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Coronary physiology derived from invasive angiography: Will it be a game changer?

Coronary physiology derived from invasive angiography: Will it be a game changer?
Coronary physiology derived from invasive angiography: Will it be a game changer?

There is a large body of evidence suggesting that having knowledge of the presence and extent of coronary atheroma and whether it is causing downstream myocardial ischaemia facilitates optimal diagnosis and management for patients presenting with chest pain. Despite this, the use of coronary pressure wire in routine practice is surprisingly low and routine assessment of all diseased vessels before making a bespoke management plan is rare. The advent of angiogram-derived models of physiology could change diagnostic practice completely. By offering routine assessment of the physiology of all the major epicardial coronary vessels, angiogram-derived physiology has the potential to radically modify current practice by facilitating more accurate patient-level, vessel-level, and even lesion-level decision-making. In this article, the authors review the current state of angiogram-derived physiology and speculate on its potential impact on clinical practice.

Angiography-derived physiology, Chronic coronary syndrome, Computational fluid dynamics, Coronary artery disease, Coronary modelling, Fractional flow reserve, Microvascular physiology, Physiology, Virtual fractional flow reserve
1756-1485
Gabara, Lavinia
47cfcd2a-1108-4599-98dd-4126aa9c9109
Hinton, Jonathan
3d2fa767-e092-41d8-a4e4-2858c84192c1
Gunn, Julian
0247234f-3794-4f17-9e6b-94093e1a8e3d
Morris, Paul D
1bc1c159-4fb2-44e5-bd4b-679fae05fb97
Curzen, Nick
c590bddc-f851-4b94-b3b8-00120e8a87ef
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4
Gabara, Lavinia
47cfcd2a-1108-4599-98dd-4126aa9c9109
Hinton, Jonathan
3d2fa767-e092-41d8-a4e4-2858c84192c1
Gunn, Julian
0247234f-3794-4f17-9e6b-94093e1a8e3d
Morris, Paul D
1bc1c159-4fb2-44e5-bd4b-679fae05fb97
Curzen, Nick
c590bddc-f851-4b94-b3b8-00120e8a87ef
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4

Gabara, Lavinia, Hinton, Jonathan, Gunn, Julian, Morris, Paul D, Curzen, Nick and Curzen, Nicholas (2020) Coronary physiology derived from invasive angiography: Will it be a game changer? Interventional Cardiology, 15 (1), [e06]. (doi:10.15420/icr.2019.25).

Record type: Article

Abstract

There is a large body of evidence suggesting that having knowledge of the presence and extent of coronary atheroma and whether it is causing downstream myocardial ischaemia facilitates optimal diagnosis and management for patients presenting with chest pain. Despite this, the use of coronary pressure wire in routine practice is surprisingly low and routine assessment of all diseased vessels before making a bespoke management plan is rare. The advent of angiogram-derived models of physiology could change diagnostic practice completely. By offering routine assessment of the physiology of all the major epicardial coronary vessels, angiogram-derived physiology has the potential to radically modify current practice by facilitating more accurate patient-level, vessel-level, and even lesion-level decision-making. In this article, the authors review the current state of angiogram-derived physiology and speculate on its potential impact on clinical practice.

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More information

Accepted/In Press date: 27 January 2020
e-pub ahead of print date: April 2020
Published date: 4 June 2020
Additional Information: Funding Information: Disclosure: NC reports grants, personal fees and non-financial support from HeartFlow; grants, personal fees and non-financial support from Boston Scientific; grants, personal fees and non-financial support from Haemonetics; and grants from Beckmann Coulter that are unrelated to this article. All other authors have no conflicts of interest to declare. Received: 28 October 2019 Accepted: 27 January 2020 Citation: Interventional Cardiology Review 2020;15:e06. DOI: https://doi.org/10.15420/icr.2019.25 Correspondence: Nick Curzen, Wessex Cardiothoracic Centre, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK. E: nick.curzen@uhs.nhs.uk Publisher Copyright: © 2020 All rights reserved.
Keywords: Angiography-derived physiology, Chronic coronary syndrome, Computational fluid dynamics, Coronary artery disease, Coronary modelling, Fractional flow reserve, Microvascular physiology, Physiology, Virtual fractional flow reserve

Identifiers

Local EPrints ID: 442522
URI: http://eprints.soton.ac.uk/id/eprint/442522
ISSN: 1756-1485
PURE UUID: c7bd2a50-da9a-4aca-a4f1-d8f56a5eac83
ORCID for Nicholas Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 17 Jul 2020 16:31
Last modified: 17 Mar 2024 03:02

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Contributors

Author: Lavinia Gabara
Author: Jonathan Hinton
Author: Julian Gunn
Author: Paul D Morris
Author: Nick Curzen
Author: Nicholas Curzen ORCID iD

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