Fractional flow reserve of infarct-related arteries identifies reversible defects on noninvasive myocardial perfusion imaging early after myocardial infarction.
Fractional flow reserve of infarct-related arteries identifies reversible defects on noninvasive myocardial perfusion imaging early after myocardial infarction.
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梗塞相关动脉的血流储备分数可识别心肌梗塞后早期无创心肌灌注成像的可逆性缺陷。
DOI：
10.1016/j.jacc.2006.01.065
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Barringhaus,KurtG
中科院分区：
文献类型：
--
作者：
Samady,Habib;Lepper,Wolfgang;Powers,EricR;Wei,Kevin;Ragosta,Michael;Bishop,GregoryG;Sarembock,IanJ;Gimple,Lawrence;Watson,DennyD;Beller,GeorgeA;Barringhaus,KurtG
ObjectivesWe hypothesized，fractional flow reserve（FFR）of an infarct related artery（伊拉）early after myocardial infarction（MI）identifies inducible ischemia on noninvasive imaging. BackgroundMI后早期，IRA经常有血管造影不确定的病变。血流储备分数是否可以检测可逆灌注缺陷MI后早期动态微血管异常present.MethodsRest和潘生丁（DP）-应力99 mTc司他米比单光子发射计算机断层扫描（SPECT）进行了48例MI后3.7 ± 1.3天，与23例患者同时进行心肌声学造影（MCE）。随后进行了伊拉的血管造影、FFR和经皮冠状动脉介入治疗（PCI）（必要时）。结果血流储备分数≤0.75检测SPECT可逆性的敏感性、特异性、阳性和阴性预测值及一致性分别为88%、50%、68%、89%和71%（卡方<0.001）;对于真实可逆性的检测，分别提高到88%、93%、88%、93%和91%（卡方<0.001）。检测DP-MCE可逆性的FFR ≤ 0. 75的相应值分别为90%、100%、100%、75%和93%（卡方<0. 001），SPECT或MCE分别为88%、93%、91%、91%和91%（卡方<0. 001）。在无创性心肌显像中，鉴别可诱发性心肌缺血的最佳血流储备分数为0.78。结论在无创性心肌显像中，伊拉血流储备分数可准确鉴别心肌梗死后早期的可逆性。这些发现支持心肌梗死后早期FFR的效用。
ObjectivesWe hypothesized that fractional flow reserve (FFR) of an infarct-related artery (IRA) early after myocardial infarction (MI) identifies inducible ischemia on noninvasive imaging.BackgroundEarly after MI, IRAs frequently have angiographically indeterminant lesions. Whether FFR can detect reversible perfusion defects early after MI when dynamic microvascular abnormalities are present is not known.MethodsRest and dipyridamole (DP)-stress99mTc sestamibi single-photon emission computed tomography (SPECT) were performed in 48 patients 3.7 ± 1.3 days after MI, with 23 patients undergoing concurrent myocardial contrast echocardiography (MCE). Angiography, FFR, and percutaneous coronary intervention (PCI) of the IRA (as necessary) were subsequently performed. Follow-up SPECT was performed 11 weeks after PCI to identify true reversibility on baseline SPECT.ResultsThe sensitivity, specificity, positive and negative predictive value, and concordance of FFR ≤0.75 for detecting reversibility on SPECT were 88%, 50%, 68%, 89%, and 71% (chi-square <0.001), respectively; which improved to 88%, 93%, 88%, 93%, and 91% (chi-square <0.001), respectively, for the detection of true reversibility. The corresponding values of FFR ≤0.75 for detecting reversibility on DP-MCE were 90%, 100%, 100%, 75%, and 93% (chi-square <0.001), respectively, and on either SPECT or MCE were 88%, 93%, 91%, 91%, and 91% (chi-square <0.001), respectively. The optimal FFR value for discriminating inducible ischemia on noninvasive imaging was 0.78.ConclusionsFractional flow reserve of the IRA accurately identifies reversibility on noninvasive imaging early after MI. These findings support the utility of FFR early after MI.
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影响因子：
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DOI：
10.3904/kjim.2002.17.1.7
发表时间：
2002-03
期刊：
The Korean journal of internal medicine
影响因子：
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DOI：
10.1016/s0002-9149(01)01887-2
发表时间：
2001
期刊：
The American journal of cardiology
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