Relationship Between Functional Exercise Capacity and Functional Stenosis in Patients With Stable Angina and Intermediate Coronary Stenosis

Coronary Flow Reserve Is a Comprehensive Indicator of Cardiovascular Risk Factors in Subjects With Chest Pain and Normal Coronary Angiogram

“…But there were no significant differences between the 2 groups in exercise time (7.8±3.0 min vs 8.4±2.8 min, P=0.112, respectively), metabolic equivalent (9.2±2.4 vs 9.7±2.8, P=0.107, respectively) and double product (25,829±6,141 mmHg×beats/min vs 26,215± LEE DH et al 6,323 mmHg×beats/min, P=0.652, respectively) according to Bruce's protocol ( Table 2). On multivariate analysis the independent factor related to CFR <2.0 defined as an ischemic range of CFR, was HbA1c level (OR = 2.195, 95%CI = 0.920-1.005, P=0.013; Table 3).…”

Independent and incremental prognostic value of exercise stress echocardiography in low cardiovascular risk female patients with chest pain

“…The European Society of Cardiology (ESC) guidelines on the management of stable coronary artery disease (SCAD) recommended Exercise ECG is the initial test for establishing a diagnosis of SCAD in patients with symptoms of angina and intermediate pretest probability (PTP) of CAD, free of anti‐ischemic drugs, unless they cannot exercise or display ECG changes which make the ECG nonevaluable . However, the practice of initial testing using exercise ECG has recently been challenged . ECG changes appear late in the ischemic cascade, and stress ECG data provide no incremental prognostic information compared with clinical assessment .…”

Novel Insights Into Stenosis on Coronary Angiography–Outline of Functional Assessment of Stable Angina Patients with Angiographic Stenosis

“…The parameters of CFR show agreement at a cut-off value of 2.0 (11,15). On the other hand, FFRmyo is an accurate functional index of epicaudal stenosis (4,5). Intracoronary pressure can be measured with a 0.014-inch pressure-monitoring guidewire, which was first calibrated, then set to be equal with the aortic pressure in the guiding catheter, and finally positioned distal to the coronary lesion.…”

“…Intracoronary pressure can be measured with a 0.014-inch pressure-monitoring guidewire, which was first calibrated, then set to be equal with the aortic pressure in the guiding catheter, and finally positioned distal to the coronary lesion. Mean aortic and distal pressures were obtained during baseline measurements, and FFRmyo was calculated as the ratio of the mean distal pressure to the mean aortic pressure during maximum hyperemia (3,4,5). Although a previous report emphasized the importance of combining pressure and flow velocity measurements to evaluate coronary lesion severity and microvascular involvement (11), FFRmyo is a reliable index of the functional severity of coronary stenosis, and an FFRmyo value of 0.75 distinguishes stenoses associated with inducible ischemia from those that are not.…”

“…Measurement of coronary flow reserve (CFR; coronary flow velocity response to adenosine) and fractional flow reserve (FFRmyo; coronary pressure-derived with adenosine) provide information about functional severity (3). Furthermore, FFRmyo, which is calculated from coronary pressure measurements, is an invasive index used to identify a stenosis responsible for reversible ischemia (4,5,6). For most patients with stable angina, the goal of treatment is complete, or nearly complete elimination of anginal chest pain and return to normal activities with a functional capacity corresponding to Canadian Cardiovascular Society (CCS) class I angina.…”