循環器ジャーナル67巻4号

2019年10月発行

特集 冠動脈疾患のリスク管理のフロントライン Ⅰ．冠動脈疾患イベントリスクをどう評価する？

FFRでどう評価する？

著者： 坂本知浩¹

所属機関： ¹済生会熊本病院心臓血管センター循環器内科

ページ範囲：P.566 - P.571

Point
・FFRは心筋虚血判定のゴールドスタンダードであり，0.80以下の病変の存在は不良な予後と関連があった．
・多枝疾患におけるFFRに基づいたPCIは，医療コストの抑制，心血管イベントの低減と関連があった．

参考文献

1) Pijls NH, De Bruyne B, Peels K, et al:Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 334:1703-1708, 1996

2) Pijls NH, van Schaardenburgh P, Manoharan G, et al:Percutaneous coronary intervention of functionally nonsignificant stenosis:5-year follow-up of the DEFER Study. J Am Coll Cardiol 49:2105-2111, 2007

3) Tonino PA, De Bruyne B, Pijls NH, et al:Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med 360:213-224, 2009

4) De Bruyne B, Fearon WF, Pijls NH, et al:Fractional flow reserve-guided PCI for stable coronary artery disease. N Engl J Med 371:1208-1217, 2014

5) Xaplanteris P, Fournier S, Pijls NHJ, et al:Five-Year Outcomes with PCI Guided by Fractional Flow Reserve. N Engl J Med 379:250-259, 2018

6) Toth GG, Johnson NP, Jeremias A, et al:Standardization of Fractional Flow Reserve Measurements. J Am Coll Cardiol 68:742-753, 2016

7) Shlofmitz E, Jeremias A:FFR in 2017:Current Status in PCI Management.　https://www.acc.org/latest-in-cardiology/articles/2017/05/25/08/34/ffr-in-2017-current-status-in-pci-management

8) Götberg M, Christiansen EH, Gudmundsdottir IJ, et al:Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med 376:1813-1823, 2017

9) Davies JE, Sen S, Dehbi HM, et al:Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. N Engl J Med 376:1824-1834, 2017

10) Lee JM, Choi KH, Park J, et al:Physiological and Clinical Assessment of Resting Physiological Indexes. Circulation 139:889-900, 2019

11) Svanerud J, Ahn JM, Jeremias A, et al:Validation of a novel non-hyperaemic index of coronary artery stenosis severity:the Resting Full-cycle Ratio（VALIDATE RFR）study. EuroIntervention 14:806-814, 2018

:The ADVANCE Registry. JACC Cardiovasc Imaging. pii:S1936-878X（19）30227-X, 2019