Ischemic Heart Disease: An Update

Area of Science:

• Cardiology
• Medical Imaging
• Atherosclerosis Research

Background:

• Ischemic heart disease (IHD) involves coronary artery atherosclerosis or functional circulation changes.
• IHD management includes lifestyle changes, medications, and revascularization, potentially stabilizing or regressing the disease.
• New classifications distinguish between acute coronary syndrome and chronic coronary syndrome.

Purpose of the Study:

• To review current diagnostic and treatment strategies for ischemic heart disease.
• To highlight the role of noninvasive imaging in diagnosing coronary artery disease.
• To emphasize the importance of optimal medical treatment and FFR-guided revascularization.

Main Methods:

• Review of current literature and clinical guidelines for ischemic heart disease diagnosis and management.
• Focus on noninvasive imaging modalities such as coronary computed tomography (CT) angiography.
• Discussion of functional assessments including nuclear, MRI, and CT-based fractional flow reserve (FFR-CT).

Main Results:

• Coronary CT angiography is a first-line diagnostic tool in suitable patients, offering high diagnostic accuracy.
• Noninvasive functional or anatomic imaging is recommended for symptomatic patients when obstructive disease is suspected.
• FFR-guided myocardial revascularization offers symptom relief and prognostic benefits for non-responsive patients.

Conclusions:

• Optimal medical treatment is crucial for managing ischemic heart disease.
• Advanced noninvasive imaging, particularly coronary CT angiography with FFR-CT, enhances diagnostic capabilities.
• Personalized treatment strategies, including FFR-guided revascularization, improve patient outcomes and reduce myocardial infarction risk.