Myocardial fractional flow reserve : Its role in guiding PCI in stable coronary artery disease.
Summary of "Myocardial fractional flow reserve : Its role in guiding PCI in stable coronary artery disease."
Revascularization of coronary artery lesions should be based on objective evidence of ischemia, as recommended by the guidelines of the European Society of Cardiology. However, even in the case of stable coronary artery disease and elective percutaneous coronary intervention (PCI), pre-procedural noninvasive stress test results are available in a minority of patients only. It is common practice for physicians to make decisions on revascularization in the catheterization laboratory after a cursory review of the angiogram, despite the well-recognized inaccuracy of such an approach. Myocardial fractional flow reserve (FFR) measured by a coronary pressure wire is a specific index of the functional significance of a coronary lesion, with superior diagnostic accuracy for the detection of ischemia than any noninvasive stress test. FFR trials on patients with single and multivessel disease, such as the DEFER and FAME studies, have demonstrated that the clinical benefit of PCI with respect to patient outcome is greatest when revascularization is limited to lesions inducing ischemia, whereas lesions not inducing ischemia should be treated medically.
Affiliation
Medizinische Klinik II - Kardiologie und Angiologie, BG Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland, michael.lindstaedt@rub.de.
Journal Details
This article was published in the following journal.
Name: Herz
ISSN: 1615-6692
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21755348
- DOI: http://dx.doi.org/10.1007/s00059-011-3486-8
Medical and Biotech [MESH] Definitions
Fractional Flow Reserve, Myocardial
The ratio of maximum blood flow to the MYOCARDIUM with CORONARY STENOSIS present, to the maximum equivalent blood flow without stenosis. The measurement is commonly used to verify borderline stenosis of CORONARY ARTERIES.
Myocardial Ischemia
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
Coronary Disease
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Myocardial Reperfusion Injury
Damage to the MYOCARDIUM resulting from MYOCARDIAL REPERFUSION (restoration of blood flow to ischemic areas of the HEART.) Reperfusion takes place when there is spontaneous thrombolysis, THROMBOLYTIC THERAPY, collateral flow from other coronary vascular beds, or reversal of vasospasm.
Myocardial Bridging
A malformation that is characterized by a muscle bridge over a segment of the CORONARY ARTERIES. Systolic contractions of the muscle bridge can lead to narrowing of coronary artery; coronary compression; MYOCARDIAL ISCHEMIA; MYOCARDIAL INFARCTION; and SUDDEN CARDIAC DEATH.
PubMed Articles
Deciding how to treat acute myocardial infarction (MI) with myocardial bridge is difficult because stent fracture and early restenosis are frequently reported. We present a 50-year-old female patient...
Fractional Flow Reserve-Guided PCI in Stable Coronary Disease.
To the Editor: In reporting the results of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 (FAME 2) study, De Bruyne et al. (Sept. 13 issue)(1) conclude that fractional flo...
Fractional Flow Reserve-Guided PCI in Stable Coronary Disease.
To the Editor: In reporting the results of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 (FAME 2) study, De Bruyne et al. (Sept. 13 issue)(1) conclude that fractional flo...
Fractional Flow Reserve-Guided PCI in Stable Coronary Disease.
To the Editor: In reporting the results of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2 (FAME 2) study, De Bruyne et al. (Sept. 13 issue)(1) conclude that fractional flo...
Recent insights into the treatment of stable CAD : FFR-guided PCI vs. medical therapy.
Cornerstones in the treatment of coronary artery disease (CAD) are medical therapy and coronary revascularization. In acute settings (ST-elevation myocardial infarction and non-ST-elevation myocardial...
Clinical Trials
Regadenoson to Achieve Maximal Hyperemia for Fractional Flow Reserve in the Catheterization Lab
The purpose of this study is to determine if regadenoson is as safe and effective as adenosine when used in the cardiac catheterization lab during measurement of coronary flow reserve and...
Comparison of Fractional Flow Reserve and Intravascular Ultrasound
This study will evaluate the relationship of Fractional Flow Reserve (FFR) and Minimal Lumen Area (MLA) by IntraVascular UltraSound (IVUS) by comparing the results of the both tests which...
Performing Fractional Flow Reserve Without Anticoagulation During Diagnostic Catheterization
The purpose of this study is to assess the safety of performing fractional flow reserve (FFR) of the myocardium without using anticoagulation by performing a retrospective review of 100 co...
Virtual Coronary Intervention and Non-invasive Fractional Flow Reserve (FFR)
The investigators examined the feasibility of treatment planning using virtual coronary revascularization and fractional flow reserve (FFR) CT before the invasive procedures.
This study will evaluate the effectiveness of CorCTA by comparing the results of the test with another imaging method called Fractional Flow Reserve (FFR), which is done as a part of the c...
