Non-hyperemic, non pressure wire, coronary physiology. A further step towards the generalization of physiology in the cath-lab?

Revascularization of coronary stenosis has demonstrated prognostic benefits in the acute coronary syndrome and an improvement in symptomatology in chronic coronary syndrome in the presence of significant ischemia. The limitation of coronary angiography in deciding the functional significance of coronary stenoses, their indication for revascularization and the result of percutaneous intervention, especially in stable coronary artery disease and intermediate-grade coronary stenoses, has been known for years [ [1] Yong A.S. Ng A.C. Brieger D. Lowe H.C. Ng M.K. Kritharides L. Three-dimensional and two-dimensional quantitative coronary angiography, and their prediction of reduced fractional flow reserve. Eur. Heart J. 2011; 32: 345-353https://doi.org/10.1093/eurheartj/ehq259 Crossref PubMed Scopus (99) Google Scholar , [2] Lopez-Palop R. Carrillo P. Agudo P. Cordero A. Frutos A. Mashlab S. Martinez R. El A.A. Ramos D. Factors associated with errors in visual estimation of the functional significance of coronary lesions. Rev Esp Cardiol (Engl Ed). 2016; 69: 657-663https://doi.org/10.1016/j.rec.2015.12.024 Crossref PubMed Google Scholar ]. (See Fig. 1.) Comparison of vessel fractional flow reserve with invasive resting full-cycle ratio in patients with intermediate coronary lesionsInternational Journal of CardiologyPreviewVessel fractional flow reserve (vFFR) is a novel angiography-derived index for the assessment of myocardial ischemia without the need for pressure wires and hyperemic agents. vFFR has demonstrated very good diagnostic performance compared with the hyperemic index fractional flow reserve (FFR). The aim of this study was to compare vFFR to the non-hyperemic pressure ratio resting full-cycle ratio (RFR). Full-Text PDF