Does Coronary Flow Trump Coronary Anatomy?

被引：160

作者：

Gould, K. Lance ^{[1
,2
]}

机构：

[1] Univ Texas Houston, Sch Med, Weatherhead PET Ctr Preventing & Reversing Athero, Houston, TX 77030 USA

[2] Mem Hermann Hosp, Houston, TX USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2009年 / 2卷 / 08期

关键词：

quantitative myocardial perfusion; quantitative cardiac PET; coronary flow; coronary stenosis; CAD; MYOCARDIAL-PERFUSION ABNORMALITIES; POSITRON-EMISSION-TOMOGRAPHY; ARTERY-DISEASE; NONINVASIVE ASSESSMENT; COMPUTED-TOMOGRAPHY; STENOSIS SEVERITY; EXPERIMENTAL VALIDATION; PRESSURE MEASUREMENTS; PHYSIOLOGIC BASIS; CARDIAC PET/CT;

D O I：

10.1016/j.jcmg.2009.06.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Coronary function versus anatomy, flow versus stenosis: which optimizes coronary artery disease (CAD) management? In patients, coronary flow is poorly related to stenosis severity, and revascularization fails to improve mortality over medical treatment in randomized trials. Yet percutaneous intervention (PCI) guided by fractional flow reserve reduces coronary events more than PCI guided by arteriographic stenosis. These paradoxes are explained by the poor relation between coronary flow reserve (CFR) and stenosis severity due to diffuse CAD, with surprising clinical implications. Should the concept of anatomically "critical" coronary stenosis be replaced by the concept of "critical" CFR reduction for managing CAD? (J Am Coll Cardiol Img 2009;2:1009-23) (C) 2009 by the American College of Cardiology Foundation

引用

页码：1009 / 1023

页数：15

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