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Updated: Jun 22, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Future of invasive and non-invasive hemodynamic assessment for coronary artery disease management
Antonella Scala1, Federico Marchini1, Sofia Meossi1
1Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy.
Insights
Accurate hemodynamic assessment is vital for managing coronary artery disease (CAD). Both non-invasive and invasive methods have advanced, offering improved diagnosis and patient care for epicardial stenosis and vasomotor disorders.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Coronary artery disease (CAD) is a significant global health issue.
- Precise evaluation of hemodynamic parameters is essential for effective patient management and improved outcomes.
- A variety of non-invasive and invasive diagnostic methods exist for assessing coronary stenosis and vasomotor disorders.
Purpose of the Study:
- To provide a comprehensive overview of the current advancements in both invasive and non-invasive hemodynamic assessment techniques for managing CAD.
- To highlight the evolution and future potential of diagnostic tools in cardiology.
Main Methods:
- Review of current non-invasive techniques including cardiac magnetic resonance imaging, coronary computed tomography (CT), fractional flow reserve derived from CT (FFR-CT), and perfusion CT.
- Discussion of invasive methods focusing on a full-physiology approach to evaluate lesions, microcirculation, and vasospastic disease.
Main Results:
- Significant progress has been made in both invasive and non-invasive diagnostic modalities for CAD.
- Non-invasive methods offer a broad spectrum of assessment options, with emerging technologies like FFR-CT.
- Invasive approaches have evolved to provide a comprehensive physiological assessment, including microvascular function.
Conclusions:
- Both invasive and non-invasive hemodynamic assessments are critical components in the modern management of coronary artery disease.
- Continued innovation in diagnostic techniques promises further advancements in CAD evaluation and treatment.
- The integration of various methods allows for a more complete understanding of CAD pathophysiology and hemodynamic significance.
Abstract:
Coronary artery disease represents a global health challenge. Accurate diagnosis and evaluation of hemodynamic parameters are crucial for optimizing patient management and outcomes. Nowadays a wide range of both non-invasive and invasive methods are available to assess the hemodynamic impact of both epicardial coronary stenosis and vasomotor disorders. In fact, over the years, important developments have reshaped the nature of both invasive and non-invasive diagnostic techniques, and the future holds promises for further innovation and integration. Non-invasive techniques have progressively evolved and currently a broad spectrum of methods are available, from cardiac magnetic resonance imaging with pharmacological stress and coronary computed tomography (CT) to the newer application of FFR-CT and perfusion CT. Invasive methods, on the contrary, have developed to a full-physiology approach, able not only to identify functionally significant lesions but also to evaluate microcirculation and vasospastic disease. The aim of this review is to summarize the current state-of-the-art of invasive and non-invasive hemodynamic assessment for CAD management.
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