Is hyperaemia essential for accurate functional assessment of coronary stenosis severity?

Hennigan, B., Robertson, K., Berry, C. and Oldroyd, K. G. (2015) Is hyperaemia essential for accurate functional assessment of coronary stenosis severity? Interventional Cardiology Review, 10(2), pp. 72-78. (doi: 10.15420/icr.2015.10.2.72) (PMID:29588678) (PMCID:PMC5808679)

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Abstract

Fractional flow reserve (FFR) requires the use of maximal hyperaemia as described in the original preclinical and clinical validation studies and subsequent practice changing randomized controlled trials. A perception that the need for hyperaemia (usually induced with adenosine) was one of the obstacles to more widespread adoption of FFR has led to interest in the use of resting non-hyperaemic indices to assess the functional significance of coronary stenoses. We examine the current evidence base and conclude that resting indices agree with FFR in only 80 % of lesions when a binary cut-off is employed but closer to 90 % when hybrid strategies utilising both resting indices and FFR are utilised. It seems counter intuitive to sacrifice diagnostic accuracy when in most patients and healthcare systems the induction of hyperaemia with adenosine is safe and emminently affordable.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Oldroyd, Dr Keith and Robertson, Dr Keith and Hennigan, Dr Barry
Authors: Hennigan, B., Robertson, K., Berry, C., and Oldroyd, K. G.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Interventional Cardiology Review
Publisher:Radcliffe Cardiology
ISSN:1756-1477
ISSN (Online):1756-1477

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