Is Coronary Physiology Assessment Valid in Special Circumstances?: Aortic Stenosis, Atrial Fibrillation, Left Ventricular Hypertrophy, and Other.

Interv Cardiol Clin

Long Beach Veterans Administration Medical Center, 5901 East 7th Street, 111C, Long Beach, CA 90822, USA. Electronic address: https://twitter.com/arnoldseto.

Published: January 2023

Fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs) provide an important clinical tool to evaluate the hemodynamic significance of coronary lesions. However, these indices have major limitations. As these indices are meant to be surrogates of coronary flow, clinical scenarios such as aortic stenosis (with increased end-systolic and end-diastolic pressures) or atrial fibrillation (with significant beat-to-beat cardiac output variability) can have significant effect on the accuracy and reliability of these hemodynamic indices. Here, we provide a comprehensive evaluation of the pitfalls, limitations, and strengths of FFR and NHPRs in common clinical scenarios paired with coronary artery disease.

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http://dx.doi.org/10.1016/j.iccl.2022.09.003DOI Listing

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