Coronary flow reserve: a versatile tool for interrogating pathophysiology, and a reliable marker of cardiovascular outcomes and mortality.
Coronary flow reserve: a versatile tool for interrogating pathophysiology, and a reliable marker of cardiovascular outcomes and mortality.
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冠状动脉血流储备：一种用于研究病理生理学的多功能工具，也是心血管结果和死亡率的可靠标志。
DOI：
10.1093/eurheartj/ehac001
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发表时间：
2022
影响因子：
39.3
通讯作者：
Taqueti,VivianyR
中科院分区：
文献类型：
--
作者：
Taqueti,VivianyR
冠状动脉血流储备（CFR）是冠状动脉血管功能障碍的综合标志物，可量化大小冠状动脉血管对心肌组织灌注的血流动力学贡献。1，2 CFR计算为充血与静息绝对心肌血流量的比值，是一种灵敏度极高的心肌缺血指标，超出了可诱导的局部室壁运动异常或可见的灌注缺陷（图形摘要，A）。作为一种询问冠状动脉生理学的工具，它可以通过提供冠状动脉微血管功能障碍（CMD）的客观评估，为冠状动脉疾病（CAD）的全谱患者提供诊断价值，3包括那些对其心绞痛症状没有解剖学解释的患者。最近，CFR测量在2019年ESC慢性冠状动脉综合征诊断和管理指南（特别是无阻塞性CAD 4的心绞痛）以及2021年美国心脏协会/美国心脏病学会胸痛评价和诊断指南中获得了II类建议。5
Coronary flow reserve (CFR) is an integrated marker of coronary vasomotor dysfunction that quantifies the haemodynamic contribution of the large and small coronary vessels to myocardial tissue perfusion. 1, 2 Calculated as the ratio of hyperaemic to rest absolute myocardial blood flow, CFR is an exquisitely sensitive measure of myocardial ischaemia beyond inducible regional wall motion abnormalities or visible perfusion defects (Graphical Abstract, A). As a tool that interrogates coronary physiology, it can provide diagnostic value in patients across the full spectrum of coronary artery disease (CAD), 3 including those without anatomic explanations for their anginal symptoms by providing an objective assessment of coronary microvascular dysfunction (CMD). Recently, measurement of CFR received a class II recommendation in the 2019 ESC Guidelines on the Diagnosis and Management of Chronic Coronary Syndromes, specifically, angina without obstructive CAD 4 and also in the 2021 American Heart Association/American College of Cardiology Guideline for the Evaluation and Diagnosis of Chest Pain. 5