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Non-hyperaemic coronary pressure measurements to guide coronary interventions
Tim P van de Hoef1, Joo Myung Lee2, Mauro Echavarria-Pinto3
1Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands. t.p.vandehoef@amsterdamumc.nl.
Nature Reviews. Cardiology
|May 16, 2020
Summary
Non-hyperemic coronary pressure measurements offer a simpler approach to guiding percutaneous coronary interventions. This review explores their principles, evidence, and advantages over fractional flow reserve for improved patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Physiological Guidance
Background:
- Coronary angiography is standard for evaluating coronary artery disease.
- Fractional flow reserve (FFR) is a key physiological metric for guiding percutaneous coronary interventions (PCI).
- Despite guideline recommendations, FFR adoption in routine practice remains limited.
Purpose of the Study:
- To review the principles and application of non-hyperemic coronary pressure measurements.
- To evaluate the evidence supporting non-hyperemic indices for stenosis assessment.
- To compare non-hyperemic pressure ratios with FFR and highlight potential benefits.
Main Methods:
- Review of existing literature on coronary physiology and non-hyperemic pressure measurements.
- Analysis of principles behind non-hyperemic coronary pressure ratios.
- Evaluation of clinical evidence and comparison with FFR.
Main Results:
- Non-hyperemic coronary pressure measurements aim to simplify physiological guidance for PCI.
- Several non-hyperemic pressure ratios have been developed and studied over the past decade.
- Understanding discordance between non-hyperemic ratios and FFR is crucial.
Conclusions:
- Non-hyperemic coronary pressure measurements represent a promising, simplified adjunct to angiography for PCI guidance.
- Further research and clinical integration are needed to fully realize the potential of these novel parameters.
- These methods may overcome barriers to FFR adoption, potentially improving patient care.
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