部分流量储备
医学
心脏病学
扬抑
主动脉压
冠状动脉
正电子发射断层摄影术
静水压力
内科学
核医学
动脉
金标准(测试)
冠状动脉疾病
冠状动脉造影
放射科
血流动力学
心肌梗塞
热力学
物理
作者
Adriaan Wilgenhof,Ruurt Jukema,Roel S. Driessen,Ibrahim Danad,Pieter G. Raijmakers,Niels van Royen,Lokien X. van Nunen,Takuya Mizukami,Guus A. de Waard,Paul Knaapen
摘要
Abstract Background Fractional flow reserve (FFR) has emerged as the invasive gold standard for assessing vessel‐specific ischemia. However, FFR measurements are influenced by the hydrostatic effect, which might adversely impact the assessment of ischemia. Aims This study aimed to investigate the impact of hydrostatic pressure on FFR measurements by correcting for the height and comparing FFR with [ 15 O]H 2 O positron emission tomography (PET)‐derived relative flow reserve (RFR). Methods The 206 patients were included in this analysis. Patients underwent coronary computed tomography angiography (CCTA), [ 15 O]H 2 O PET, and invasive coronary angiography with routine FFR in every epicardial artery. Height differences between the aortic guiding catheter and distal pressure sensor were quantified on CCTA images. An FFR ≤ 0.80 was considered significant. Results The study found a reclassification in 7% of the coronary arteries. Notably, 11% of left anterior descending (LAD) arteries were reclassified from hemodynamically significant to nonsignificant. Conversely, 6% of left circumflex (Cx) arteries were reclassified from nonsignificant to significant. After correcting for the hydrostatic pressure effect, the correlation between FFR and PET‐derived RFR increased significantly from r = 0.720 to r = 0.786 ( p = 0.009). The average magnitude of correction was +0.05 FFR units in the LAD, −0.03 in the Cx, and −0.02 in the right coronary artery. Conclusion Hydrostatic pressure has a small but clinically relevant influence on FFR measurements obtained with a pressure wire. Correcting for this hydrostatic error significantly enhances the correlation between FFR and PET‐derived RFR.
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