Published online Sep 26, 2015. doi: 10.4330/wjc.v7.i9.525
Peer-review started: May 26, 2015
First decision: June 24, 2015
Revised: July 10, 2015
Accepted: July 24, 2015
Article in press: July 27, 2015
Published online: September 26, 2015
Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.
Core tip: Assessment of the coronary circulation in the cathlab cannot be limited to angiography nowadays. The interventional cardiologist needs to be aware of current knowledge on coronary physiology and of the methods and measurements available for its characterization in clinical practice and research. In this article we review the main methods to assess the functional severity of coronary stenosis, myocardial blood flow, microvascular circulation, and endothelial function.