Invasive measures of myocardial perfusion and ischemia

Progress in Cardiovascular Diseases
Julien AdjedjBernard De Bruyne

Abstract

Until recently, our understanding of coronary artery disease (CAD) has been largely based on a purely anatomical approach as derived from the invasive angiogram. The confirmation of the diagnosis of "significant" CAD, the assessment of its extent, the risk stratification of patients, the therapeutic decisions, the definition of study end-points, and the validation of non-invasive testing, all mainly relied on "eyeballing" the angiogram, i.e. a subjective evaluation of the presence of at least 50% (or 70%) diameter stenosis.With the development of invasive, wire-based, means to quantify coronary pressure and flow with high spatial resolution, one realized that purely angiographic metrics correlated poorly with functional information. Currently, it is admitted that both anatomical and functional information are needed to define CAD and to optimize its management. In the present review, we summarize the main characteristics of invasive functional indices of ischemia and perfusion.

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Citations

Aug 16, 2016·Journal of the American College of Cardiology·Gabor G TothBernard De Bruyne
Nov 14, 2016·JACC. Cardiovascular Interventions·Sean T Chen, Manesh R Patel
Mar 7, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Fabien PicardJulien Adjedj
Oct 13, 2020·Expert Review of Medical Devices·Olivier VillemainLuc Mertens
Dec 7, 2021·Wiener klinische Wochenschrift·Samuel A FreitasGabriel de O Ramos

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