Stress Echocardiography in the Era of Fractional Flow Reserve

AbstractPurpose of ReviewIt is the aim of this review to demonstrate the relevance of stress echocardiography in the era of fractional flow reserve by establishing the current use of stress echocardiography and fractional flow reserve, underlining their physiological basis and through this demonstrating the clear differences in their application.Recent FindingsThe importance of the microcirculation is only now being understood, no more so than in the fact that abnormalities in the microcirculation, determined by abnormal coronary flow reserve, predict adverse mortality regardless of the normality of the epicardial coronary lesions. Stress echocardiography therefore gives a fuller picture of the overall cardiovascular risk to our patients in its ability to interrogate the epicardial vessels down to the microcirculation, with a number of techniques available to measure coronary flow reserve such as myocardial perfusion stress echocardiography and transthoracic Doppler stress echocardiography of epicardial coronary vessels. Fractional flow reserve can then add further information by determining whether a coronary artery lesion is responsible for myocardial ischaemia.SummaryIn an era of fractional flow reserve affording the resolution of myocardial ischaemia down to the specific lesion, it can be tempting to think that other generally non-invasive techniques no longer have a role in the investigation and management of coronary artery disease. This, however, betrays a lack of unde...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research