The Prognostic Role of Coronary Flow Reserve during Stress Echocardiography in Coronary Artery Disease in Clinical Practice

Dear Colleagues,

Coronary artery disease, as you are all aware, is a leading cause of death worldwide. Although we have numerous methods which are able to help us to diagnose the presence of a plaque inside the coronary arteries early and effectively, few are really able to provide pathophysiological elements on the functional significance of the obstruction to the flow due to coronary obstruction itself. On the other hand, we have coronary microcirculation, which represents a great part of coronary circulation and which it is impossible to measure directly. Coronary flow reserve is the only functional parameter capable of quantifying the state of the entire coronary circulation. Some techniques, invasive and above all noninvasive, allow us to quantify coronary flow reserve in clinical practice, but today, this approach is somewhat underutilized. It is therefore very important to invite the evaluation of noninvasive coronary flow reserve during clinical practice. In fact, a reduced coronary flow is strongly associated with an increased risk of all-cause mortality and MACE across a wide range of pathological processes. This finding supports recent recommendations that coronary flow should be measured more routinely in clinical practice to target aggressive vascular risk modification for individuals at higher risk. It is imperative to spread the research culture of this important functional parameter to better personalize the therapeutic strategies in individual patients. Given the importance of CFR in medicine and research, the journal Medicina is launching this Special Issue. We encourage you and your co-workers to submit your articles reporting on this topic. Reviews or original articles dealing with functional aspects of CFR in the different subset of cardiac and systemic diseases, as well as articles providing an up-to-date overview of the use of new functional parameters in early diagnosis and management of coronary artery disease are particularly welcome. In addition, we warmly invite you to submit articles reporting on evidence and expectations from innovative techniques, with a special focus on individualized approaches.

Prof. Dr. Fausto Rigo
Guest Editor

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• coronary artery disease
• stress echocardiography
• coronary flow reserve
• MACE