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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2015; 7(9): 525-538
Published online Sep 26, 2015. doi: 10.4330/wjc.v7.i9.525
Coronary physiology assessment in the catheterization laboratory
Felipe Díez-delhoyo, Enrique Gutiérrez-Ibañes, Gerard Loughlin, Ricardo Sanz-Ruiz, María Eugenia Vázquez-Álvarez, Fernando Sarnago-Cebada, Rocío Angulo-Llanos, Ana Casado-Plasencia, Jaime Elízaga, Francisco Fernández Avilés Diáz
Felipe Díez-delhoyo, Enrique Gutiérrez-Ibañes, Gerard Loughlin, Ricardo Sanz-Ruiz, María Eugenia Vázquez-Álvarez, Fernando Sarnago-Cebada, Rocío Angulo-Llanos, Ana Casado-Plasencia, Francisco Fernández Avilés Diáz, Jaime Elízaga-Corrales, Instituto de Investigación Sanitaria Gregorio Marañón, Servicio de Cardiología, Departamento de Medicina, Universidad Complutense de Madrid, 28007 Madrid, Spain
Author contributions: All authors helped with the writing of the article.
Conflict-of-interest statement: None declared.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Enrique Gutiérrez-Ibañes, MD, Instituto de Investigación Sanitaria Gregorio Marañón, Servicio de Cardiología, Departamento de Medicina, Universidad Complutense de Madrid, Calle Dr Esquerdo 46, 28007 Madrid, Spain. e-guti@hotmail.es
Telephone: +34-65-3992157
Received: May 23, 2015
Peer-review started: May 26, 2015
First decision: June 24, 2015
Revised: July 10, 2015
Accepted: July 24, 2015
Article in press: July 27, 2015
Published online: September 26, 2015
Processing time: 119 Days and 23.6 Hours
Abstract

Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.

Keywords: Coronary heart disease; Coronary physiology; Endothelial dysfunction; Microvascular dysfunction; Fractional flow reserve; Coronary flow reserve; Index of microcirculatory resistance

Core tip: Assessment of the coronary circulation in the cathlab cannot be limited to angiography nowadays. The interventional cardiologist needs to be aware of current knowledge on coronary physiology and of the methods and measurements available for its characterization in clinical practice and research. In this article we review the main methods to assess the functional severity of coronary stenosis, myocardial blood flow, microvascular circulation, and endothelial function.