Why the study?
FFR assesses myocardial ischemia, but CFR and IMR are needed to evaluate microvascular status without significant epicardial disease.
Does comprehensive physiological assessment using CFR and IMR improve prognostic discrimination in patients with high FFR and deferred lesions?
Does comprehensive physiological assessment using CFR and IMR improve prognostic discrimination in patients with high FFR and deferred lesions?
Comprehensive physiological assessment using FFR, CFR, and IMR improves the ability to discriminate patients at high risk of future events by identifying microvascular disease.
Identifies high-risk microvascular disease despite high FFR; leaves open whether routine CFR/IMR integration alters deferral decisions.
While fractional flow reserve (FFR) is a good diagnostic index to assess the myocardial ischemia, coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR) can be used to address microvascular status without any significant epicardial disease. The independent predictors for FFR and IMR are totally different and acts differently on the macro- and micro-vascular dysfunction. In high FFR patients, low CFR and high IMR which indicates the presence of overt microvascular disease demonstrated poor prognosis. Thus, comprehensive physiological assessments using FFR, CFR and IMR could improve the ability to discriminate patients at high risk of future events.
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Chung et al. (2018) studied this question.
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