Contemporary Use of Coronary Physiology in Cardiology.
Ayman ElbadawiRamy SedhomMohamed GhowebaAbdelazeem Mohamed EtewaWaleed KayaniFaisal RahmanPublished in: Cardiology and therapy (2023)
Coronary angiography has a limited ability to predict the functional significance of intermediate coronary lesions. Hence, physiological assessment of coronary lesions, via fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR), has been introduced to determine their functional significance. An accumulating body of evidence has consolidated the role of physiology-guided revascularization, particularly among patients with stable ischemic heart disease. The use of FFR or iFR to guide decision-making in patients with stable ischemic heart disease and intermediate coronary lesions received a class I recommendation from major societal guidelines. Nevertheless, the role of coronary physiology testing is less clear among certain patients' groups, including patients with serial coronary lesions, acute coronary syndromes, aortic stenosis, heart failure, as well as post-percutaneous coronary interventions. In this review, we aimed to discuss the utility and clinical evidence of coronary physiology (mainly FFR and iFR), with emphasis on those specific patient groups.
Keyphrases
- aortic stenosis
- coronary artery disease
- coronary artery
- ejection fraction
- heart failure
- transcatheter aortic valve replacement
- aortic valve replacement
- left ventricular
- aortic valve
- transcatheter aortic valve implantation
- acute coronary syndrome
- coronary artery bypass grafting
- acute kidney injury
- case report
- patient reported outcomes
- radiofrequency ablation