通过冠状动脉压力测量进行经血管造影证实的冠状动脉中度狭窄的功能评估和治疗

作     者：Pirel M. Rioufol G. André-Fouёt X. G. Finet 高登峰 

作者机构：Serv. Hemodynamique/Cardiol. I. Hop. Cardiovasculaire Louis Pradel BP Lyon-Monchat 69394 Lyon Cedex 03 France Prof. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第3期

页      面：21-22页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：中度狭窄 血管造影 功能评估 血管成形术 压力测量 多血管病变 多巴酚丁胺 闪烁扫描 局部解剖结构 功能情况 

摘      要：Accurate understanding of the physiopathology of a coronary stenosis is a major objective in management during diagnostic coronary angiography. Measurement of fractional flow reserve(FFR) by coronary pressure measurement is a reliable method for evaluating the functional consequences of a lesion of the myocardium. This retrospective monocentric study of 114 patients showed that routine coronary pressure measurement for assessing the functional consequences of intermediate(30 to 70%stenosis) lesions or those of ambiguous topography: was necessary in 4%of diagnostic coronary angiographies enabling an immediate management decision. Using this method, 34%of complementary investigations were not performed(stress test, myocardial scintigraphy, dobutamine stress echocardiography). Seventeen per cent of unnecessary angioplasties were also avoided so that acute coronary event were also avoided when lesions with a FFR 0.75 were not treated by angioplasty. A 10-14%reduction in cost was achieved compared with a strategy of systematic angioplasty in respectively mono-or multi vessel disease patients and 39%compared with performing ambulatory myocardial scintigraphy in patients with multivessel disease.