Современные математические методы моделирования коронарного кровотока: история вопроса и клиническое значение

Одним из современных методов диагностики ишемической болезни сердца является рентгеновская компьютерно-томографическая коронарография (КТКГ). Хотя данный метод обладает высокими специфичностью и отрицательной предсказательной ценностью в аспекте диагностики обструктивного поражения коронарных артерий, имеются ограничения в определении гемодинамической значимости стенозов. Широкое использование инвазивных методов оценки гемодинамики коронарных сосудов, в частности, оценки фракционного резерва кровотока (ФРК), ограничено в связи с высокой стоимостью и рисками осложнений. Математическое моделирование коронарного кровотока и его резерва на основе данных, полученных при выполнении КТКГ, является современной методикой, имеющей экспериментальное подтверждение и клиническую валидизацию. Метод показал высокие значения диагностической эффективности в ряде крупных исследований, где в качестве «золотого стандарта» было использовано инвазивное определение ФРК. Настоящий обзор литературы посвящен современному состоянию исследований в области математического моделирования фракционного коронарного резерва у пациентов с ишемической болезнью сердца, а также ограничениям и перспективам данного метода.

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