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Archives of cardiovascular diseases
Volume 103, n° 11-12
pages 615-622 (novembre 2010)
Doi : 10.1016/j.acvd.2010.10.006
Received : 24 August 2010 ;  accepted : 19 October 2010
Fractional flow reserve: Concepts, applications and use in France in 2010
Mesure de la réserve coronaire : concept, indications et utilisation en France en 2010

Figure 1

Figure 1 : 

Coronary circulation. As the epicardial vessels contribute only a minimal fraction of the total vascular resistance there is no significant pressure drop along the conductance vessels. In contrast, passage through the resistive vessels produces a large drop in pressure. CFR: coronary flow reserve; FFR: fractional flow reserve; IMR: index of microvascular resistance.

Figure 2

Figure 2 : 

Fractional flow reserve calculation. Simplified theoretical explanation illustrating how a ratio of two flows can be derived from a ratio of two pressures provided that these pressures are recorded during maximal hyperaemia.

Figure 3

Figure 3 : 

Fractional flow reserve (FFR) in intermediate lesion. A) Intermediate stenosis of the middle left anterior descending estimated at 45% by quantitative coronary angiography. B) Typical example of simultaneous aortic pressure (Pa) and distal coronary pressure (Pd) recordings at rest and during maximal steady state hyperaemia, as induced by an intracoronary bolus of adenosine. Soon after starting the infusion, the decrease in distal pressure is preceded by a transient increase in aortic pressure.

Figure 4

Figure 4 : 

Fractional flow reserve and myocardial infarction. Schematic representation of the relationship between fractional flow reserve (FFR) and myocardial mass before and after myocardial infarction. DS: diameter stenosis.

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