Physiological Assessment of Coronary Stenoses and the Microcirculation

This book offers a comprehensive review of coronary artery disease, focusing on the physiological assessment of epicardial vessels and microcirculation, and discusses advanced imaging techniques and their clinical implications.

Physiological Assessment of Coronary Stenoses and the Microcirculation delves into the evolution of coronary angiography as a crucial method for understanding coronary artery disease. Since its inception, the field has witnessed significant shifts in paradigms related to the study and interpretation of coronary conditions. The book emphasizes the advancements in angiographic and intracoronary imaging techniques, highlighting the importance of functional assessments of coronary circulation, which have profound implications for both diagnosis and treatment.

A key focus of the text is on fractional flow reserve (FFR), a pressure-derived index that gauges the severity of stenosis. While FFR has gained acceptance among cardiologists, the book points out gaps in understanding the fundamental principles of coronary physiology. It also discusses alternative techniques to FFR that offer a more holistic evaluation of coronary circulation. This is particularly relevant when assessing the microcirculation, which often plays a critical role in acute coronary syndromes and is influenced by various cardiovascular risk factors.

The book further explores the relationship between epicardial vessels and microcirculatory function, enhanced by the emergence of advanced imaging techniques such as invasive optical coherence tomography and non-invasive CT and NMR methods. Aimed at clinicians and researchers, this comprehensive review provides an in-depth analysis of anatomy, physiology, and diagnostic techniques, addressing both epicardial and microcirculatory diseases. It serves as an essential resource for understanding the complexities of coronary circulation and the best practices for assessment and treatment.