定量血流分数的临床应用与进展

赵国力, 尹德录, 姚月明. 定量血流分数的临床应用与进展[J]. 临床心血管病杂志, 2023, 39(11): 831-835. doi: 10.13201/j.issn.1001-1439.2023.11.003
引用本文: 赵国力, 尹德录, 姚月明. 定量血流分数的临床应用与进展[J]. 临床心血管病杂志, 2023, 39(11): 831-835. doi: 10.13201/j.issn.1001-1439.2023.11.003
ZHAO Guoli, YIN Delu, YAO Yueming. Clinical application and progress of quantitative flow fraction[J]. J Clin Cardiol, 2023, 39(11): 831-835. doi: 10.13201/j.issn.1001-1439.2023.11.003
Citation: ZHAO Guoli, YIN Delu, YAO Yueming. Clinical application and progress of quantitative flow fraction[J]. J Clin Cardiol, 2023, 39(11): 831-835. doi: 10.13201/j.issn.1001-1439.2023.11.003

定量血流分数的临床应用与进展

  • 基金项目:
    江苏省卫生健康委科研项目(No:ZDB2020029)
详细信息

Clinical application and progress of quantitative flow fraction

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  • 近年来,冠状动脉(冠脉)功能学指标在临床应用中愈发受到重视。血流储备分数(FFR)作为评估冠脉功能学狭窄的金标准,其高准确性及临床价值已被大量研究证实。但FFR操作复杂耗时,需要使用部分患者无法耐受的微循环扩张药物,导致其临床应用停滞不前。而定量血流分数(QFR)克服了传统FFR方法的主要不足,同时与FFR具有良好的一致性,在不同的患者亚群之间具有相当的诊断效能,使其在临床上具有广泛的适用性和实用性。本文将对QFR的原理、诊断效能、临床决策、预后风险评估等多个方面进行阐述。
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  • [1]

    Stone GW, Ellis SG, Gori T, et al. Blinded outcomes and angina assessment of coronary bioresorbable scaffolds: 30-day and 1-year results from the ABSORB IV randomised trial[J]. Lancet, 2018, 392(10157): 1530-1540. doi: 10.1016/S0140-6736(18)32283-9

    [2]

    Valgimigli M, Tebaldi M, Borghesi M, et al. Two-year outcomes after first-or second-generation drug-eluting or bare-metal stent implantation in all-comer patients undergoing percutaneous coronary intervention: a pre-specified analysis from the PRODIGY study(PROlonging Dual Antiplatelet Treatment After Grading stent-induced Intimal hyperplasia studY)[J]. JACC Cardiovasc Interv, 2014, 7(1): 20-28. doi: 10.1016/j.jcin.2013.09.008

    [3]

    Baron SJ, Chinnakondepalli K, Magnuson EA, et al. Quality-of-Life After Everolimus-Eluting Stents or Bypass Surgery for Left-Main Disease: Results From the EXCEL Trial[J]. J Am Coll Cardiol, 2017, 70(25): 3113-3122. doi: 10.1016/j.jacc.2017.10.036

    [4]

    Toth G, Hamilos M, Pyxaras S, et al. Evolving concepts of angiogram: fractional flow reserve discordances in 4000 coronary stenoses[J]. Eur Heart J, 2014, 35(40): 2831-2838. doi: 10.1093/eurheartj/ehu094

    [5]

    Parikh RV, Liu G, Plomondon ME, et al. Utilization and Outcomes of Measuring Fractional Flow Reserve in Patients With Stable Ischemic Heart Disease[J]. J Am Coll Cardiol, 2020, 75(4): 409-419. doi: 10.1016/j.jacc.2019.10.060

    [6]

    Elbadawi A, Sedhom R, Dang AT, et al. Fractional flow reserve versus angiography alone in guiding myocardial revascularisation: a systematic review and meta-analysis of randomised trials[J]. Heart, 2022, 108(21): 1699-1706. doi: 10.1136/heartjnl-2021-320768

    [7]

    杨巧妮, 谢学建, 梁田. 血流储备分数指导下分期PCI干预非梗死相关动脉对STEMI患者短期预后的影响[J]. 临床心血管病杂志, 2019, 35(3): 259-263. doi: 10.13201/j.issn.1001-1439.2019.03.015

    [8]

    Lee JM, Kim HK, Park KH, et al. Fractional flow reserve versus angiography-guided strategy in acute myocardial infarction with multivessel disease: a randomized trial[J]. Eur Heart J, 2023, 44(6): 473-484. doi: 10.1093/eurheartj/ehac763

    [9]

    Johnson NP, Tóth GG, Lai D, et al. Prognostic value of fractional flow reserve: linking physiologic severity to clinical outcomes[J]. J Am Coll Cardiol, 2014, 64(16): 1641-1654. doi: 10.1016/j.jacc.2014.07.973

    [10]

    Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. The Task Force on myocardial revascularization of the European Society of Cardiology(ESC)and European Association for Cardio-Thoracic Surgery(EACTS)[J]. G Ital Cardiol(Rome), 2019, 20(7-8 Suppl 1): 1S-61S.

    [11]

    Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation, 2022, 145(3): e18-e114.

    [12]

    Toth GG, Toth B, Johnson NP, et al. Revascularization decisions in patients with stable angina and intermediate lesions: results of the international survey on interventional strategy[J]. Circ Cardiovasc Interv, 2014, 7(6): 751-759. doi: 10.1161/CIRCINTERVENTIONS.114.001608

    [13]

    Götberg M, Cook CM, Sen S, et al. The Evolving Future of Instantaneous Wave-Free Ratio and Fractional Flow Reserve[J]. J Am Coll Cardiol, 2017, 70(11): 1379-1402. doi: 10.1016/j.jacc.2017.07.770

    [14]

    Tu S, Echavarria-Pinto M, von Birgelen C, et al. Fractional flow reserve and coronary bifurcation anatomy: a novel quantitative model to assess and report the stenosis severity of bifurcation lesions[J]. JACC Cardiovasc Interv, 2015, 8(4): 564-574. doi: 10.1016/j.jcin.2014.12.232

    [15]

    Tu S, Westra J, Yang J, et al. Diagnostic Accuracy of Fast Computational Approaches to Derive Fractional Flow Reserve From Diagnostic Coronary Angiography: The International Multicenter FAVOR Pilot Study[J]. JACC Cardiovasc Interv, 2016, 9(19): 2024-2035. doi: 10.1016/j.jcin.2016.07.013

    [16]

    Jeremias A, Kirtane AJ, Stone GW. A Test in Context: Fractional Flow Reserve: Accuracy, Prognostic Implications, and Limitations[J]. J Am Coll Cardiol, 2017, 69(22): 2748-2758. doi: 10.1016/j.jacc.2017.04.019

    [17]

    Xu B, Tu S, Qiao S, et al. Diagnostic Accuracy of Angiography-Based Quantitative Flow Ratio Measurements for Online Assessment of Coronary Stenosis[J]. J Am Coll Cardiol, 2017, 70(25): 3077-3087. doi: 10.1016/j.jacc.2017.10.035

    [18]

    Westra J, Andersen BK, Campo G, et al. Diagnostic Performance of In-Procedure Angiography-Derived Quantitative Flow Reserve Compared to Pressure-Derived Fractional Flow Reserve: The FAVOR Ⅱ Europe-Japan Study[J]. J Am Heart Assoc, 2018, 7(14): e009603. doi: 10.1161/JAHA.118.009603

    [19]

    Smit JM, Koning G, van Rosendael AR, et al. Referral of patients for fractional flow reserve using quantitative flow ratio[J]. Eur Heart J Cardiovasc Imaging, 2019, 20(11): 1231-1238. doi: 10.1093/ehjci/jey187

    [20]

    Zhang R, Dou K, Guan C, et al. Outcomes of quantitative flow ratio-based percutaneous coronary intervention in an all-comers study[J]. EuroIntervention, 2022, 17(15): 1240-1251. doi: 10.4244/EIJ-D-21-00176

    [21]

    Bär S, Kavaliauskaite R, Ueki Y, et al. Quantitative Flow Ratio to Predict Nontarget Vessel-Related Events at 5 Years in Patients With ST-Segment-Elevation Myocardial Infarction Undergoing Angiography-Guided Revascularization[J]. J Am Heart Assoc, 2021, 10(9): e019052. doi: 10.1161/JAHA.120.019052

    [22]

    Zhang R, Xu B, Dou K, et al. Post-PCI outcomes predicted by pre-intervention simulation of residual quantitative flow ratio using augmented reality[J]. Int J Cardiol, 2022, 352: 33-39. doi: 10.1016/j.ijcard.2022.01.054

    [23]

    Xu B, Tu S, Song L, et al. Angiographic quantitative flow ratio-guided coronary intervention(FAVOR Ⅲ China): a multicentre, randomised, sham-controlled trial[J]. Lancet, 2021, 398(10317): 2149-2159. doi: 10.1016/S0140-6736(21)02248-0

    [24]

    Lee JM, Koo BK, Shin ES, et al. Clinical implications of three-vessel fractional flow reserve measurement in patients with coronary artery disease[J]. Eur Heart J, 2018, 39(11): 945-951. doi: 10.1093/eurheartj/ehx458

    [25]

    Lee CH, Choi SW, Hwang J, et al. 5-Year Outcomes According to FFR of Left Circumflex Coronary Artery After Left Main Crossover Stenting[J]. JACC Cardiovasc Interv, 2019, 12(9): 847-855. doi: 10.1016/j.jcin.2019.02.037

    [26]

    Hwang D, Koo BK, Zhang J, et al. Prognostic Implications of Fractional Flow Reserve After Coronary Stenting: A Systematic Review and Meta-analysis[J]. JAMA Netw Open, 2022, 5(9): e2232842. doi: 10.1001/jamanetworkopen.2022.32842

    [27]

    Fournier S, Ciccarelli G, Toth GG, et al. Association of Improvement in Fractional Flow Reserve With Outcomes, Including Symptomatic Relief, After Percutaneous Coronary Intervention[J]. JAMA Cardiol, 2019, 4(4): 370-374. doi: 10.1001/jamacardio.2019.0175

    [28]

    Biscaglia S, Tebaldi M, Brugaletta S, et al. Prognostic Value of QFR Measured Immediately After Successful Stent Implantation: The International Multicenter Prospective HAWKEYE Study[J]. JACC Cardiovasc Interv, 2019, 12(20): 2079-2088. doi: 10.1016/j.jcin.2019.06.003

    [29]

    Kogame N, Takahashi K, Tomaniak M, et al. Clinical Implication of Quantitative Flow Ratio After Percutaneous Coronary Intervention for 3-Vessel Disease[J]. JACC Cardiovasc Interv, 2019, 12(20): 2064-2075. doi: 10.1016/j.jcin.2019.08.009

    [30]

    Zhang R, Wu S, Yuan S, et al. Effects of diabetes mellitus on post-intervention coronary physiological assessment derived by quantitative flow ratio in patients with coronary artery disease underwent percutaneous coronary intervention[J]. Diabetes Res Clin Pract, 2022, 186: 109839. doi: 10.1016/j.diabres.2022.109839

    [31]

    You W, Zhou Y, Wu Z, et al. Post-PCI quantitative flow ratio predicts 3-year outcome after rotational atherectomy in patients with heavily calcified lesions[J]. Clin Cardiol, 2022, 45(5): 558-566. doi: 10.1002/clc.23816

    [32]

    Yu W, Huang J, Jia D, et al. Diagnostic accuracy of intracoronary optical coherence tomography-derived fractional flow reserve for assessment of coronary stenosis severity[J]. EuroIntervention, 2019, 15(2): 189-197. doi: 10.4244/EIJ-D-19-00182

    [33]

    Huang Y, Lin Z, Wu Q, et al. Morphometric Assessment for Functional Evaluation of Coronary Stenosis with Optical Coherence Tomography and the Optical Flow Ratio in a Vessel with Single Stenosis[J]. J Clin Med, 2022, 11(17): 5198. doi: 10.3390/jcm11175198

    [34]

    Huang J, Emori H, Ding D, et al. Diagnostic performance of intracoronary optical coherence tomography-based versus angiography-based fractional flow reserve for the evaluation of coronary lesions[J]. EuroIntervention, 2020, 16(7): 568-576. doi: 10.4244/EIJ-D-19-01034

    [35]

    Gutiérrez-Chico JL, Chen Y, Yu W, et al. Diagnostic accuracy and reproducibility of optical flow ratio for functional evaluation of coronary stenosis in a prospective series[J]. Cardiol J, 2020, 27(4): 350-361. doi: 10.5603/CJ.a2020.0071

    [36]

    Geng L, Shi X, Yuan Y, et al. Anatomical and Functional Discrepancy in Diabetic Patients With Intermediate Coronary Lesions-An Intravascular Ultrasound and Quantitative Flow Ratio Study[J]. Circ J, 2023, 87(2): 320-328. doi: 10.1253/circj.CJ-22-0238

    [37]

    Milzi A, Dettori R, Burgmaier K, et al. Quantitative Flow Ratio Is Related to Intraluminal Coronary Stenosis Parameters as Assessed with Optical Coherence Tomography[J]. J Clin Med, 2021, 10(9): 1856. doi: 10.3390/jcm10091856

    [38]

    Dobrolińska MM, Gąsior PM, Pociask E, et al. Performance of Integrated Near-Infrared Spectroscopy and Intravascular Ultrasound(NIRS-IVUS)System against Quantitative Flow Ratio(QFR)[J]. Diagnostics(Basel), 2021, 11(7): 1148.

    [39]

    Li X, Sun S, Luo D, et al. Microvascular and Prognostic Effect in Lesions With Different Stent Expansion During Primary PCI for STEMI: Insights From Coronary Physiology and Intravascular Ultrasound[J]. Front Cardiovasc Med, 2022, 9: 816387. doi: 10.3389/fcvm.2022.816387

    [40]

    Lee JM, Choi G, Koo BK, et al. Identification of High-Risk Plaques Destined to Cause Acute Coronary Syndrome Using Coronary Computed Tomographic Angiography and Computational Fluid Dynamics[J]. JACC Cardiovasc Imaging, 2019, 12(6): 1032-1043. doi: 10.1016/j.jcmg.2018.01.023

    [41]

    Buono A, Mühlenhaus A, Schäfer T, et al. QFR Predicts the Incidence of Long-Term Adverse Events in Patients with Suspected CAD: Feasibility and Reproducibility of the Method[J]. J Clin Med, 2020, 9(1): 220. doi: 10.3390/jcm9010220

    [42]

    Tu S, Ding D, Chang Y, et al. Diagnostic accuracy of quantitative flow ratio for assessment of coronary stenosis significance from a single angiographic view: A novel method based on bifurcation fractal law[J]. Catheter Cardiovasc Interv, 2021, 97 Suppl 2: 1040-1047.

    [43]

    Cortés C, Liu L, Berdin SL, et al. Agreement between Murray law-based quantitative flow ratio(μQFR)and three-dimensional quantitative flow ratio(3D-QFR)in non-selected angiographic stenosis: A multicenter study[J]. Cardiol J, 2022, 29(3): 388-395. doi: 10.5603/CJ.a2022.0030

    [44]

    Mejía-Rentería H, Lee JM, Lauri F, et al. Influence of Microcirculatory Dysfunction on Angiography-Based Functional Assessment of Coronary Stenoses[J]. JACC Cardiovasc Interv, 2018, 11(8): 741-753. doi: 10.1016/j.jcin.2018.02.014

    [45]

    Mejia-Renteria H, Lee JM, Choi KH, et al. Coronary microcirculation assessment using functional angiography: Development of a wire-free method applicable to conventional coronary angiograms[J]. Catheter Cardiovasc Interv, 2021, 98(6): 1027-1037. doi: 10.1002/ccd.29863

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出版历程
收稿日期:  2022-12-14
刊出日期:  2023-11-13

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