Before coronary angiography (nondiagnostic or equivocal exercise stress ECG) | |
---|---|
• Suspected epicardial coronary stenosis (LAD, Cx, RCA) | • Suspected microvascular abnormalities (young patients with chest pain despite no risk factor for epicardial CAD) |
1. WM (LV global) assessment (if negative) | CFR in LAD |
2. CFR (regional assessment of LAD) | |
After coronary angiography | |
Abnormal coronary angiogram | Normal coronary angiogram |
• Functional assessment of intermediate stenosis | • Confirmation or exclusion of microvascular dysfunction in patients with chest pain |
1. Flow acceleration at stenotic site (if not possible) | CFR |
2. Dual assessment of WM + CFR | |
Control during follow-up after initial coronary angiogram | |
• Patients deferred from PTCA due to intermediate stenosis | • Verify the benefit of pharmacological interventions |
• Patients with suspected restenosis | |
1. Flow acceleration at stenotic site (if not possible) | CFR |
2. Dual assessment of WM + CFR |