Physiological Assessment of Coronary Stenoses and the Microcirculation

  • Javier Escaned
  • Justin Davies

Table of contents

  1. Front Matter
    Pages I-XIII
  2. The Physiology of the Coronary Circulation

    1. Front Matter
      Pages 1-1
    2. Lorena Casadonte, Maria Siebes
      Pages 3-18
  3. Pathological Changes in the Coronary Circulation

    1. Front Matter
      Pages 19-19
    2. Hiroyoshi Mori, Aloke V. Finn, Frank D. Kolodgie, Harry R. Davis, Michael Joner, Renu Virmani
      Pages 21-37
    3. Nina W. van der Hoeven, Hernán Mejía-Rentería, Maurits R. Hollander, Niels van Royen, Javier Escaned
      Pages 39-53
    4. Nieves Gonzalo, Vera Rodriguez, Christopher J. Broyd, Pilar Jimenez-Quevedo, Javier Escaned
      Pages 55-63
    5. Christian Seiler
      Pages 65-77
  4. The Epicardial Vessels and the Coronary Microcirculation in Different Pathologies

    1. Front Matter
      Pages 79-79
    2. Luis Felipe Valenzuela-García, Yasushi Matsuzawa, Amir Lerman
      Pages 81-98
    3. Murat Sezer, Mauro Echavarria Pinto, Nicola Ryan, Sabahattin Umman
      Pages 99-110
    4. Diego Arroyo, Serban Puricel, Mario Togni, Stéphane Cook
      Pages 111-117
    5. Christopher J. Broyd, Fernando Dominguez, Pablo Garcia-Pavia
      Pages 119-135
    6. Arnold H. Seto, Morton J. Kern
      Pages 137-156
  5. Coronary Flow Reserve

    1. Front Matter
      Pages 157-157
    2. Tim P. van de Hoef, Jan J. Piek
      Pages 159-171
  6. Indices of Coronary Resistance

    1. Front Matter
      Pages 173-173
    2. Guus A. de Waard, Nicolaas Westerhof, Koen M. Marques, Niels van Royen
      Pages 175-183
    3. Nicola Ryan, Mauro Echavarría-Pinto, Alicia Quirós, Hernán Mejía-Rentería, María Del Trigo, Pilar Jiménez-Quevedo et al.
      Pages 185-192
  7. Fractional Flow Reserve (FFR)

    1. Front Matter
      Pages 193-193
    2. Antonio Maria Leone, Giancarla Scalone, Giampaolo Niccoli
      Pages 195-208
    3. David Neves, Ruben Ramos, Luís Raposo, Sérgio Baptista, Pedro de Araújo Gonçalves
      Pages 209-221
  8. Instantaneous Wave Free Ratio (iFR)

    1. Front Matter
      Pages 223-223
    2. Ricardo Petraco, Javier Escaned, Justin Davies
      Pages 225-231
    3. Sukhjinder Nijjer, Justin Davies
      Pages 233-248
  9. Multimodality Assessment of the Coronary Circulation

    1. Front Matter
      Pages 249-249
    2. Hernan Mejia-Rentería, Nicola Ryan, Fernando Macayo, Ivan Nuñéz-Gil, Luis Nombela-Franco, Javier Escaned
      Pages 251-260
  10. Wave Intensity Analysis

    1. Front Matter
      Pages 261-261
    2. Christopher J. Broyd, Kim Parker, Justin Davies
      Pages 263-275
  11. Assessment of Endothelial Dysfunction

    1. Front Matter
      Pages 277-277
  12. Research Models

    1. Front Matter
      Pages 285-285
    2. Ilkka H. A. Heinonen, Oana Sorop, Daphne Merkus, Dirk J. Duncker
      Pages 287-294
    3. Carlos Collet, Chrysafios Girasis, Charles Taylor, Patrick W. Serruys, Yoshinobu Onuma
      Pages 295-305
  13. Back Matter
    Pages 307-313

About this book


​​Since the introduction of coronary angiography, a key technique in understanding coronary artery disease, a number of paradigms regarding its study and interpretation have taken place. Following an emphasis on improved angiographic and subsequent intracoronary imaging techniques, functional assessment of coronary circulation has demonstrated to have major implications for diagnosis and treatment of coronary artery disease.  Fractional flow reserve, a pressure derived index of stenosis severity, constitutes the best example of the current importance of physiological assessment in clinical practice. However, the acceptance of FFR by cardiologists contrasts with important voids in knowledge on the basic principles of coronary physiology and of other available techniques that, as an alternative to FFR, allow a more comprehensive assessment of coronary circulation. This is particularly noticeable in the assessment of microcirculation, an unavoidable compartment of coronary circulation that is frequently affected in acute coronary syndromes of in the presence of cardiovascular risk factors or non-coronary heart disease. A deeper understanding of the relationship between epicardial vessel and microcirculatory involvement has started with the advent of newer imaging techniques like invasive optical coherence tomography, and non-invasive CT and NMR techniques. This book aims to be an indispensable tool for clinicians and researches in the field of coronary artery disease. It provides a balanced, comprehensive review of anatomy, physiology and available techniques, discusses both the diagnosis of epicardial vessel and microcirculatory disease, the impact of different diseases at different levels of coronary circulation, and the best way to address a separate or combined assessment of different levels of coronary circulation.  ​


Coronary Angiography Coronary Circulation Fractional Flow Reserve Intracoronary Imaging Microcirculation Stenosis

Editors and affiliations

  • Javier Escaned
    • 1
  • Justin Davies
    • 2
  1. 1.Hospital Clínico San Carlos, Universidad Complutense de MadridMadridSpain
  2. 2.Imperial College LondonLondonUnited Kingdom

Bibliographic information

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Health & Hospitals
Internal Medicine & Dermatology