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Catheter-based functional metrics of the coronary circulation

  • Review Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

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.

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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

P a :

Proximal (aortic) pressure

P d :

Distal coronary pressure

P w :

Coronary occlusive pressure

P v :

Venous pressure

PET:

Positron emission tomography

Q :

Flow

QCA:

Quantitative coronary angiography

R :

Resistance

RCT:

Randomized controlled trial

T mn :

Mean transit time

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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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  1. Cardiovascular Center Aalst, OLV-Clinic, Moorselbaan 164, 9300, Aalst, Belgium

    Panagiotis Xaplanteris MD, PhD, Emanuele Barbato MD, PhD & Bernard De Bruyne MD, PhD

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  1. Panagiotis Xaplanteris MD, PhD
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  2. Emanuele Barbato MD, PhD
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  3. Bernard De Bruyne MD, PhD
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Correspondence to Bernard De Bruyne MD, PhD.

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Xaplanteris, P., Barbato, E. & De Bruyne, B. Catheter-based functional metrics of the coronary circulation. J. Nucl. Cardiol. 24, 1178–1189 (2017). https://doi.org/10.1007/s12350-016-0652-7

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