Elsevier

IJC Heart & Vasculature

Volume 18, March 2018, Pages 39-45
IJC Heart & Vasculature

Invasive physiological indices to determine the functional significance of coronary stenosis

https://doi.org/10.1016/j.ijcha.2018.02.003Get rights and content
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Abstract

Physiological measurements are now commonly used to assess coronary lesions in the cardiac catheterisation laboratory, and this practice is evidence-based and supported by clinical guidelines. Fractional flow reserve is currently the gold standard method to determine whether coronary lesions are functionally significant, and is used to guide revascularization. There are however several other physiological measurements that have been proposed as alternatives to the fractional flow reserve. This review aims to comprehensively discuss physiological indices that can be used in the cardiac catheterisation laboratory to determine the functional significance of coronary lesions. We will focus on their advantages and disadvantages, and the current evidence supporting their use.

Abbreviations

FFR
fractional flow reserve
Pa
proximal (aortic) pressure
Pd
distal coronary pressure
iFR
instantaneous wave-free reserve
cFFR
contrast Fractional Flow Reserve
CFR
coronary Flow Reserve
HSR
hyperaemic stenosis resistance
BSR
basal stenosis resistance

Keywords

Coronary physiology
Fractional flow reserve
Resting physiological indices
Coronary flow reserve

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