Читать книгу Interventional Cardiology - Группа авторов - Страница 183

The modern iteration of FFR considers the venous contribution to resistance to be minimal (zero). This simplifies the equation and obviates the need to measure the right atrial pressure [7,50]. However, typical venous pressures of 2–8 mmHg are reported during hyperemia and patients with cardiac impairment may have higher values. The implications are that stenosis severity may be underestimated, particularly if venous pressure is elevated [52]. The impact of this is unlikely to be detectible in large outcome studies where a modest number of lesions being falsely deferred would not generate a sufficient signal of MACE. For individual patients the effects and the change in categorization can be marked; in those with elevated venous pressures such as those with heart failure and those with renal failure, measurement of right atrial pressure should be considered.