Fractional flow reserve (FFR) and instantaneous wave-free ratio are the present standard diagnostic methods for invasive assessment of the functional significance of epicardial coronary stenosis. Despite the overall trend towards more physiology-guided revascularization, there remains a gap between guideline recommendations and the clinical adoption of functional evaluation of stenosis severity. A number of image-based approaches have been proposed to compute FFR without the use of pressure wire and induced hyperaemia. In order to better understand these emerging technologies, we sought to highlight the principles, diagnostic performance, clinical applications, practical aspects, and current challenges of computational physiology in the catheterization laboratory. Computational FFR has the potential to expand and facilitate the use of physiology for diagnosis, procedural guidance, and evaluation of therapies, with anticipated impact on resource utilization and patient outcomes.

中文翻译：

---

临床实践中的血流储备分数：从基于线的有创测量到基于图像的计算

血流储备分数 (FFR) 和瞬时无波比是目前用于对心外膜冠状动脉狭窄的功能意义进行侵入性评估的标准诊断方法。尽管总体趋势是生理学指导的血运重建，但指南建议与临床采用狭窄严重程度的功能评估之间仍然存在差距。已经提出了许多基于图像的方法来计算 FFR，而不使用压力线和引起的充血。为了更好地理解这些新兴技术，我们试图强调导管插入实验室中计算生理学的原理、诊断性能、临床应用、实践方面和当前挑战。