Functional significance of intermediate coronary stenosis in patients with single-vessel coronary artery disease: A comparison of dynamic SPECT coronary flow reserve with intracoronary pressure-derived fractional flow reserve (FFR)
Functional significance of intermediate coronary stenosis in patients with single-vessel coronary artery disease: A comparison of dynamic SPECT coronary flow reserve with intracoronary pressure-derived fractional flow reserve (FFR)
复制标题
单支冠状动脉疾病患者中度冠状动脉狭窄的功能意义：动态 SPECT 冠状动脉血流储备与冠状动脉内压力衍生的血流储备分数 (FFR) 的比较。
DOI：
10.1007/s12350-020-02293-z
复制
发表时间：
2020-08-07
影响因子：
2.4
通讯作者：
Ge, Junbo
中科院分区：
文献类型：
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作者：
Li, Chenguang;Xu, Rende;Ge, Junbo
背景本研究的目的是研究在单支冠状动脉疾病（CAD）患者中通过静息/负荷心肌灌注成像和动态单光子发射计算机断层扫描（SPECT）评估的冠状动脉血流储备（CFR）与冠状动脉内压力衍生血流储备分数（FFR）的相关性。方法前瞻性入选可疑或已知稳定性CAD并转诊进行有创冠状动脉造影的患者。在单支血管中度冠状动脉狭窄的受试者中进行了有创FFR和SPECT。使用< 0.8的截止值定义血流储备分数异常。结果共纳入34例患者。受试者的平均年龄为62.1 ± 6.7岁，79.4%为男性。SPECT推导的CFR与FFR显示出显著的中度相关性（r = 0.505，P = 0.003）。对于CFR，在灵敏度、特异性和准确性方面识别异常FFR的诊断性能分别为88.9%、83.3%和87.9%，优化临界值为1.73。结论在单支冠状动脉病变中，SPECT CFR可用于检测功能显著性狭窄。我们的数据支持使用该技术作为血流动力学评估的可选方法，尤其是当FFR结果在正常范围内时。
Background The aim of this study was to investigate the correlation of coronary flow reserve (CFR) assessed by rest/stress myocardial perfusion imaging with dynamic single-photon emission computed tomography (SPECT) with intracoronary pressure-derived fractional flow reserve (FFR) in patients with single-vessel coronary artery disease (CAD). Methods Patients with suspected or known stable CAD who were referred for invasive coronary angiography were prospectively enrolled. Both invasive FFR and SPECT were performed in subjects with single-vessel intermediate coronary stenosis. A cutoff value of < 0.8 was used to define abnormal FFR. Results A total of 34 patients were enrolled. The mean age of the subjects was 62.1 +/- 6.7 years, and 79.4% were male. SPECT-derived CFR showed a significantly moderate correlation with FFR (r = 0.505,P = .003). The diagnostic performance for the identification of abnormal FFR in terms of sensitivity, specificity, and accuracy was 88.9%, 83.3%, and 87.9%, respectively, for CFR, with an optimized cutoff value of 1.73. Conclusion In patients with single-vessel CAD, SPECT CFR was useful for the detection of functionally significant stenosis. Our data support the use of this technique as an optional method for hemodynamic assessment, especially when FFR results are in normal range.