Invasive Coronary Physiology Assessment for Patients With Stable Coronary Disease

被引：4

作者：

Elgendy, Islam Y. ^{[1
]}

Denktas, Ali ^{[2
]}

Johnson, Nils P. ^{[3
]}

Jaffer, Farouc A. ^{[4
,5
]}

Jneid, Hani ^{[2
]}

机构：

[1] Weill Cornell Med Qatar, Dept Med, Doha, Qatar

[2] Baylor Coll Med, Cardiol Sect, Houston, TX 77030 USA

[3] UTHlth McGovern Med Sch & Mem Hermann Hosp, Houston, TX USA

[4] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA

[5] Harvard Med Sch, Boston, MA 02115 USA

来源：

CARDIOLOGY IN REVIEW | 2022年 / 30卷 / 05期

关键词：

coronary artery disease; fractional flow reserve; nonhyperemic pressure ratios; major adverse cardiac events; revascularization; FRACTIONAL FLOW RESERVE; 5-YEAR FOLLOW-UP; INTRAVASCULAR ULTRASOUND; STENOSIS SEVERITY; MEDICAL THERAPY; INTERVENTION; ANGIOGRAPHY; REVASCULARIZATION; METAANALYSIS; VALIDATION;

D O I：

10.1097/CRD.0000000000000396

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Visual assessment of coronary stenosis severity using conventional coronary angiography is associated with wide interoperator variability and a weak relationship with hemodynamics. Invasive coronary physiology assessment using fractional flow reserve (FFR) has been shown to be safe and beneficial. Large multicenter randomized trials have demonstrated the superiority of FFR-guided percutaneous coronary intervention in reducing the risk of major cardiac adverse events, number of stents used, and total cost in patients with multivessel coronary disease. FFR requires vasodilatory agents for the microvasculature to induce maximal hyperemia, which carry a slight risk, cost, and effort. Nonhyperemic pressure ratios provide a physiologic metric without vasodilator medications but with more limited clinical outcomes data. The transition from anatomy to physiology for coronary artery disease decision-making represents a cultural sea change in the cardiac catheterization laboratory that requires time and retooling.

引用

页码：263 / 266

页数：4

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