冠脉生理学检测技术发展2021年研究进展

心血管疾病是危害人类生命健康最严重的疾病之一，中国每5人中就有2人死于心血管疾病。心肌缺血是重要的心血管疾病之一。心肌血流储备分数（fractional flow reserve，FFR）用于量化心外膜下冠状动脉狭窄是否产生心肌缺血；微血管阻力指数（index of microcirculatory resistance，IMR）是定量评价冠脉微循环状态的有创指标。传统FFR和IMR测量临床上依靠导丝，在最大充血态下进行介入测量，临床上辅助心肌缺血的诊断。基于冠脉造影的caFFR和caIMR（coronary angiography-derived FFR and IMR）无需介入操作、无需血管扩张药物、无禁忌症限制，可以快速同步计算FFR和IMR，进而辅助冠脉介入手术的诊疗。本文总结了近年来基于冠脉造影的caFFR和caIMR以及其他冠脉生理学检测技术的研究进展.进一步开展基于造影的FFR和IMR组合研究，从宏观到微观开展冠脉功能学研究具有重要的临床价值。

Research Progress of Coronary Physiological Evaluation Development in 2021

Cardiovascular disease is one of the most serious diseases endangering human life and health. In China, 2 out of every 5 people die of cardiovascular diseases. Myocardial ischemia is one of the important cardiovascular diseases. Fractional flow reserve (FFR) is used to quantify myocardial ischemia in epicardial stenoses. Index of microvascular resistance (IMR) is an invasive index for quantitative evaluation of coronary microcirculation. Traditional FFR and IMR measurements rely on guide wires to perform interventional measurements under the maximum hyperemia state,so as to assist the diagnosis of myocardial ischemia clinically. Coronary angiography-derived FFR and IMR without using invasive pressure-wire measurement, hyperemic stimulus and contraindications can assist the diagnosis and treatment of percutaneous coronary intervention by fast simultaneous calculation of FFR and IMR. In this review, the research progress of coronary angiography-derived FFR and IMR as well as other coronary physiological evaluation in recent years were summarized. It is of great clinical value to further study the combination of coronary angiography-derived FFR and IMR in functional research of coronary circulation from macro to micro.