课件：FFR基本理论及临床意义.ppt

* * In a vessel without any stenosis the FFR is one (1.0). Nothing in the vessel disturbs the pressure. * * In the presence of a stenosis the pressure drops distal to the stenosis (compare to a kinked garden hose – the pressure after the kink isnt as high as before the kink). The FFR is 1; in this case 0.70 (Pd=70/Pa=100) * * The characteristics of FFR have been extensively described and validated over recent years. It has a sharp cut-off value to indicate inducible ischemia. FFR0.75 always indicates ischemia; FFR 0.80 excludes ischemia in 90% of the cases. The grey zone is very limited, which is important for clinical decision-making in an individual patient. * * Notes: * * Notes: * * A small perfusion area does not require as much blood flow as a large area. FFR always tells you to what extent a particular perfusion area is being supplied with blood, compared to what could be achieved by removing the stenosis. In this way FFR always gives the right information for deciding whether or not to intervene. * * An infarction reduces the perfusion area so that it no longer requires as much blood flow as if it were normal. FFR always tells you to what extent a particular perfusion area is being supplied with blood, compared to what could be achieved by removing the stenosis. * * In this case the collaterals are not developed well enough to be able to supply the myocardium with sufficient blood. The FFR is 0.70. * * Despite a severe stenosis, the myocardium may be receiving an adequate supply of blood from collaterals. In this case the collaterals are well developed. FFR takes into account the contribution of collateral blood supply to the perfusion area. FFR always provides the information necessary for deciding whether or not to intervene. * * * * * * FFR is measured during a diagnostic angiogram or angioplasty when the angio images are inconclusive and the cardiologist is uncertain how to treat the patient. FFR is used to assess for example single intermedia