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  • Changes in Resting Coronary Blood Flow During a Cardiac Catheterization Procedure - Implications for Use of Non-Hyperemic Pressure Ratios for Lesion Assessment

    The current standard of invasive coronary stenosis assessment is the hyperemic translesional pressure ratio, widely known as the fractional flow reserve (FFR). FFR is the ratio of distal post-stenotic pressure (Pd) to the aortic pressure (Pa) during pharmacologically-induced maximal flow stimulation usually with adenosine. In the last decade in order to simplify workflow and reduce the side effects of adenosine, clever investigators demonstrated that a resting diastolic sub-cycle pressure measurement, the instantaneous wave-free pressure ratio (iFR), is non-inferior to FFR in low risk coronary artery disease (CAD) patients and that other non-hyperemic pressure ratios (NHPRs) are numerically and clinically equivalent to iFR for the limited outcome data available. 

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