Title:The Role of Coronary Physiology in Contemporary Percutaneous Coronary
Interventions
Volume: 18
Issue: 1
Author(s): Federico Marin*, Roberto Scarsini, Dimitrios Terentes-Printzios, Rafail A. Kotronias, Flavio Ribichini, Adrian P. Banning and Giovanni Luigi De Maria
Affiliation:
- Division of Cardiology, University of Verona, Verona, Italy
- Oxford Heart Centre, Oxford University Hospitals, Oxford,
United Kingdom
Keywords:
Coronary physiology, myocardial revascularization, functional assessment, percutaneous coronary intervention, ischemic heart disease, microvascular dysfunction.
Abstract:
Invasive assessment of coronary physiology has radically changed the paradigm of myocardial
revascularization in patients with coronary artery disease. Despite the prognostic improvement
associated with ischemia-driven revascularization strategy, functional assessment of angiographic
intermediate epicardial stenosis remains largely underused in clinical practice. Multiple
tools have been developed or are under development in order to reduce the invasiveness, cost, and
extra procedural time associated with the invasive assessment of coronary physiology. Besides epicardial
stenosis, a growing body of evidence highlights the role of coronary microcirculation in regulating
coronary flow with consequent pathophysiological and clinical and prognostic implications.
Adequate assessment of coronary microcirculation function and integrity has then become another
component of the decision-making algorithm for optimal diagnosis and treatment of coronary syndromes.
This review aims at providing a comprehensive description of tools and techniques currently available
in the catheterization laboratory to obtain a thorough and complete functional assessment of
the entire coronary tree (both for the epicardial and microvascular compartments).