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1、首都医科大学附属北京安贞医院 Anzhen HospitalCapital Medical University,Clinical Application of Coronary flow Reserve in Echocardiography 冠状动脉血流储备的临床应用,杨 娅 首都医科大学附属北京安贞医院,Coronary Flow Reserve, CFR 冠状动脉血流储备,CFR was assessed as the ratio of peak hyperemic to basal coronary flow CFR=CFh/CFb CFVR=CFVh/CFVb冠状动脉血流储备最大冠
2、脉血流与静息冠脉血流的比值,即最大冠状动脉扩张状态下的冠脉血流与静息状态下冠脉血流的比值,Coronary Flow 冠状动脉血流,Intracoronary Doppler Flow (ICD) 冠状动脉内多普勒血流 “Gold-standard“ method Invasive method Coronary flow Imaging(CFI)-Transthoracic Doppler Echocardiography (TTDE) 冠状动脉血流显像经胸多普勒超声心动图,Coronary flow Imaging(CFI) Transthoracic Doppler echocardio
3、graphy (TTDE) 冠状动脉血流显像经胸多普勒超声心动图,LAD,正常LAD中段,LAD,Adenosine Stress-Echo腺苷负荷试验,Rest 基础状态,140gkg-1min-1,CFV 冠脉血流速度,3min,CFV 冠脉血流速度,Rest 基础状态,50 g,75 g,100 g,140 g,1min,1min,1min,3min,注入腺苷后所致的心率、血压及平均血流速度的变化,Regression analysis of APV-values: TTDE vs. ICD TTDE探测CFVR的准确性,Regression analysis of APV-values
4、: TTDE vs. ICD TTDE探测CFVR的准确性,Regression analysis of CFVR: TTDE vs. ICD TTDE探测CFVR的准确性,冠状动脉狭窄,Coronary Stenosis,H Lambertz et al. J Am Soc Echo 1999,12:186-95,Coronary Stenoses冠状动脉狭窄,CFVR=1.3,CFVR=2.8,CFVR=3.3,冠状动脉介入治疗的效果并追踪随访,以ICD探测的CFVR2.5为判断CFVR受损的切断点， TTDE的敏感性和特异性分别为92.31%和88.46%,Microvascular D
5、ysfunction,正常冠脉-微循环受损,Microvascular Dysfunction,Hypertrophic Cardiomyopathy 肥厚型心肌病,肥厚型心肌病,Coronary Flow in Patients with Hypertension 高血压患者与正常人冠脉血流参数的比较,Coronary Flow in Patients with Hypertension 高血压患者的CFVR变化,CFVR and LV Diastolic Function CFVR与舒张功能的关系,CFVR in Patients with Familial Hypercholestero
6、lemia(FH) FH患者CFVR的变化,CFVR of FH group was lower than control group significantly,CFVR减低,SUMMERY 小结,Clinical Application of Coronary Flow Imaging Coronary Stenosis Follow-Up after PTCA Hypertrophic Cardiomyopathy Hypertension Microvascular disease 临床应用价值 判断冠状动脉狭窄及心肌梗死患者的侧支循环 肥厚型心肌病 化学消融靶血管的选择和疗效评估 评价冠状动脉介入治疗的效果并追踪随访 了解冠状动脉微循环变化,谢谢! Thank You!,
