FFR, iFR, CFR, and IMR: Results from clinical trials

Area of Science:

• Cardiology
• Vascular Physiology
• Diagnostic Imaging

Background:

• Coronary microvascular dysfunction (CMD) is increasingly recognized as a significant contributor to ischemic heart disease.
• Accurate diagnosis and management of CMD are crucial for improving patient outcomes.
• Current diagnostic tools and therapeutic strategies for CMD require further refinement.

Purpose of the Study:

• To provide a comprehensive overview of key physiological indices used in assessing coronary artery disease.
• To discuss the definition, application, and limitations of FFR, iFR, CFR, and IMR in the context of CMD.
• To review recent evidence and emerging clinical indications for these indices in various cardiovascular conditions.

Main Methods:

• Systematic review of current literature on FFR, iFR, CFR, and IMR.
• Analysis of diagnostic and prognostic performance of these indices in CMD.
• Evaluation of their utility in managing epicardial and microvascular coronary artery disease.

Main Results:

• FFR, iFR, CFR, and IMR offer valuable insights into coronary hemodynamics and microvascular function.
• Each index has specific limitations that must be considered in clinical practice.
• Emerging evidence supports their use in acute myocardial infarction, heart failure with preserved ejection fraction, and post-transplant settings.

Conclusions:

• FFR, iFR, CFR, and IMR are essential tools for evaluating CMD, complementing traditional angiography.
• Understanding their limitations and appropriate application is key to optimizing patient care.
• Further research is warranted to fully elucidate their role in complex cardiovascular scenarios.