Related Experiment Video
Updated: Jan 29, 2026
15:45
Cardiac Stress Test Induced by Dobutamine and Monitored by Cardiac Catheterization in Mice
Published on: February 10, 2013
18.7K
Coronary Physiology in the Cardiac Catheterization Laboratory
Samit M Shah1, Steven E Pfau2,3
1Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA. samit.shah@yale.edu.
Journal of Clinical Medicine
|February 21, 2019
Summary
Coronary physiology assessment, including fractional flow reserve (FFR) and instantaneous wave free ratio (iFR), accurately guides treatment for coronary artery disease. These methods enable personalized medicine in the cardiac catheterization laboratory.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Technology
Background:
- Coronary angiography is a standard for assessing coronary artery disease severity.
- A complex relationship exists between angiographic stenosis and myocardial ischemia.
- Technological advancements enable in-catheterization lab coronary physiology assessment.
Purpose of the Study:
- To review the theory, technical aspects, and clinical trials of coronary physiology assessment.
- To inform general medical practitioners about these advanced diagnostic tools.
- To highlight the role of physiology in guiding revascularization decisions.
Main Methods:
- Assessment of coronary flow reserve (CFR).
- Measurement of fractional flow reserve (FFR) and instantaneous wave free ratio (iFR).
- Coronary thermodilution for index of microcirculatory resistance (IMR) and Doppler velocity for coronary flow velocity reserve (CFVR).
Main Results:
- FFR and iFR have demonstrated physiologic accuracy and prognostic value.
- These physiological measurements are validated by large multi-center clinical trials.
- Physiology-based assessment aids in diagnosing chest pain without epicardial coronary artery disease.
Conclusions:
- Coronary physiology assessment provides objective, evidence-based guidance for revascularization.
- These techniques facilitate personalized medicine in cardiology.
- Objective physiological data improves decision-making for cardiologists and referring providers.
More Related Videos
Related Concept Videos
01:21Cardiac Catheterization II: Right Heart Catheterization
942
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
942
01:24Cardiac Catheterization III: Left Heart Catheterization
649
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
649
01:28Cardiac Catheterization I: Pre-Procedure Overview
1.3K
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
1.3K
01:26Cardiac Catheterization IV: Nursing Management
718
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
718
01:18Physiology of the Heart: The Cardiac Cycle
9.0K
The cardiac cycle describes the events from one heartbeat to the next. It includes three main phases: diastole, atrial systole, and ventricular systole, all driven by changes in chamber pressures and the function of heart valves.
Diastole: The Relaxation Phase
During diastole, all four heart chambers relax. The atrioventricular (AV) valves open, and the semilunar valves close. This phase sees the lowest chamber pressures, promoting ventricular filling. Venous blood enters the heart through the...
Diastole: The Relaxation Phase
During diastole, all four heart chambers relax. The atrioventricular (AV) valves open, and the semilunar valves close. This phase sees the lowest chamber pressures, promoting ventricular filling. Venous blood enters the heart through the...
9.0K
01:21Coronary Circulation
7.1K
The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
7.1K