Coronary physiology assessments: historical overview and future challenges

Area of Science:

• Cardiology
• Interventional Cardiology
• Physiology

Background:

• Coronary physiological assessment is vital for managing coronary artery disease (CAD).
• It traditionally defines lesion significance but now offers comprehensive epicardial and microvascular insights.
• Longitudinal assessment aids in management and procedural planning.

Purpose of the Study:

• To review the diverse applications of coronary physiology.
• To provide a historical perspective on its use.
• To highlight current challenges and future directions in coronary physiology.

Main Methods:

• Review of existing literature on coronary physiological assessment.
• Focus on pressure wire technology and its applications.
• Inclusion of non-invasive angiography-based indices.

Main Results:

• Coronary physiology guides management and procedural planning in CAD.
• Post-percutaneous coronary intervention (PCI) reassessment correlates with clinical outcomes.
• Physiology reassessment identifies residual pressure gradients for optimization.

Conclusions:

• Coronary physiology is a cornerstone in CAD management.
• Non-invasive methods are emerging to complement invasive assessments.
• Future applications promise further refinement in patient care.