Weryfikacja użyteczności klinicznej iFR a potencjał optymalizacji metody
Streszczenie
Pomiarem iFR jest stosowany w ocenie istotności zwężeń w tętnicach wieńcowych niewymagającym stosowania środków indukujących hiperemię. Opiera się on na gradiencie ciśnień w spoczynku i umożliwia podejmowanie decyzji w kwestii przezskórnej interwencji wieńcowej. Do tej pory udowodniono, iż iFR jest równorzędnym pomiarem w stosunku do rutynowo już używanego FFR, niemniej jednak jest to nadal rozwijająca się metoda. W niniejszym artykule przedstawiono nie tylko wyniki najnowszych badań klinicznych, w których oceniano bezpieczeństwo i skuteczność stosowania iFR, ale również stosowanie iFR w ostrym zespole wieńcowym, wykorzystanie korejestracji w optymalizowaniu zabiegów PCI, a także analizę efektywności kosztowej tej metody.
Słowa kluczowe: gradient ciśnieńPd/PakorejestracjaiFR pullback
Referencje
- Bil J. iFR — alternatywne narzędzie do oceny czynnościowej zwężeń w tętnicach wieńcowych. Kardiologia Inwazyjna. 2015; 10(4): 20–24.
- Matsuo H, Kawase Y. FFR and iFR guided percutaneous coronary intervention. Cardiovasc Interv Ther. 2016; 31(3): 183–195.
- Götberg M, Cook CM, Sen S, et al. The Evolving Future of Instantaneous Wave-Free Ratio and Fractional Flow Reserve. J Am Coll Cardiol. 2017; 70(11): 1379–1402.
- Gould K, Lipscomb K, Hamilton G. Physiologic basis for assessing critical coronary stenosis. The American Journal of Cardiology. 1974; 33(1): 87–94.
- Matsuo H. Effect of Aging on Fractional Flow Reserve - Hyperemic Index Fractional Flow Reserve May Not Be Sufficient to Reveal the Whole Picture of Coronary Circulation. Circ J. 2016; 80(7): 1527–1528.
- Broyd CJ, Davies JE, Escaned JE, et al. Wave intensity analysis and its application to the coronary circulation. Glob Cardiol Sci Pract. 2017; 2017(1): e201705.
- Nijjer SS, de Waard GA, Sen S, et al. Coronary pressure and flow relationships in humans: phasic analysis of normal and pathological vessels and the implications for stenosis assessment: a report from the Iberian-Dutch-English (IDEAL) collaborators. Eur Heart J. 2016; 37(26): 2069–2080.
- Lee JM, Park J, Hwang D, et al. Similarity and Difference of Resting Distal to Aortic Coronary Pressure and Instantaneous Wave-Free Ratio. J Am Coll Cardiol. 2017; 70(17): 2114–2123.
- Kobayashi Y, Johnson NP, Zimmermann FM, et al. CONTRAST Study Investigators. Agreement of the Resting Distal to Aortic Coronary Pressure With the Instantaneous Wave-Free Ratio. J Am Coll Cardiol. 2017; 70(17): 2105–2113.
- Shiode N, Okimoto T, Tamekiyo H, et al. A Comparison between the Instantaneous Wave-free Ratio and Resting Distal Coronary Artery Pressure/Aortic Pressure and the Fractional Flow Reserve: The Diagnostic Accuracy Can Be Improved by the Use of both Indices. Intern Med. 2017; 56(7): 749–753.
- Petraco R, Escaned J, Sen S, et al. Classification performance of instantaneous wave-free ratio (iFR) and fractional flow reserve in a clinical population of intermediate coronary stenoses: results of the ADVISE registry. EuroIntervention. 2013; 9(1): 91–101.
- Sen S, Escaned J, Malik IS, et al. Development and validation of a new adenosine-independent index of stenosis severity from coronary wave-intensity analysis: results of the ADVISE (ADenosine Vasodilator Independent Stenosis Evaluation) study. J Am Coll Cardiol. 2012; 59(15): 1392–1402.
- Götberg M, Christiansen EH, Gudmundsdottir IJ, et al. iFR-SWEDEHEART Investigators. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med. 2017; 376(19): 1813–1823.
- Sen S, Asrress KN, Nijjer S, et al. Diagnostic classification of the instantaneous wave-free ratio is equivalent to fractional flow reserve and is not improved with adenosine administration. Results of CLARIFY (Classification Accuracy of Pressure-Only Ratios Against Indices Using Flow Study). J Am Coll Cardiol. 2013; 61(13): 1409–1420.
- Waard Gde, Danad I, Cunha Rda, et al. HYPEREMIC FFR AND BASELINE IFR HAVE AN EQUIVALENT DIAGNOSTIC ACCURACY WHEN COMPARED TO MYOCARDIAL BLOOD FLOW QUANTIFIED BY H215O PET PERFUSION IMAGING. Journal of the American College of Cardiology. 2014; 63(12): A1692.
- Petraco R, van de Hoef TP, Nijjer S, et al. Baseline instantaneous wave-free ratio as a pressure-only estimation of underlying coronary flow reserve: results of the JUSTIFY-CFR Study (Joined Coronary Pressure and Flow Analysis to Determine Diagnostic Characteristics of Basal and Hyperemic Indices of Functional Lesion Severity-Coronary Flow Reserve). Circ Cardiovasc Interv. 2014; 7(4): 492–502.
- Hwang D, Jeon KH, Lee JM, et al. Diagnostic Performance of Resting and Hyperemic Invasive Physiological Indices to Define Myocardial Ischemia: Validation With N-Ammonia Positron Emission Tomography. JACC Cardiovasc Interv. 2017; 10(8): 751–760.
- Härle T, Bojara W, Meyer S, et al. Comparison of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR)--first real world experience. Int J Cardiol. 2015; 199: 1–7.
- Ding WY, Nair S, Appleby C. Diagnostic accuracy of instantaneous wave free-ratio in clinical practice. J Interv Cardiol. 2017; 30(6): 564–569.
- Davies J, Sen S, Dehbi HM, et al. Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. New England Journal of Medicine. 2017; 376(19): 1824–1834.
- Götberg M, Christiansen EH, Gudmundsdottir IJ, et al. iFR-SWEDEHEART Investigators. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med. 2017; 376(19): 1813–1823.
- Nijjer SS, Sen S, Petraco R, et al. Advances in coronary physiology. Circ J. 2015; 79(6): 1172–1184.
- Nijjer SS, Sen S, Petraco R, et al. Pre-angioplasty instantaneous wave-free ratio pullback provides virtual intervention and predicts hemodynamic outcome for serial lesions and diffuse coronary artery disease. JACC Cardiovasc Interv. 2014; 7(12): 1386–1396.
- Nijjer SS, Sen S, Petraco R, et al. Pre-angioplasty instantaneous wave-free ratio pullback provides virtual intervention and predicts hemodynamic outcome for serial lesions and diffuse coronary artery disease. JACC Cardiovasc Interv. 2014; 7(12): 1386–1396.
- Nijjer SS, Sen S, Petraco R, et al. The Instantaneous wave-Free Ratio (iFR) pullback: a novel innovation using baseline physiology to optimise coronary angioplasty in tandem lesions. Cardiovasc Revasc Med. 2015; 16(3): 167–171.
- iFR Cheaper Than FFR Over Trajectory of 1 Year: DEFINE-FLAIR Analysis. https://www.tctmd.com/news/ifr-cheaper-ffr-over-trajectory-1-year-define-flair-analysis.