静息全周期比值与冠脉血流储备分数的一致性

王佳旺; 吴琼; 刘莲莲; 韩雪; 董传政; 于靖

doi:10.12125/j.chj.202306058

静息全周期比值与冠脉血流储备分数的一致性

Study on consistency of resting full-cycle ratio and fractional flow reserve

摘要

摘要:
目的评价静息全周期比值（resting full-cycle ratio，RFR）与金标准冠脉血管储备分数(fractional flow reserve，FFR)的一致性。
方法纳入2021年9月～2022年9月在沧州市中心医院接受侵入性生理学检查的冠心病患者。以RFR ≤ 0.89作为参考值与FFR ≤ 0.80作为参考值进行比较，评价RFR与FFR一致性，RFR的敏感性、特异性、阳性预测值、阴性预测值等指标。
结果本研究共纳入138例患者，共189支血管。以RFR ≤ 0.89作为参考值与FFR ≤ 0.80作为参考值比较，两种方法一致性达81.5% ，并具有统计学意义（R²=0.629，P<0.01），RFR ≤ 0.89作为参考值其敏感度 70.1%，特异度 87.7%，阳性预测值 75.8%，阴性预测值 84.3%，准确率 81.5%，ROC曲线下AUC面积为0.889（95%CI：0.842～0.937，P<0.01），RFR的cutoff值：0.915。约登指数为0.609。
结论 RFR与金标准FFR具有良好的相关性，是冠脉生理学评估方法的选择之一。

Abstract:
AIM To evaluate the agreement between resting full-cycle ratio (RFR) and fractional flow reserve (FFR) with the currently recommended thresholds.
METHODS The study included coronary heart disease patients undergoing invasive physiology check from September 2021 to September 2022 in our hospital. Comparison between RFR ≤0.89 and FFR ≤ 0.80 value was made to evaluate the sensitivity, specificity, positive predictive value and negative predictive value of RFR.
RESULTS A total of 189 lesions were evaluated in 138 patients. Significant correlation was observed (R²=0.629, P<0.01) between the two techniques, with 81.5% agreement between RFR ≤ 0.89 and FFR ≤ 0.80 (sensitivity 70.1%, specificity 87.7%, positive predictive value 75.8%, negative predictive value 84.3%, and accuracy 81.5%). The AUC area under the ROC curve was 0.889 (95%CI:0.842～0.937, P<0.01). The Youden index was 0.609.
CONCLUSION Significant agreement is found between RFR and FFR with the recommended thresholds and they can be used for coronary physiology assessment.

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