The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

Age-related iFR/FFR discordance: does it matter?

EuroIntervention 2021;17:704-705. DOI: 10.4244/EIJV17I9A123

1. Division of Cardiovascular Medicine and Cardiovascular Institute, Stanford University, Stanford, CA, USA; 2. VA Palo Alto Health Care System, Palo Alto, CA, USA
The relationship between microvascular dysfunction and fractional flow reserve (FFR) has long been recognised1. Microvascular dysfunction results in a lower maximal achievable flow down a coronary artery, a lower pressure gradient and a higher FFR across a given stenosis. Some have argued that this represents an underappreciation by FFR of the functional significance of a stenosis. However, De Bruyne and colleagues demonstrated that, in the presence of microvascular dysfunction resulting from a remote myocardial infarction, FFR remained accurate for detecting lesions responsible for myocardial ischaemia1. The higher FFR which occurs in the setting of microvascular dysfunction is not falsely high, ...

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