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Journal of Nuclear Cardiology

, Volume 24, Issue 4, pp 1178–1189 | Cite as

Catheter-based functional metrics of the coronary circulation

  • Panagiotis Xaplanteris
  • Emanuele Barbato
  • Bernard De BruyneEmail author
Review Article

Abstract

In patients with stable chest pain, decision making about treatment strategy should be based on anatomical and functional information on the coronary circulation. Traditionally, the functional data are obtained by non-invasive testing which aims at detecting and localizing ‘myocardial ischemia.’ Yet, the diagnostic accuracy of diagnostic testing is over-rated in the literature, so that in clinical practice, a sizable proportion of patients undergo a coronary angiogram without prior useful functional information. Therefore, several methods have been developed to obtain similar information in the catheterization laboratory. Here we review briefly some of these methods. Some of them are used routinely in clinical practice, and others are under development.

Keywords

Coronary angiogram coronary artery disease microcirculation coronary flow reserve fractional flow reserve ischemic testing index of microvascular resistance 

Abbreviations

CAD

Coronary artery disease

CFR

Coronary flow reserve

FFR

Fractional flow reserve

FFRCT

Computed tomography-derived fractional flow reserve

iFR

Instantaneous wave-free ratio

IMR

Index of microvascular resistance

IVUS

Intravascular ultrasound

LAD

Left anterior descending artery

OCT

Optical coherence tomography

Pa

Proximal (aortic) pressure

Pd

Distal coronary pressure

Pw

Coronary occlusive pressure

Pv

Venous pressure

PET

Positron emission tomography

Q

Flow

QCA

Quantitative coronary angiography

R

Resistance

RCT

Randomized controlled trial

Tmn

Mean transit time

Notes

Disclosure

Dr Xaplanteris has received research grants from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the Hellenic Cardiological Society (HCS) for 2016. Dr. Barbato reports institutional research grants and speaker’s fees from St. Jude Medical not related to this manuscript to the Cardiovascular Center Aalst. Dr. De Bruyne is a shareholder for Siemens,GE, Bayer, Philips, HeartFlow, Edwards Life Sciences, Sanofi, Omega Pharma; The Cardiovascular Center Aalst has received grant support from Abbott, Boston Scientific, Biotronik, and St Jude Medical and receives consulting fees on his behalf from St. Jude Medical, Opsens, and Boston Scientific outside of the submitted work.

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Panagiotis Xaplanteris
    • 1
  • Emanuele Barbato
    • 1
  • Bernard De Bruyne
    • 1
    Email author
  1. 1.Cardiovascular Center AalstOLV-ClinicAalstBelgium

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