Past, Present and Future of Coronary Physiology
Rev Esp Cardiol (Engl Ed). 2018 Aug;71(8):656-667.
doi: 10.1016/j.rec.2018.02.003.
Epub 2018 Mar 16.
[Article in
English,
Spanish]
Affiliations
- 1 International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
- 2 International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
- 3 Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
- 4 International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom. Electronic address: justin.davies@imperial.ac.uk.
Abstract
It is well known that the apparent significant coronary stenosis on angiography sometimes does not cause significant ischemia, and vice versa. For this reason, decision-making based on coronary physiology is becoming more and more important. Fractional flow reserve (FFR), which has emerged as a useful tool to determine which lesions need revascularization in the catheterization laboratory, now has a class IA indication in the European Society of Cardiology guidelines. More recently, the instantaneous wave-free ratio, which is considered easier to use than FFR, has been graded as equivalent to FFR. This review discusses the concepts of FFR and instantaneous wave-free ratio, current evidence supporting their use, and future directions in coronary physiology.
Keywords:
Cociente diastólico instantáneo sin ondas; Coronary physiology; Fisiología coronaria; Fractional flow reserve; Instantaneous wave-free ratio; Reserva fraccional de flujo.
Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Cardiology / trends*
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Coronary Artery Disease / epidemiology
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Coronary Artery Disease / physiopathology*
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Coronary Vessels / physiopathology*
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Fractional Flow Reserve, Myocardial / physiology*
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Global Health
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Humans
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Morbidity / trends