Correlation of Fractional Flow Reserve With Ischemic Burden Measured by Cardiovascular Magnetic Resonance Perfusion Imaging
Correlation of Fractional Flow Reserve With Ischemic Burden Measured by Cardiovascular Magnetic Resonance Perfusion Imaging
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DOI：
10.1016/j.amjcard.2017.08.002
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发表时间：
2017-12-01
影响因子：
2.8
通讯作者：
Nagel, Eike
中科院分区：
文献类型：
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作者：
Hussain, Shazia T.;Paul, Matthias;Nagel, Eike
心血管磁共振(CMR)灌注成像和血流储备分数(FFR)评估心肌缺血。FFR测量狭窄处的压力损失，确定血流动力学意义，但不评估狭窄血管所覆盖的区域。CMR灌注成像测量心肌血流量减少的程度(=缺血负荷)。这两种技术都允许进行连续的评估，而不是绝对的评估，但人们对它们的关系知之甚少。本研究探讨FFR值与心肌缺血程度的关系。49例心绞痛患者接受了CMR灌注成像。FFR是在视线直径狭窄40%的血管中测量的。通过在CMR图像上勾画灌注缺损区并以左室心肌的百分比表示来测量每条冠状动脉的缺血程度。CmR测量的缺血范围与FFR之间具有良好的相关性(r=-0.85p<；0.0005)。平均FFR为0.67±0.17，平均血流灌注缺损率为8.9+/-9.3%。>；=0.75的FFR与CMR上的缺血无关。当FFR为0.4~0.5时，缺血量最大(23.0+/-1.5%)。单支病变患者(49%)的平均缺血负荷为153+/-8.3%。2支病变患者(18%)的平均缺血负荷为26.0+/-12%。缺血负荷测量的重复性很好，Kappa系数为k=0.826，p=0.048。结果表明，FFR值与心肌缺血量之间存在良好的相关性。(C)爱思唯尔公司出版的2017年。
Cardiovascular magnetic resonance (CMR) perfusion imaging and fractional flow reserve (FFR) assess myocardial ischemia. FFR measures the pressure loss across a stenosis determining hemodynamic significance but does not assess the area subtended by the stenotic vessel. CMR perfusion imaging measures the extent of myocardial blood flow reduction (=ischemic burden). Both techniques allow for continuous rather than categorical evaluation, but their relationship is poorly understood. This study investigates the relationship between the FFR value and the extent of myocardial ischemia. Forty-nine patients with angina underwent CMR perfusion imaging. FFR was measured in vessels with a visual diameter stenosis >40%. The extent of ischemia for each coronary artery was measured by delineating the perfusion defect on the CMR images and expressing as a percentage of the left ventricular myocardium. The correlation between the extent of ischemia measured by CMR and FFR was good (r = -0.85, p < 0.0005). The mean FFR value was 0.67 +/- 0.17, and the mean perfusion defect was 8.9 +/- 9.3%. An FFR value of >= 0.75 was not associated with ischemia on CMR. The maximum amount of ischemia (23.0 +/- 1.5%) was found at FFR values 0.4 to 0.5. In patients with 1 vessel disease (49%), the mean ischemic burden was 153 +/- 8.3%. In patients with 2 vessel diseases (18%), the mean ischemic burden was 26.0 +/- 12%. Reproducibility for the measurement of ischemic burden was very good with a Kappa coefficient (k = 0.826, p = 0.048). In conclusion, there is good correlation between the FFR value and the amount of myocardial ischemia in the subtended myocardium. (C) 2017 Published by Elsevier Inc.