Anatomic versus physiologic assessment of coronary artery disease. Role of coronary flow reserve, fractional flow reserve, and positron emission tomography imaging in revascularization decision-making
K Lance Gould, Nils P Johnson, Timothy M Bateman, Rob S Beanlands, Frank M Bengel, Robert Bober, Paolo G Camici, Manuel D Cerqueira, Benjamin J W Chow, Marcelo F Di Carli, Sharmila Dorbala, Henry Gewirtz, Robert J Gropler, Philipp A Kaufmann, Paul Knaapen, Juhani Knuuti, Michael E Merhige, K Peter Rentrop, Terrence D Ruddy, Heinrich R Schelbert, Thomas H Schindler, Markus Schwaiger, Stefano Sdringola, John Vitarello, Kim A Williams Sr, Donald Gordon, Vasken Dilsizian, Jagat Narula, K Lance Gould, Nils P Johnson, Timothy M Bateman, Rob S Beanlands, Frank M Bengel, Robert Bober, Paolo G Camici, Manuel D Cerqueira, Benjamin J W Chow, Marcelo F Di Carli, Sharmila Dorbala, Henry Gewirtz, Robert J Gropler, Philipp A Kaufmann, Paul Knaapen, Juhani Knuuti, Michael E Merhige, K Peter Rentrop, Terrence D Ruddy, Heinrich R Schelbert, Thomas H Schindler, Markus Schwaiger, Stefano Sdringola, John Vitarello, Kim A Williams Sr, Donald Gordon, Vasken Dilsizian, Jagat Narula
Abstract
Angiographic severity of coronary artery stenosis has historically been the primary guide to revascularization or medical management of coronary artery disease. However, physiologic severity defined by coronary pressure and/or flow has resurged into clinical prominence as a potential, fundamental change from anatomically to physiologically guided management. This review addresses clinical coronary physiology-pressure and flow-as clinical tools for treating patients. We clarify the basic concepts that hold true for whatever technology measures coronary physiology directly and reliably, here focusing on positron emission tomography and its interplay with intracoronary measurements.
Keywords: CAD; CFR; ECG; FFR; MI; PCI; PET; PET perfusion imaging; SPECT; coronary artery disease; coronary flow; coronary flow reserve; coronary physiology; electrocardiographic/electrocardiography; fractional flow reserve; ischemia; myocardial infarction; percutaneous intervention; positron emission tomography; revascularization; single-photon emission computed tomography.
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Source: PubMed