Pressure-derived measurement of coronary flow reserve
Pressure-derived measurement of coronary flow reserve
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DOI：
10.1016/j.jacc.2004.09.063
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发表时间：
2005-01-18
影响因子：
24
通讯作者：
De Bruyne, B
中科院分区：
文献类型：
--
作者：
MacCarthy, P;Berger, A;De Bruyne, B
我们的目的是验证技术的测量冠状动脉血流储备（CFR）与冠状动脉压力测量对一个既定的thermodilution technology. Background CFR传统上需要测量冠状动脉血流速度与多普勒线，最近，使用热稀释技术与冠状动脉压力线。然而，最近的研究表明，CFR可以单独从压力测量值中得出（充血期间心外膜狭窄处压降的平方根与静息时该值的比值）。这取决于整个冠状动脉狭窄的摩擦损失是可以忽略不计的假设。方法我们比较了压力推导的CFR值与那些通过热稀释技术获得的34例患者中的38个狭窄的冠状动脉狭窄进行经皮介入治疗的冠状动脉内压力线。我们还比较了这两种技术测量CFR在25个狭窄结果天然和人工类固醇的压力和热稀释CFR之间存在密切的线性关系（r（2）= 0.54; r（2）= 0.52; p < 0.001），而人工类固醇的压力和热稀释CFR之间存在密切的线性关系（r（2）= 0.52; p < 0.001）。p < 0.05），尽管在这两种情况下，压力衍生技术似乎系统性地低估了CFR值。这适用于本地和人工stenose.CONCLUSIONS冠状动脉血流储备不能仅仅用压力测量，它不能安全地假设，摩擦损失是可以忽略不计的整个本地冠状动脉狭窄。这些数据表明，摩擦损失是一个重要的决定因素的压力梯度沿着动脉粥样硬化冠状动脉。(C)2005年，美国心脏病学会基金会。
OBJECTIVES We aimed to validate the technique of measuring the coronary flow reserve (CFR) with coronary pressure measurements against an established thermodilution technique.BACKGROUND The CFR has traditionally required measurement of coronary blood flow velocity with the Doppler wire and, more recently, using a thermodilution technique with the coronary pressure wire. However, recent work has suggested that the CFR may be derived from pressure measurements alone (the ratio of the square root of the pressure drop across an epicardial stenosis during hyperemia to that value at rest). This depends on the assumption that friction losses across a coronary stenosis are negligible.METHODS We compared pressure-derived CFR values with those obtained by the thermodilution technique using the intracoronary pressure wire in 38 stenoses in 34 patients with significant coronary stenoses undergoing percutaneous intervention. We also compared these two techniques of measuring CFR in 25 stenoses (6 vessels) artificially created by inflating small balloons within a stented coronary artery after percutaneous intervention.RESULTS There is a close linear relationship between pressure-derived and thermodilution CFR in native (r(2) = 0.52; p < 0.001) and artificial sterroses (r(2) = 0.54; p < 0.05), although the pressure-derived technique appears to systematically underestimate CFR values in both situations. This applies to native and artificial stenoses.CONCLUSIONS Coronary flow reserve cannot be measured merely with pressure alone, and it cannot be safely assumed that friction losses are negligible across a native coronary stenosis. These data suggest that friction loss is an important determinant of the pressure gradient along an atherosclerotic coronary artery. (C) 2005 by the American College of Cardiology Foundation.