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


Ischaemic risk stratification after deferral of revascularisation on the basis of fractional flow reserve

EuroIntervention 2021;16:1131-1133. DOI: 10.4244/EIJV16I14A204

1. Hospital General ISSSTE Querétaro - Autonomous University of Querétaro, Santiago de Querétaro, México; 2. Department of Cardiology, Amsterdam UMC, Amsterdam, the Netherlands

In a seminal experimental work almost 50 years ago, Gould and Lipscomb described the haemodynamic consequences of progressive focal reductions in coronary artery diameter on coronary flow1. It was observed that stenosis ≥50% and ≥85% of the lumen diameter impairs maximal hyperaemic and baseline flow, respectively. A sine qua non relationship between coronary stenosis, myocardial ischaemia and adverse cardiovascular events matured, and slowly became the reigning paradigm of ischaemic heart disease (IHD). In contrast with this “stenosis-centred” theory of IHD, Likoff et al described a group of women with angina, ischaemic electrocardiographic responses to physical exercise, and normal ...

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