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Current state of practical application of invasive methods for assessing intracoronary physiology

Authors: Golukhova E.Z., Petrosian K.V., Abrosimov A.V., Losev V.V.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2020-14-3-272-279

For citation: Golukhova E.Z., Petrosian K.V., Abrosimov A.V., Losev V.V. Current state of practical application of invasive methods for assessing intracoronary physiology. Creative Cardiology. 2020; 14 (3): 272–9 (in Russ.). DOI: 10.24022/1997-3187-2020-14-3-272-279

Received / Accepted:  02.09.2020 / 12.09.2020

Keywords: instantaneous flow reserve wave-free period intracoronary physiology

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Abstract

Nowadays, the assessment of instantaneous flow reserve (iFR) is considered a modern diagnostic modality for determining the hemodynamic significance of coronary artery stenosis. At the beginning of development stenotic lesion in the lumen of the coronary artery microcirculatory collaterals start to form around the affected area to compensate for coronary homeostasis, and as a result, the preservation of optimal pressure indicators in the coronary artery distal to stenosis. The physiological principal of the iFR based on the calculation of the hemodynamic significance of coronary stenosis by determining the fluctuations of microvascular resistance. The iFR registrates pressure in the coronary artery at the time of a special diastolic phase, called the “wave-free ratio”. During this phase, coronary blood flow is at its peak, and coronary resistance, on the contrary, reaches its minimum value. The mathematical algorithm in the systems used by iFR is able to automatically register this phase and use it as a control value without the appointment of pharmacological vasodilators. This literature review provides an analysis of the results of large-scale studies, as well as the recommendations of major associations involved in the treatment of coronary pathology, which indicate that the use of iFR is an equivalent alternative to fractional flow reserve.

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About Authors

  • Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of RAS, Chief of Chair, Acting Head of A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Deputy Chief Editor of the Journal, ORCID
  • Karen V. Petrosian, Dr. Med. Sc., Head of Department, ORCID
  • Andrey V. Abrosimov, Cand. Med. Sc., Researcher, Specialist in Endovascular Diagnosis and Treatment, ORCID
  • Vladimir V. Losev, Postgraduate, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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