Database management expert program for integrated evaluation of non-invasive and invasive results of coronary heart disease

摘要

The coronary angiography giving the morphological data of epicardiac coronary stenoses and non-invasive tests sometimes even together are insufficient for evaluating the functional consequences of the epicardiac coronary stenoses. However, catheterisation allows us to detect the blunting of coronary flow increase during maximal vasodilatation (coronary flow reserve, CFR, e.g. by Doppler flow wire) and by measuring the translesional pressure gradient by pressure wire (fractional flow reserve, FFR) providing accurate functional assessment. According to this concept the authors have developed a complex cardiac database management program (Holistic Coronary Care, HCC). The database has been built on client-server technology where the central object is the 16-segment polar map. The system contains contextual and graphical elements for a quick data entry. By the assessment of 16 left ventricular segments on a polar map display there is a possibility for direct comparison of the invasive functional and morphologic and the non-invasive functional data. Details measured by pressure or Doppler wire are also stored in the coronary evaluating unit and the coronary segments are rendered to the supplied left ventricular segments. For the correct indication of coronary interventions (from functional and financial point of view) it is important to verify unambiguously the functionally significant coronary stenoses. To the best of our knowledge, the necessity of percutan or surgical intervention can be decided the most accurately by FFR and CFR, furthermore CFR objectively shows the failure of the coronary microvasculature.