Применение методов фракционного резерва кровотока и моментального резерва кровотока при оценке протяженных и многоуровневых поражений коронарных артерий

   У пациентов с ишемической болезнью сердца инвазивные методы физиологической оценки коронарных стенозов (фракционный резерв кровотока (ФРК) и моментальный резерв кровотока – МРК) признаны показателями, коррелирующими с клиническим прогнозом при единичном поражении. Однако, учитывая системный характер
атеросклероза, часто встречаются диффузные и многоуровневые стенозы коронарных артерий. В таких случаях выбор оптимальной стратегии реваскуляризации зависит от определения индивидуального вклада каждого отдельного стеноза, а не только кумулятивного эффекта всех сужений, полученного в дистальной части исследуемой артерии. Тем не менее, как показала практика, обнаружение стенозов, «ответственных» за ишемию и достоверно требующих лечения, является сложной задачей у этой группы больных.

   Цель данной работы – рассмотрение особенностей физиологии серийных стенозов и определение преимуществ и недостатков методов ФРК и МРК при планировании стратегий реваскуляризации миокарда у пациентов с диффузным и многоуровневым поражением в реальной клинической практике.

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