{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:18:40Z","timestamp":1769159920270,"version":"3.49.0"},"reference-count":80,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T00:00:00Z","timestamp":1550448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Coronary angiography has been the principle modality for assessing the severity of atherosclerotic coronary artery disease for several decades. However, there is a complex relationship between angiographic coronary stenosis and the presence or absence of myocardial ischemia. Recent technological advances now allow for the assessment of coronary physiology in the catheterization laboratory at the time of diagnostic coronary angiography. Early studies focused on coronary flow reserve (CFR) but more recent work has demonstrated the physiologic accuracy and prognostic value of the fractional flow reserve (FFR) and instantaneous wave free ratio (iFR) for the assessment of coronary artery disease. These measurements have been validated in large multi-center clinical trials and have become indispensable tools for guiding revascularization in the cardiac catheterization laboratory. The physiological assessment of chest pain in the absence of epicardial coronary artery disease involves coronary thermodilution to obtain the index of microcirculatory resistance (IMR) or Doppler velocity measurement to determine the coronary flow velocity reserve (CFVR). Physiology-based coronary artery assessment brings \u201cpersonalized medicine\u201d to the catheterization laboratory and allows cardiologists and referring providers to make decisions based on objective findings and evidence-based treatment algorithms. The purpose of this review is to describe the theory, technical aspects, and relevant clinical trials related to coronary physiology assessment for an intended audience of general medical practitioners.<\/jats:p>","DOI":"10.3390\/jcm8020255","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T04:08:20Z","timestamp":1550549300000},"page":"255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Coronary Physiology in the Cardiac Catheterization Laboratory"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3664-4102","authenticated-orcid":false,"given":"Samit M.","family":"Shah","sequence":"first","affiliation":[{"name":"Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven E.","family":"Pfau","sequence":"additional","affiliation":[{"name":"Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA"},{"name":"VA Connecticut Healthcare System, West Haven, CT 06516, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E42-2","DOI":"10.1161\/01.CIR.0000053958.38681.81","article-title":"First selective coronary arteriogram","volume":"107","author":"Cheng","year":"2003","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1161\/01.CIR.0000024109.12658.D4","article-title":"The coronary angiogram and its seminal contributions to cardiovascular medicine over five decades","volume":"106","author":"Ryan","year":"2002","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1056\/NEJMoa0907272","article-title":"Low diagnostic yield of elective coronary angiography","volume":"362","author":"Patel","year":"2010","journal-title":"N. 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