© 2017

Physiological Assessment of Coronary Stenoses and the Microcirculation

  • Javier Escaned
  • Justin Davies
  • Provides a clear and comprehensive review of the principles of coronary physiology

  • Gives a detailed description of available techniques for physiological assessment of coronary circulation in the catheterisation laboratory

  • Addresses the needs of clinicians and researchers working in the field of coronary artery disease for treating patients in their clinical practice ?


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

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

About the editors

Javier Escaned MD PhD FESC is Head of Section (Interventional Cardiology) at Hospital Clinico 

San Carlos, and Associate Professor of Medicine at Complutense University (Madrid, Spain). He 

trained as a cardiologist the United Kingdom (Queen Elizabeth University Hospital, Birmingham 

and Walsgrave Hospital, Coventry) before moving to the Thoraxcenter / Rotterdam (The 

Netherlands), where he obtained his PhD degree in 1994. He is author of more than 250 scientific 

articles, books and book chapters on different aspects of interventional cardiology, imaging and 

physiology. He is co-editor with Patrick Serruys of the textbook “Coronary Stenosis. Imaging, 

Structure and Physiology”, whose new edition was launched in May 2015. Current positions in 

scientific societies include: board member (treasurer) of European Association of Percutaneous 

Cardiovascular Interventions (EAPCI), nucleus member of the ESC Working Group on 

Pathophysiology and Microcirculation, and co-director of EuroPCR. In 2014 he served as director of 

the ESC International Summit on Coronary Microcirculation and Heart Disease. Recent or on-going 

international multicentre trials in which he has a principal investigator role include: ADVISE II, 


interests are philosophy, education and music. 

Bibliographic information

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