Anatomic versus physiologic assessment of coronary artery disease: Role of coronary flow reserve, fractional flow reserve, and positron emission tomography imaging in revascularization decision-making

K. Lance Gould, Nils P. Johnson, Timothy M. Bateman, Rob S. Beanlands, Frank M. Bengel, Robert Bober, Paolo G. Camici, Manuel D. Cerqueira, Benjamin J.W. Chow, Marcelo F. Di Carli, Sharmila Dorbala, Henry Gewirtz, Robert J. Gropler, Philipp A. Kaufmann, Paul Knaapen, Juhani Knuuti, Michael E. Merhige, K. Peter Rentrop, Terrence D. Ruddy, Heinrich R. SchelbertThomas H. Schindler, Markus Schwaiger, Stefano Sdringola, John Vitarello, Kim A. Williams, Donald Gordon, Vasken Dilsizian, Jagat Narula

Research output: Contribution to journalReview articlepeer-review

476 Scopus citations

Abstract

Angiographic severity of coronary artery stenosis has historically been the primary guide to revascularization or medical management of coronary artery disease. However, physiologic severity defined by coronary pressure and/or flow has resurged into clinical prominence as a potential, fundamental change from anatomically to physiologically guided management. This review addresses clinical coronary physiology - pressure and flow - as clinical tools for treating patients. We clarify the basic concepts that hold true for whatever technology measures coronary physiology directly and reliably, here focusing on positron emission tomography and its interplay with intracoronary measurements.

Original languageEnglish
Pages (from-to)1639-1653
Number of pages15
JournalJournal of the American College of Cardiology
Volume62
Issue number18
DOIs
StatePublished - Oct 29 2013

Keywords

  • PET perfusion imaging
  • coronary flow
  • coronary physiology
  • ischemia
  • revascularization

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