IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305158
Open Access Review
Coronary Physiology: Delivering Precision Medicine?
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1 Department of Cardiology, University Hospital, 38000 Grenoble Alpes, France
2 Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, LRB, 38000 Grenoble, France
3 French Alliance Clinical Trial, French Clinical Research Infrastructure Network, 75018 Paris, France
*Correspondence: GBarone@chu-grenoble.fr (Gilles Barone-Rochette)
Academic Editors: Marco Zimarino and Nick Curzen
Rev. Cardiovasc. Med. 2022, 23(5), 158; https://doi.org/10.31083/j.rcm2305158
Submitted: 31 December 2021 | Revised: 28 February 2022 | Accepted: 17 March 2022 | Published: 27 April 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Coronary physiological assessment is now widely used to assess epicardial coronary lesions in cath lab. Based on clinical evidence, fractional flow reserve (FFR) is the gold standard method to select whether epicardial coronary lesions need revascularization. While additional epicardial indexes, such as instantaneous wave-free ratio (iFR), are also used for revascularization decision-making, several indexes are now also available to explore the coronary microcirculation. Therefore, coronary physiological assessment now allows to explore the entire coronary tree and offer the potential of precision medicine for patients affected by coronary artery disease (CAD). This paper will provide review of the epicardial and microvascular indexes available for the assessment of coronary physiology. More specifically, the already demonstrated contributions of these indexes in the management of CAD and the role they could play in precision medicine will be reviewed with special emphasis on chronic coronary syndrome.

Keywords
coronary physiology assessment
coronary microcirculation dysfunction
precise medicine
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