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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 16 - 23 (8page)
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초록· 키워드
오류제보하기
Treatment strategies for patients with coronary artery disease (CAD) should be based on objective evidence of inducible ischemia in the subtended myocardium to improve clinical outcomes, symptoms, and cost-effectiveness. Fractional flow reserve (FFR) is the most verified index to-date for invasively evaluating lesion-specific myocardial ischemia. Favorable results from large clinical trials that applied FFR-guided percutaneous coronary intervention (PCI) prompted changes in coronary revascularization guidelines to emphasize the importance of this ischemia-based strategy using invasive coronary physiology. However, the frequency of functional evaluations is lacking in daily practice, and visual assessment still dominates treatment decisions in CAD patients. Despite recent efforts to integrate functional and anatomical assessments for coronary stenosis, there is considerable discordance between the 2 modalities, and the diagnostic accuracy of simple parameters obtained from current imaging tools is not satisfactory to determine functional significance. Although evidence that supports or justifies anatomy-guided PCI is more limited, and FFR-guided PCI is currently recommended, it is important to be aware of conditions and factors that influence FFR for accurate interpretation and application. In this article, we review the limitations of the current anatomy-derived evaluation of the functional significance of coronary stenosis, detail considerations for the clinical utility of FFR, and discuss the importance of an integrated physiologic approach to determine treatment strategies for CAD patients.
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등록된 정보가 없습니다.
참고문헌 (47)
참고문헌 신청
Hachamovitch R / 1998 / Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction / Circulation 97:535~543
Shaw LJ / 2008 / Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy / Circulation 117:1283~1291
Pijls NH / 2007 / Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study / J Am Coll Cardiol 49:2105~2111
Tonino PA / 2009 / Fractional flow reserve versus angiography for guiding percutaneous coronary intervention / N Engl J Med 360:213~224
Fearon WF / 2010 / Economic evaluation of fractional flow reserve-guided percutaneous coronary intervention in patients with multivessel disease / Circulation 122:2545~2550
Shaw LJ / 2008 / Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy / Circulation 117:1283~1291
Pijls NH / 2007 / Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study / J Am Coll Cardiol 49:2105~2111
Tonino PA / 2009 / Fractional flow reserve versus angiography for guiding percutaneous coronary intervention / N Engl J Med 360:213~224
Fearon WF / 2010 / Economic evaluation of fractional flow reserve-guided percutaneous coronary intervention in patients with multivessel disease / Circulation 122:2545~2550
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