Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:656-67 - Vol. 71 Num.08 DOI: 10.1016/j.rec.2018.02.003

Past, Present and Future of Coronary Physiology

Takayuki Warisawa a,b, Christopher M. Cook a, Yoshihiro J. Akashi b, Justin E. Davies a,

a International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
b Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan

Keywords

Coronary physiology. Fractional flow reserve. Instantaneous wave-free ratio.

Abstract

It is well known that the apparent significant coronary stenosis on angiography sometimes does not cause significant ischemia, and vice versa. For this reason, decision-making based on coronary physiology is becoming more and more important. Fractional flow reserve (FFR), which has emerged as a useful tool to determine which lesions need revascularization in the catheterization laboratory, now has a class IA indication in the European Society of Cardiology guidelines. More recently, the instantaneous wave-free ratio, which is considered easier to use than FFR, has been graded as equivalent to FFR. This review discusses the concepts of FFR and instantaneous wave-free ratio, current evidence supporting their use, and future directions in coronary physiology.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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