title: Coronary pressure-derived fractional flow reserve in the assessment of coronary artery stenoses.
abstract: OBJECTIVE
  Catheter-based angiography is the reference-standard to establish coronary anatomy. While routinely employed clinically, lumen assessment correlates poorly with physiological measures of ischaemia. Moreover, functional studies to identify and localise ischaemia before elective angiography are often not available. This article reviews fractional flow reserve (FFR) and its role in guiding patient management for patients with a potentially haemodynamic significant coronary lesion.
  
  
  METHODS
  This review discusses the theory, evidence, indications, and limitations of FFR. Also included are emerging non-invasive imaging FFR surrogates currently under evaluation for accuracy with respect to standard FFR.
  
  
  RESULTS
  Coronary pressure-derived fractional flow reserve (FFR) rapidly assesses the haemodynamic significance of individual coronary artery lesions and can readily be performed in the catheterisation laboratory. The use of FFR has been shown to effectively guide coronary revascularization procedures leading to improved patient outcomes.
  
  
  CONCLUSIONS
  FFR is an invaluable modality in guiding coronary disease treatment decisions. It is safe, cost-effective and leads to improved patient outcomes. Non-invasive imaging modalities to assess the physiologic significance of CAD are currently being  developed and evaluated.
authors.affiliation: Division of Cardiology, Johns Hopkins Hospital and Johns Hopkins University, 600 N. Wolfe Street, Blalock 536, Baltimore, MD 21287, USA.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kakouros
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Rybicki
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Mitsouras
authors.forename: Julie M
authors.initials: JM
authors.lastname: Miller
mesh_terms: D062186:Arterial Pressure; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D014057:Tomography, X-Ray Computed / Q000379:methods*