Cumulative evidence has shown that coronary revascularization should be guided by functional significance of coronary lesions. Fractional flow reserve (FFR) is the gold standard for assessment of hemodynamic significance of coronary stenosis and FFR-guided percutaneous coronary intervention has improved clinical outcomes in patients with coronary artery disease. However, limitations of FFR such as increased operational time and cost, requirement of pressure wire and adenosine and technical difficulties have led to significant underutilization of the method in clinical practice. In the last few years, several methods of FFR estimation based on coronary angiography images have emerged to overcome invasive FFR limitations. The common elements of the novel indices include a 3D anatomical reconstruction of coronary vessels by angiographic projections and various approaches to fluid dynamics computation. Angiography-derived FFR methods have shown high diagnostic accuracy compared to invasive FFR. Although there are promising results regarding their prognostic role, large randomized trials evaluating clinical outcomes are lacking. The aim of this review is to present currently available angiography-derived FFR indices and highlight their differences, advantages, disadvantages and potential clinical implications.

累积证据表明，冠状动脉血运重建应以冠状动脉病变的功能意义为指导。血流储备分数 (FFR) 是评估冠状动脉狭窄血流动力学意义的金标准，FFR 引导的经皮冠状动脉介入治疗改善了冠状动脉疾病患者的临床结果。然而，FFR 的局限性，如增加的操作时间和成本、对压力线和腺苷的要求以及技术困难，导致该方法在临床实践中的应用严重不足。在过去的几年里，几种基于 FFR 估计的方法冠状动脉造影图像的出现克服了侵入性 FFR 限制。新指数的共同元素包括通过血管造影投影对冠状血管进行 3D 解剖重建以及流体动力学计算的各种方法。与侵入性 FFR 相比，血管造影衍生的 FFR 方法已显示出更高的诊断准确性。尽管关于它们的预后作用有有希望的结果，但缺乏评估临床结果的大型随机试验。本综述的目的是介绍目前可用的血管造影衍生的 FFR 指数，并强调它们的差异、优点、缺点和潜在的临床意义。