FFR的基本概念和技术课件.ppt

有没有什么更好的指标？ 有 FFR＝Qsmax /Qnmax =Pd/Pa 精品 Why Flow (Q) = Pressure 精品 Coronary Stenosis Rheology Pressure-Flow Relationship Pressure drop across stenosis increases with flow in a non-linear fashion Entrance effects Separation losses Friction loss 精品 FFR Definition 精品 FFR Definition 精品 FFR Definition 精品 FRACTIONAL FLOW RESERVE: The index FFR (Fractional Flow Reserve) is based upon the two following principles: It is not resting flow, but maximum achievable flow which determines the functional capacity (exercise tolerance) of a patient At maximum vasodilation (corresponding with maximum hyperemia or with maximum exercise), blood flow to the myocardium is proportional to myocardial perfusion pressure (~hyperemic distal coronary pressure) 精品 Normal Value of Myocardial Fractional Flow Reserve Normal FFR = 1 Pa Pd FFR = Pa Pd 精品 0.014” 3 cm Pressure Monitoring Guide Wires 精品 1、冠状动脉解剖构成 2、冠状动脉生理调节，血流储备CFR，rCFR， 3、FFR定义，压力差和狭窄的关系 4、怎么完成一个FFR测定 The coronary circulation can be divided into three parts: the epicardial arterial vessels, the myocardial microcirculation and the venous component. Although oversimplified, this view is well suited to understanding the mechanisms of ischemic heart disease. The epicardial vessels are conductance vessels and have no noteworthy resistance. The resistive properties of the coronary circulation are located in the coronary microcirculation, which keep the basal flow steady under a wide range of perfusion pressures, a mechanism called autoregulation. Under circumstances of increased oxygen consumption, coronary flow can increase up to 5 times its basal value in healthy individuals. This incremental rise is accomplished by the opening of resistive vessels that lie in the proximal part of the microcirculation, and is necessary since in basal conditions in the myocardium, the oxygen extraction is already almost maximal. 冠状动脉血流增加5倍靠什么调节？靠微循环阻力。 44 This example illustrates an essential difference b