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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

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[Invasive physiological evaluation of coronary artery disease]

P Marechal1, M Lempereur1, O Gach1

  • 1Service de Cardiologie, CHU Liège, Belgique.

Revue Medicale De Liege
|May 10, 2019
PubMed

Insights

Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) invasively assess coronary lesion impact. These methods help determine if revascularization is needed when non-invasive tests are inconclusive or unavailable.

Area of Science:

  • Cardiovascular medicine
  • Interventional cardiology
  • Diagnostic imaging

Background:

  • Myocardial ischemia requires clear demonstration before revascularization.
  • Non-invasive tests for ischemia are not always performed or yield equivocal results.
  • Coronary angiography visually assesses stenosis but not hemodynamic significance.

Purpose of the Study:

  • To highlight the importance of hemodynamic assessment in coronary artery disease.
  • To introduce fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) as key diagnostic tools.
  • To discuss the role of coronary angiography and provocative testing for spastic angina.

Main Methods:

  • Coronary angiography for visual stenosis evaluation.
  • Measurement of coronary flow reserve using FFR and iFR for hemodynamic significance.
  • Provocative methylergonovine test during angiography for suspected spastic angina.

Main Results:

  • FFR and iFR provide a simple, invasive method to assess the hemodynamic impact of coronary lesions.
  • These invasive measurements complement or clarify results from non-invasive testing.
  • Angiography combined with functional testing confirms lesion significance and aids treatment decisions.

Conclusions:

  • Hemodynamic assessment using FFR or iFR is crucial for guiding coronary revascularization decisions.
  • Coronary angiography, while essential, requires functional assessment for definitive stenosis evaluation.
  • Invasive physiological measurements improve the accuracy of diagnosing and managing coronary artery disease.

Keywords:
Fractional flow reserveVasospastic anginaCoronary revascularization

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