F,et al.Fractional flow reserve-guided versus angiography-guided coronary artery bypass graft surgery.Circulation,2013,128:1405-1411.
- [10]Nam CW,Mangiacapra F,Entjes R,et al.Functional SYNTAX score for risk assessment in multivessel coronary artery disease.J Am Coll Cardiol,2011,58:1211-1218.
- [11]Novara M,D'Ascenzo F,Gonella A,et al.Changing of SYNTAX score performing fractional flow reserve in multivessel coronary artery disease.J Cardiovasc Med(Hagerstown),2012,13:368-375.
- [12]Sen S,Escaned J,Malik IS,et al.Development and validation of a new adenosine-independent index of stenosis severity from coronary wave-intensity analysis:results of the ADVISE(ADenosine Vasodilator Independent Stenosis Evaluation)study.J Am Coll Cardiol,2012,59:1392-1402.
- [13]Petraco R,Park JJ,Sen S,et al.Hybrid iFR-FFR decisionmaking strategy:implications for enhancing universal adoption of physiology-guided coronary revascularisation.EuroIntervention,2013,8:1157-1165.
- [14]Petraco R,Escaned J,Sen S,et al.Classification performance of instantaneous wave-free ratio(iFR)and fractional flow reserve in a clinical population of intermediate coronary stenoses:results of the ADVISE registry.EuroIntervention,2013,9:91-101.
- [15]Berry C,van't Veer M,Witt N,et al.VERIFY(VERification of Instantaneous Wave-Free Ratio and Fractional Flow Reserve for the Assessment of Coronary Artery Stenosis Severity in EverydaY Practice):a multicenter study in consecutive patients.J Am Coll Cardiol,2013,61:1421-1427.
- [16]Sen S,Asrress KN,Nijjer S,et al.Diagnostic classification of the instantaneous wave-free ratio is equivalent to fractional flow reserve and is not improved with adenosine administration.Results of CLARIFY(Classification Accuracy of Pressure-Only Ratios Against Indices Using Flow Study).J Am Coll Cardiol,2013,61:1409-1420.
- [17]Meimoun P,Malaquin D,Benali T,et al.Non-invasive coronary flow reserve after successful primary angioplasty for acute anterior myocardial infarction is an independent predictor of left ventricular recovery and in-hospital cardiac events.J Am Soc Echocardiogr,2009,22:1071-1079.
- [18]Ruscazio M,Montisci R,Bezante G,et al.Early noninvasive evaluation of coronary flow reserve after angioplasty in the left anterior descending coronary artery identifies patients at high risk of restenosis at follow-up.J Am Soc Echocardiogr,2012,25:902-910.
- [19]Ascione L,Carlomagno G,Sordelli C,et al.Dipyridamole coronary flow reserve stratifies prognosis in acute coronary syndrome patients without left anterior descending disease.Eur Heart J Cardiovasc Imaging,2013,14:858-864.
- [20]Chamuleau SA,van Eck-Smit BL,Meuwissen M,et al.Longterm prognostic value of CFVR and FFR versus perfusion scintigraphy in patients with multivessel disease.Neth Heart J,2007,15:369-374.
- [21]Fearon WF,Balsam LB,Farouque HM,et al.Novel index for invasively assessing the coronary microcirculation.Circulation,2003,107:3129-3132.
- [22]Fearon WF,Shah M,Ng M,et al.Predictive value of the index of microcirculatory resistance in patients with ST-segment elevation myocardial infarction.J Am Coll Cardiol,2008,51:560-565.
- [23]Ng MK,Yong AS,Ho M,et al.The index of microcirculatory resistance predicts myocardial infarction related to percutaneous coronary intervention.Circ Cardiovasc Interv,2012,5:515-522.
- [24]McGeoch R,Watkins S,Berry C,et al.The index of microcirculatory resistance measured acutely predicts the extent and severity of myocardial infarction in patients with ST-segment elevation myocardial infarction.JACC Cardiovasc Interv,2010,3:715-722.
- [25]Fearon WF,Low AF,Yong AS,et al.Prognostic value of the Index of Microcirculatory Resistance measured after primary percutaneous coronary intervention.Circulation,2013,127:2436-2441.
- [26]Koo BK,Erglis A,Doh JH,et al.Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms.Results from the prospective multicenter DISCOVER-FLOW(Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve)study.J Am Coll Cardiol,2011,58:1989-1997.
- [27]Min JK,Berman DS,Budoff MJ,et al.Rationale and design of the DeFACTO(Determination of Fractional Flow Reserve by Anatomic Computed Tomographic AngiOgraphy)study.J Cardiovasc Comput Tomogr,2011,5:301-309.
- [28]Min JK,Leipsic J,Pencina MJ,et al.Diagnostic accuracy of fractional flow reserve from anatomic CT angiography.JAMA,2012,308:1237-1245.
- [29]Min JK,Koo BK,Erglis A,et al.Usefulness of noninvasive fractional flow reserve computed from coronary computed tomographic angiograms for intermediate stenoses confirmed by quantitative coronary angiography.Am J Cardiol,2012,110:971-976.
- [30]Yoon YE,Choi JH,Kim JH,et al.Noninvasive diagnosis of ischemia-causing coronary stenosis using CT angiography:diagnostic value of transluminal attenuation gradient and fractional flow reserve computed from coronary CT angiography compared to invasively measured fractional flow reserve.JACC Cardiovasc Imaging,2012,5:1088-1096.
- [31]Taylor CA,Fonte TA,Min JK.Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve:scientific basis.J Am Coll Cardiol,2013,61:2233-2241.
- [32]Zarins CK,Taylor CA,Min JK.Computed Fractional Flow Reserve(FFTCT)Derived from Coronary CT Angiography.J Cardiovasc Transl Res,2013.[Epub ahead of print].