全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

冠状动脉CT血流储备分数研究进展
Advances in Coronary CT Flow Reserve Frac-tion Studies

DOI: 10.12677/ACM.2023.13112551, PP. 18182-18188

Keywords: 冠心病,血流储备分数,冠状动脉CT血管成像,CT-FFR
Coronary Artery Disease
, Fractional Flow Reserve, Coronary CT Angiography, CT-FFR

Full-Text   Cite this paper   Add to My Lib

Abstract:

血流储备分数值(Fractional flow reserve, FFR)是评价冠状动脉生理功能的金标准,但介入性有创操作限制了其在临床实践中的广泛应用。近些年来,已经开发出从冠状动脉CT血管成像(Coronary CT angiography, CCTA)中获取功能信息的新方法,即利用CCTA提供的解剖学信息与流体动力学算法相结合,从CCTA图像数据集中计算FFR。计算机断层扫描衍生的血流储备分数值(CT derived fractional flow reserve, CT-FFR)能够无创地识别病变生理特性,CT-FFR建模技术提供了整个冠状动脉树的FFR,同时CT-FFR与FFR的良好相关性有助于引导冠心病(Coronary artery disease, CAD)患者选择最佳治疗策略,并提高治疗预期。本文对国内外有关FFR检测方法及临床进展进行综述,旨在为相关人员提供参考借鉴。
Fractional flow reserve (FFR) is the gold standard for evaluating the physiological function of coro-nary vessels, but its widespread use in clinical practice is limited by the invasive nature of the in-tervention. In recent years, new methods have been developed to obtain functional information from coronary CT angiography (CCTA). That is, the anatomical information provided by CCTA is used in combination with computational fluid dynamics to calculate FFR values from CCTA image da-tasets. Computed tomography-derived fractional flow reserve (CT-FFR) can identify the physiologi-cal characteristics of the lesion noninvasively, and CT-FFR modeling provides FFR values of the en-tire coronary tree, while the good correlation between CT-FFR and FFR can help guide the selection of patients with coronary artery disease (CAD) patients to choose the best treatment strategy and improve treatment expectations. In this paper, we review the FFR detection methods and clinical advances at home and abroad, aiming to provide reference for relevant personnel.

References

[1]  Lozano, R., Naghavi, M., Foreman, K., et al. (2012) Global and Regional Mortality from 235 Causes of Death for 20 Age Groups in 1990 and 2010: A Systematic Analysis for the Global Burden of Disease Study 2010. The Lancet, 380, 2095-2128.
https://doi.org/10.1016/S0140-6736(12)61728-0
[2]  GBD 2019 Diseases and Injuries Collaborators (2020) Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet, 396, 1204-1222.
[3]  Min, J.K., Taylor, C.A., Achenbach, S., et al. (2015) Noninvasive Fractional Flow Reserve Derived from Coronary CT Angiography: Clinical Data and Sci-entific Principles. JACC: Cardiovascular Imaging, 8, 1209-1222.
https://doi.org/10.1016/j.jcmg.2015.08.006
[4]  Pijls, N.H. and De Bruyne, B. (1998) Coronary Pressure Meas-urement and Fractional Flow Reserve. Heart, 80, 539-542.
https://doi.org/10.1136/hrt.80.6.539
[5]  Neumann, F.J., Sousa-Uva, M., Ahlsson, A., et al. (2019) 2018 ESC/EACTS Guidelines on Myocardial Revascularization. EuroInter-vention, 14, 1435-1534.
https://doi.org/10.4244/EIJY19M01_01
[6]  Levine, G.N., Bates, E.R., Blankenship, J.C., et al. (2011) 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation, 124, 2574-2609.
https://doi.org/10.1161/CIR.0b013e31823a5596
[7]  Windecker, S., Kolh, P., Alfonso, F., et al. (2014) 2014 ESC/EACTS Guidelines on Myocardial Revascularization: The Task Force on Myocardial Revascularization of the Eu-ropean Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the Special Contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eu-ropean Heart Journal, 35, 2541-2619.
https://doi.org/10.1093/eurheartj/ehu278
[8]  徐磊, 张龙江, 张佳胤, 等. 无创性CT血流储备分数研究现状与展望[J]. 中华放射学杂志, 2020, 54(10): 921-924.
https://doi.org/10.3760/cma.j.cn112149-20200807-00991
[9]  Tonino, P.A., Fearon, W.F., De Bruyne, B., et al. (2010) Angiographic versus Functional Severity of Coronary Artery Stenoses in the FAME Study Fractional Flow Re-serve versus Angiography in Multivessel Evaluation. Journal of the American College of Cardiology, 55, 2816-2821.
https://doi.org/10.1016/j.jacc.2009.11.096
[10]  Gould, K.L. and Lipscomb, K. (1974) Effects of Coronary Stenoses on Coronary Flow Reserve and Resistance. The American Journal of Cardiology, 34, 48-55.
https://doi.org/10.1016/0002-9149(74)90092-7
[11]  Pijls, N.H., De Bruyne, B., Peels, K., et al. (1996) Measure-ment of Fractional Flow Reserve to Assess the Functional Severity of Coronary-Artery Stenoses. The New England Journal of Medicine, 334, 1703-1708.
https://doi.org/10.1056/NEJM199606273342604
[12]  Nazir, M.S., Mittal, T.K., Weir-Mccall, J., et al. (2020) Op-portunities and Challenges of Implementing Computed Tomography Fractional Flow Reserve into Clinical Practice. Heart, 106, 1387-1393.
https://doi.org/10.1136/heartjnl-2019-315607
[13]  Gao, Z., Wang, X., Sun, S., et al. (2020) Learning Physical Properties in Complex Visual Scenes: An Intelligent Machine for Perceiving Blood Flow Dynamics from Static CT An-giography Imaging. Neural Networks, 123, 82-93.
https://doi.org/10.1016/j.neunet.2019.11.017
[14]  Bech, G.J., De Bruyne, B, Pijls, N.H., et al. (2001) Fractional Flow Reserve to Determine the Appropriateness of Angioplasty in Moderate Coronary Stenosis: A Randomized Trial. Circulation, 103, 2928-2934.
https://doi.org/10.1161/01.CIR.103.24.2928
[15]  De Bruyne, B., Fearon, W.F., Pijls, N.H., et al. (2014) Fractional Flow Reserve-Guided PCI for Stable Coronary Artery Disease. The New England Journal of Medicine, 371, 1208-1217.
https://doi.org/10.1056/NEJMoa1408758
[16]  Pijls, N.H. and Sels, J.W. (2012) Functional measure-ment of Coronary Stenosis. Journal of the American College of Cardiology, 59, 1045-1057.
https://doi.org/10.1016/j.jacc.2011.09.077
[17]  Liu, X., Wang, Y., Zhang, H., et al. (2019) Evaluation of Fractional Flow Reserve in Patients with Stable Angina: Can CT Compete with Angiography? European Radiology, 29, 3669-3677.
https://doi.org/10.1007/s00330-019-06023-z
[18]  Norgaard, B.L., Jensen, J.M. and Leipsic, J. (2015) Fractional Flow Reserve Derived from Coronary CT Angiography in Stable Coronary Disease: A New Standard in Non-Invasive Testing? European Radiology, 25, 2282-2290.
https://doi.org/10.1007/s00330-015-3619-1
[19]  Coenen, A., Kim, Y.H., Kruk, M., et al. (2018) Diagnostic Accu-racy of a Machine-Learning Approach to Coronary Computed Tomographic Angiography-Based Fractional Flow Re-serve: Result from the Machine Consortium. Circulation: Cardiovascular Imaging, 11, e007217.
https://doi.org/10.1161/CIRCIMAGING.117.007217
[20]  Itu, L., Rapaka, S., Passerini, T., et al. (1985) A Ma-chine-Learning Approach for Computation of Fractional Flow Reserve from Coronary Computed Tomography. Journal of Applied Physiology, 121, 42-52.
https://doi.org/10.1152/japplphysiol.00752.2015
[21]  杨琳, 徐磊, 徐超, 等. 基于示踪动力学的冠状动脉CT血流储备分数诊断冠状动脉缺血病变的初步研究[J]. 中华放射学杂志, 2020, 54(10): 941-947.
[22]  Fujii, Y., Kitagawa, T., Ikenaga, H., et al. (2023) The Reliability and Utility of On-Site CT-Derived Fractional Flow Reserve (FFR) Based on Fluid Structure Interactions: Comparison with FFR(CT) Based on Computational Fluid Dynamics, Invasive FFR, and Resting Full-Cycle Ratio. Heart and Vessels, 38, 1095-1107.
https://doi.org/10.1007/s00380-023-02265-6
[23]  Casanova-Sandoval, J., Fernández-Rodríguez, D., Otaegui, I., et al. (2021) Usefulness of the Hybrid RFR-FFR Approach: Results of a Prospective and Multicenter Analysis of Diagnos-tic Agreement between RFR and FFR—The RECOPA (REsting Full-Cycle Ratio Comparation versus Fractional Flow Reserve (A Prospective Validation)) Study. Journal of Interventional Cardiology, 2021, Article ID: 5522707.
https://doi.org/10.1155/2021/5522707
[24]  Driessen, R.S., Danad, I., Stuijfzand, W.J., et al. (2019) Comparison of Coronary Computed Tomography Angiography, Fractional Flow Reserve, and Perfusion Imaging for Ischemia Diagno-sis. Journal of the American College of Cardiology, 73, 161-173.
https://doi.org/10.1016/j.jacc.2018.10.056
[25]  Coenen, A., Rossi, A., Lubbers, M.M., et al. (2017) Integrating CT Myocardial Perfusion and CT-FFR in the Work-Up of Coronary Artery Disease. JACC: Cardiovascular Imaging, 10, 760-770.
https://doi.org/10.1016/j.jcmg.2016.09.028
[26]  Pontone, G., Baggiano, A., Andreini, D., et al. (2019) Stress Computed Tomography Perfusion versus Fractional Flow Reserve CT Derived in Suspected Coronary Artery Disease: The Perfection Study. JACC: Cardiovascular Imaging, 12, 1487-1497.
https://doi.org/10.1016/j.jcmg.2018.08.023
[27]  Nakanishi, R., Osawa, K., Ceponiene, I., et al. (2017) The Diag-nostic Performance of SPECT-MPI to Predict Functional Significant Coronary Artery Disease by Fractional Flow Re-serve Derived from CCTA (FFR(CT)): Sub-Analysis from ACCURACY and VCT001 Studies. The International Journal of Cardiovascular Imaging, 33, 2067-2072.
https://doi.org/10.1007/s10554-017-1207-y
[28]  Zhao, N., Gao, Y., Xu, B., et al. (2021) Effect of Coronary Calcification Severity on Measurements and Diagnostic Performance of CT-FFR with Computational Fluid Dynamics: Results from CT-FFR CHINA Trial. Frontiers in Cardiovascular Medicine, 8, Article 810625.
https://doi.org/10.3389/fcvm.2021.810625
[29]  Peper, J., Becker, L.M., Van Den Berg, H., et al. (2022) Diagnostic Performance of CCTA and CT-FFR for the Detection of CAD in TAVR Work-Up. JACC: Cardiovascular Interventions, 15, 1140-1149.
https://doi.org/10.1016/j.jcin.2022.03.025
[30]  Tonino, P.A., De Bruyne, B., Pijls, N.H., et al. (2009) Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention. The New England Journal of Medi-cine, 360, 213-224.
https://doi.org/10.1056/NEJMoa0807611
[31]  Pijls, N.H., Fearon, W.F., Tonino, P.A., et al. (2010) Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary Intervention in Patients with Multivessel Coro-nary Artery Disease: 2-Year Follow-Up of the FAME (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) Study. Journal of the American College of Cardiology, 56, 177-184.
https://doi.org/10.1016/j.jacc.2010.04.012
[32]  Koo, B.K., Erglis, A., Doh, J.H., et al. (2011) Diagnosis of Ische-mia-Causing Coronary Stenoses by Noninvasive Fractional Flow Reserve Computed from Coronary Computed Tomo-graphic Angiograms. Results from the Prospective Multicenter DISCOVER-FLOW (Diagnosis of Ischemia-Causing Stenoses Obtained via Noninvasive Fractional Flow Reserve) Study. Journal of the American College of Cardiology, 58, 1989-1997.
https://doi.org/10.1016/j.jacc.2011.06.066
[33]  Min, J.K., Leipsic, J., Pencina, M.J., et al. (2012) Diagnostic Accu-racy of Fractional Flow Reserve from Anatomic CT Angiography. JAMA, 308, 1237-1245.
https://doi.org/10.1001/2012.jama.11274
[34]  Kim, K.H., Doh, J.H., Koo, B.K., et al. (2014) A Novel Noninvasive Technology for Treatment Planning Using Virtual Coronary Stenting and Computed Tomography-Derived Computed Fractional Flow Reserve. JACC: Cardiovascular Interventions, 7, 72-78.
https://doi.org/10.1016/j.jcin.2013.05.024
[35]  Norgaard, B.L., Leipsic, J., Gaur, S., et al. (2014) Diagnostic Per-formance of Noninvasive Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography in Suspected Coronary Artery Disease: The NXT Trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). Journal of the American College of Cardiology, 63, 1145-1155.
https://doi.org/10.1016/j.jcin.2013.05.024
[36]  Renker, M., Schoepf, U.J., Wan, G.R., et al. (2014) Comparison of Diagnostic Value of a Novel Noninvasive Coronary Computed Tomography Angiography Method versus Standard Coronary Angiography for Assessing Fractional Flow Reserve. The American Journal of Cardiology, 114, 1303-1308.
https://doi.org/10.1016/j.amjcard.2014.07.064
[37]  Coenen, A., Lubbers, M.M., Kurata, A., et al. (2015) Fractional Flow Reserve Computed from Noninvasive CT Angiography Data: Diagnostic Performance of an On-Site Clini-cian-Operated Computational Fluid Dynamics Algorithm. Radiology, 274, 674-683.
https://doi.org/10.1148/radiol.14140992
[38]  Wolfrum, M., De Maria, G.L., Benenati, S., et al. (2018) What Are the Causes of a Suboptimal FFR after Coronary Stent Deployment? Insights from a Consecutive Series Using OCT Im-aging. EuroIntervention, 14, e1324-e1331.
https://doi.org/10.4244/EIJ-D-18-00071
[39]  Hakeem, A. and Uretsky, B.F. (2019) Role of Postintervention Frac-tional Flow Reserve to Improve Procedural and Clinical Outcomes. Circulation, 139, 694-706.
https://doi.org/10.1161/CIRCULATIONAHA.118.035837
[40]  Schuijf, J.D., Ko, B.S., Di Carli, M.F., et al. (2018) Fractional Flow Reserve and Myocardial Perfusion by Computed Tomography: A Guide to Clinical Application. Euro-pean Heart Journal Cardiovascular Imaging, 19, 127-315.
https://doi.org/10.1093/ehjci/jex240
[41]  Mallidi, J. and Lotfi, A. (2015) Fractional Flow Reserve for the Evaluation of Tandem and Bifurcation Lesions, Left Main, and Acute Coronary Syndromes. Interventional Cardiology Clinics, 4, 471-480.
https://doi.org/10.1016/j.iccl.2015.06.007
[42]  Conte, E., Sonck, J., Mushtaq, S., et al. (2020) FFR (CT) and CT Perfusion: A Review on the Evaluation of Functional Impact of Coronary Artery Stenosis by Cardiac CT. International Journal of Cardiology, 300, 289-296.
https://doi.org/10.1016/j.ijcard.2019.08.018

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133