CRITICAL COMMENT ON THE ARTICLE “FRACTIONAL RESERVE FLOW, INSTANTANEOUS PRESSURE

RATIO IN THE WAVE-FREE PERIOD, AND ANGIOTOMOGRAPHY OF CORONARY ARTERIES”

Name: Anguie Tatiana Herrera Hernandez

Physiological indices allow us to calculate the hemodynamic impact of coronary lesions. Currently,
the most used intracoronary physiological indices that best evaluate the functional severity of
these lesions are the fractional reserve flow and the instantaneous pressure ratio in the wave-free
period. The simplified formula for fractional flow reserve is the ratio of the mean pressure distal to
the lesion to the mean aortic pressure under a hyperemic stimulus with adenosine; The value 0.8
is the accepted cut-off point to define that a coronary lesion is relevant from the hemodynamic
point of view. For its part, the wave-free period is defined as a relationship between the mean
distal intracoronary pressure and the mean aortic pressure, during a diastolic period that begins
after 25% of diastole and ends 5 milliseconds before the end of this (period wave-free), which
allows this relationship to be determined without the need to administer hyperemic agents.
Coronary angiography using computed tomography has been positioned as a non-invasive
alternative for the evaluation of coronary anatomy, and at present, the addition of functional tests
to this study, such as fractional flow reserve and coronary angiotomography, provides information
on coronary anatomy, and in a complementary way, on the physiological impact of coronary
lesions.