Invasive functional testing

The concept of "significant" coronary stenosis has been revisited since the introduction of physiological measurements in the cardiac catheterisation laboratory. Invasive functional testing evaluates coronary physiology by recording blood pressure, flow or velocity and yields important information about the epicardial arteries and the respective myocardial territory. Numerous clinical studies have demonstrated the value of physiological testing in the assessment of challenging angiographic subsets, such as multivessel disease, bifurcation lesions and diffuse coronary atherosclerosis. In selected cases, deferral of revascularisation on the basis of functional indices can actually decrease adverse cardiac events. Furthermore, physiological measurements after angioplasty and stent implantation can be used to optimise the angiographic results and improve patient outcome. This review will discuss the basic concepts of functional testing in the catheterisation laboratory and its main applications for the interventional cardiologist.

• View at Pubmed