[Ischemic burden vs. coronary artery morphology : What is crucial for the indication of revascularization?]

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Ischemic heart disease remains a leading cause of mortality globally.
• Invasive coronary angiography is the gold standard for coronary artery morphology.
• Functional diagnostics are increasingly important for ischemia testing.

Purpose of the Study:

• Compare ischemia testing with morphological methods for diagnosing coronary artery disease.
• Evaluate the role of functional diagnostics in risk stratification and therapy guidance.
• Discuss the potential of hybrid imaging for integrated anatomical and functional assessment.

Main Methods:

• Review of current imaging modalities for functional assessment: stress echocardiography, MRI, SPECT, PET.
• Comparison of functional diagnostics (e.g., fractional flow reserve) with anatomical methods.
• Discussion of hybrid imaging approaches.

Main Results:

• Functional diagnostics provide advanced risk stratification and therapy guidance for coronary artery disease.
• Fractional flow reserve (FFR) measurement during angiography is recommended for ischemia testing.
• Hybrid imaging may offer a combined anatomical and functional assessment in a single investigation.

Conclusions:

• Ischemia testing plays a crucial role in managing coronary artery disease.
• Integrating functional and morphological assessments improves patient management.
• Future imaging algorithms may enhance diagnostic efficiency through hybrid approaches.