The field of cardiovascular imaging is undergoing a new era of innovation. For decades the gold standard of measuring the degree of coronary vessel occlusion was fractional flow reserve (FFR) during diagnostic catheterization. FFR requires a medicine like adenosicAne to induce maximum blood flow to measure the severity of coronary blockage. Unfortunately, adenosine induced blood flow also puts stress on the patient's heart in order to perform the diagnostic test.

The introduction of novel nonhyperemic pressure ratio (NHPR) options are driving innovations, enabling less burdensome techniques that are deemed equivalent to FFR without putting stress on a patient's heart because the tests remove the need for a maximum blood flow to obtain clinically accurate diagnostic information.

The ACC is committed to leveraging innovations such as these NHPR options to improve patient care and remove waste from the health care system. To that end, all of these tests are considered to be appropriate in patients undergoing further procedures such as PCI or CABG as outlined in ACC Appropriate Use Criteria For Coronary Revascularization in Patients With Stable Ischemic Heart Disease.

On the NCDR front, the CathPCI Registry Version 5 update, released in 2018, continued to include reporting on the use of FFR and introduced the option to report instant wave-free ratio (iFR) based on U.S. Food and Drug Administration (FDA) approval in 2014. The College is building resting full-cycle ratio (RFR) into the next CathPCI Registry Version 5 update as a result of the FDA's approval last year. This update is expected in about a year. In order to meet the needs of hospitals and clinicians using RFR today, as well as ensure access for patients who could benefit from this test, the ACC is also developing a short-term workaround that we expect to be available in the next two months.

More information will be posted on the CathPCI Registry Announcements page when the update is available and made available in future News & Views emails.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Aortic Surgery

Keywords: Coronary Vessels, Adenosine, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention, Coronary Occlusion, Registries, National Cardiovascular Data Registries, Hemodynamics, Catheterization, Coronary Artery Bypass, CathPCI Registry

< Back to Listings