Intracoronary physiological indices for coronary microvascular dysfunction: from concept to clinical application

Area of Science:

• Cardiovascular Medicine
• Physiology
• Medical Diagnostics

Background:

• Coronary microcirculation was historically difficult to assess, often termed a 'black box'.
• Coronary microvascular dysfunction (CMD) is increasingly recognized as a key factor in myocardial ischemia and various cardiovascular diseases.
• Accurate diagnosis and targeted treatments for CMD are crucial for patient outcomes.

Purpose of the Study:

• To provide an overview of current intracoronary physiological indices (IPA) for assessing coronary microcirculation.
• To summarize the clinical applications, strengths, and limitations of IPA in diagnosing and managing CMD.
• To highlight the evolving role of IPA in risk stratification and personalized therapy for cardiovascular conditions.

Main Methods:

• Review of intracoronary physiological assessment techniques used during coronary catheterization.
• Analysis of data on the diagnostic capabilities of various physiological indices for CMD.
• Evaluation of the strengths and limitations of current IPA methods.

Main Results:

• IPA techniques allow for direct, patient-specific assessment of coronary microcirculation.
• Established indices provide valuable information for diagnosing CMD.
• IPA aids in risk stratification and guides the development of tailored treatment strategies.

Conclusions:

• Invasive physiological assessments are essential tools for understanding and managing coronary microvascular dysfunction.
• IPA offers precise diagnostic and prognostic information, moving beyond the 'black box' concept.
• The role of IPA in cardiovascular medicine is expanding, impacting diagnosis, risk assessment, and therapeutic decisions.