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Updated: Apr 16, 2026
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Coronary functional tests in the catheterization laboratory - pathophysiological and clinical relevance
Giampaolo Niccoli1, Giancarla Scalone, Filippo Crea
1Institute of Cardiology, Catholic University of the Sacred Heart.
Summary
Coronary angiography alone is insufficient for assessing coronary artery disease severity. Functional tests in the catheterization lab now complement angiography for a complete evaluation of coronary circulation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Coronary angiography is the traditional invasive method for diagnosing coronary artery disease (CAD).
- However, it cannot determine the functional significance of epicardial stenoses or assess disorders of the coronary arteries and microcirculation.
- There is a need for methods that provide a more comprehensive assessment of coronary circulation.
Purpose of the Study:
- To review and interpret key functional tests used in clinical practice.
- To highlight the role of these tests as adjuncts to coronary angiography.
- To discuss their application in various clinical settings.
Main Methods:
- Review of current literature on functional tests used during cardiac catheterization.
- Description of techniques including fractional flow reserve (FFR) and intracoronary electrocardiography (ICG).
- Interpretation of results in the context of epicardial stenosis and microvascular dysfunction.
Main Results:
- Functional tests provide crucial information on the hemodynamic impact of coronary stenoses.
- These tests help differentiate between anatomical narrowing and physiological significance.
- Assessment of coronary microcirculation is now feasible in the catheterization laboratory.
Conclusions:
- Functional tests are essential for a comprehensive evaluation of coronary artery disease.
- They improve diagnostic accuracy and guide revascularization decisions.
- Integrating functional testing with coronary angiography enhances patient care.
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