CIT 2018:QFR在患者水平诊断精度荟萃分析结果首发

2018-03-24 今日循环 中国医学论坛报今日循环

3月24日上午,在CIT2018 PCR at CIT专场,丹麦奥胡思大学医院(Aarhus University Hospital)Niels Holm博士首次发布“定量血流分数的诊断精度-一项来自四个前瞻性多中心临床研究的患者水平荟萃分析”。这不仅意味着国际心血管领域对QFR临床价值的认可,也意味着QFR推向临床应用又迈出了坚实的一步。

3月24日上午,在CIT2018 PCR at CIT专场,丹麦奥胡思大学医院(Aarhus University Hospital)Niels Holm博士首次发布“定量血流分数的诊断精度-一项来自四个前瞻性多中心临床研究的患者水平荟萃分析”。这不仅意味着国际心血管领域对QFR临床价值的认可,也意味着QFR推向临床应用又迈出了坚实的一步。



Niels Holm博士在CIT现场

血流储备分数(FFR)是诊断冠脉狭窄是否导致下游心肌缺血的“金标准”。然而,由于FFR的检测需要使用压力导丝以及冠脉微循环扩张药,加上检测步骤相对比较复杂,限制了FFR在临床上的推广。定量血流分数(QFR)是一种检测血流动力学异常的新方法,无需采用压力导丝与微循环扩张药,仅需要使用两个体位的冠脉造影影像便可进行血管的三维重建并计算出重建血管每个位置的FFR数值。

本研究纳入QFR前瞻性多中心临床验证研究样本,以压力导丝测量的FFR作为金标准,研究QFR在检测冠心病患者血流动力学异常的诊断精度,识别对QFR诊断精度存在影响的因素,并对比QFR与定量冠脉造影(QCA)的诊断精度。四个前瞻性多中心临床研究(FAVOR Pilot、FAVORⅡChina、FAVORⅡEurope/Japan、WIFIⅡ)符合入选标准,共819例患者的969根血管同时完成了QFR与FFR的核心实验室分析。

结果显示,QFR与FFR相关性良好(r=0.80,P<0.001),QFR总体精度达87%,阳性预测值为80.3%,阴性预测值为94.5%,AUC=0.92。QFR和QCA的对比结果显示,QFR与QCA诊断敏感性分别为84%和45%,特异性分别为88%和73%,总体精度分别为87%和63%(P<0.001)。

本研究表明,以FFR为对照,QFR诊断表现良好。左前降支(LAD)狭窄和狭窄严重程度增加是QFR值[≥0.10]低于FFR的独立预测因子。此外,与2D-QCA相比,QFR在功能性狭窄诊断方面也表现出良好的敏感性和特异性。

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    2021-07-23 pengpeng749

    学习!

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    2018-07-21 venlin
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    2018-05-07 zwjnj2

    学习学习认真学习

    0

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    2018-03-27 大爰

    学习了谢谢分享学习

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    2018-03-24 神功盖世

    0

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