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      Invasive physiological indices to determine the functional significance of coronary stenosis

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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.

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          Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI

          Justin E. Davies, Sayan Sen, Hakim-Moulay Dehbi … (2017)
          Coronary revascularization guided by fractional flow reserve (FFR) is associated with better patient outcomes after the procedure than revascularization guided by angiography alone. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR.
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            Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trial.

            Lokien X van Nunen, Frederik Zimmermann, Pim Tonino … (2015)
            In the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) study, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) improved outcome compared with angiography-guided PCI for up to 2 years of follow-up. The aim in this study was to investigate whether the favourable clinical outcome with the FFR-guided PCI in the FAME study persisted over a 5-year follow-up.
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              Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd/Pa with fractional flow reserve: the RESOLVE study.

              Allen Jeremias, Akiko Maehara, Philippe Genereux … (2014)
              This study sought to examine the diagnostic accuracy of the instantaneous wave-free ratio (iFR) and resting distal coronary artery pressure/aortic pressure (Pd/Pa) with respect to hyperemic fractional flow reserve (FFR) in a core laboratory-based multicenter collaborative study.
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                Author and article information

                Contributors
                Andy S.C. Yong
                Journal
                Journal ID (nlm-ta): Int J Cardiol Heart Vasc
                Journal ID (iso-abbrev): Int J Cardiol Heart Vasc
                Title: International Journal of Cardiology. Heart & Vasculature
                Publisher: Elsevier
                ISSN (Electronic): 2352-9067
                Publication date PMC-release: 23 February 2018
                Publication date Collection: March 2018
                Publication date (Electronic): 23 February 2018
                Volume: 18
                Pages: 39-45
                Affiliations
                [a ]Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
                [b ]College of Medicine, University of Thi Qar, Iraq
                [c ]Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
                [d ]ANZAC Research Institute, Concord Hospital, Sydney, Australia
                Author notes
                [* ]Corresponding author at: Faculty of Medicine and Health Sciences, Suite 17, Level 1, 75 Talavera Road, Macquarie University, NSW 2109, Australia. andy.yong@ 123456sydney.edu.au
                Article
                Publisher ID: S2352-9067(18)30005-8
                DOI: 10.1016/j.ijcha.2018.02.003
                PMC ID: 5988484
                PubMed ID: 29876502
                SO-VID: 68740179-8bb1-42fe-a90d-ddac5399481e
                Copyright © © 2018 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 17 November 2017
                Date accepted : 13 February 2018
                Categories
                Subject: Review

                Keywords: 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,coronary physiology,fractional flow reserve,resting physiological indices,coronary flow reserve
                Data availability:
                Keywords: 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, coronary physiology, fractional flow reserve, resting physiological indices, coronary flow reserve

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