Over the past two decades a robust evidence base has established a definitive role of a physiological approach (FFR guided) in determining the appropriateness (medical therapy alone vs. revascularization), type (PCI vs. CABG) and extent (number of vessels stented/grafted) of revascularization in patients with CAD. Such an approach has proven clinical and cost effectiveness and provides powerful risk stratification of patietns with ischemic heart disease. Newer modatlities including non hyperemic pressure and aniography based indices like QFR have been validated against the gold standard FFR and their efficacy proven in randomized clinical trials. Yet a physiology guided approach to patients with ischemic heart disease remains substantially underutilized. In light of the recent advances in the field, we welcome state of the art reviews focusing on the contemporary role of coronary physiology in the evaluation and management of ischemic heart disease.
- Role of coronary physiology as an aribiter of appropriateness of revascularization.
- Role of Post PCI coronary physiology in optimizing PCI results and clinical outcomes
- Comparison of Non hyperemic pressure ratios and FFR- selection and pitfalls
- Role of Coronary physiology in patients with Acute Coronary Syndromes
- Limitations of coronary physiology evaluation- when anatomy trumps physiology!
Dr. Abdul Hakeem and Dr. Bobby Ghosh
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