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Erschienen in: Journal of Nuclear Cardiology 2/2019

01.04.2019 | Review Article

Coronary circulation: Pressure/flow parameters for assessment of ischemic heart disease

verfasst von: Henry Gewirtz, MD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 2/2019

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Abstract

Both invasive and non-invasive parameters have been reported for assessment of the physiological status of the coronary circulation. Fractional flow reserve and coronary (or myocardial) flow reserve may be obtained by invasive or non-invasive means. These metrics of coronary stenosis severity have achieved wide clinical acceptance for guiding revascularization decisions and risk stratification. Other indices are obtained invasively (e.g., instantaneous wave-free ratio, iFR; hyperemic stenosis resistance) or non-invasively (e.g., PET absolute myocardial blood flow (mL/min/g)) and have been used for the same purposes. Both iFR, and whole-cycle distal coronary to aortic mean pressure (Pd/Pa) are measured under basal condition and used for assessment of hemodynamic stenosis severity as is index of basal stenosis resistance (BSR). These metrics typically are dichotomized at an empirically derived cut point into “normal” and “abnormal” categories for purposes of clinical decision making and data analysis. Once dichotomized the indices do not always point in the same direction and so confusion may arise. This review, therefore, will present basic principles relevant to understanding commonly employed metrics of the physiological status of the coronary circulation, potential strengths and weaknesses, and hopefully an improved appreciation of the clinical information provided by each.
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Metadaten
Titel
Coronary circulation: Pressure/flow parameters for assessment of ischemic heart disease
verfasst von
Henry Gewirtz, MD
Publikationsdatum
01.04.2019
Verlag
Springer International Publishing
Erschienen in
Journal of Nuclear Cardiology / Ausgabe 2/2019
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-018-1270-3

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