{"id":8918,"date":"2025-10-19T19:59:07","date_gmt":"2025-10-19T16:59:07","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=8918"},"modified":"2025-10-19T19:59:07","modified_gmt":"2025-10-19T16:59:07","slug":"cardiac-imaging-for-the-detection-of-ischemia-current-status-and-future-perspectives-when-50-60-stenosis-isnt-the-full-story-can-imaging-replace-th","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/cardiac-imaging-for-the-detection-of-ischemia-current-status-and-future-perspectives-when-50-60-stenosis-isnt-the-full-story-can-imaging-replace-th\/","title":{"rendered":"Cardiac imaging for the detection of ischemia: current status and future perspectives \u2013\u00a0 When \u201c50\u201360% Stenosis\u201d Isn\u2019t the Full Story: Can Imaging Replace the Functional FFR?"},"content":{"rendered":"<div>Cardiac imaging for the detection of ischemia: current status and future perspectives \u2013<\/div>\n<div>When \u201c50\u201360% Stenosis\u201d Isn\u2019t the Full Story: Can Imaging Replace the Functional FFR?<\/div>\n<div><\/div>\n<div>Source: ,JACC , October 2025.<\/div>\n<div>Background:<\/div>\n<div><\/div>\n<div>Intermediate coronary stenosis (\u224850\u201360%) remains a daily challenge in cardiology.<\/div>\n<div>Angiography shows anatomy, not ischemia, while traditional FFR and stress tests can be invasive or inconclusive.<\/div>\n<div>Modern cardiac imaging now bridges anatomy and physiology \u2014 revealing perfusion, viability, and the true burden of ischemia.<\/div>\n<div><\/div>\n<div>Keynotes:<\/div>\n<div>Imaging Spectrum \u2013 From Anatomy to Function<\/div>\n<div><span> 1. CCTA: Excellent for anatomy and plaque, limited for microvascular ischemia.<\/span><\/div>\n<div><span> 2. Stress Echocardiography: Detects wall-motion abnormalities, operator-dependent.<\/span><\/div>\n<div><span> 3. Nuclear (SPECT\/PET): Assesses perfusion; PET quantifies flow but uses radiation.<\/span><\/div>\n<div><span> 4. Cardiac MRI (CMR): Combines stress perfusion, LGE, and mapping \u2014 detects ischemia, viability, and microvascular dysfunction without radiation.<\/span><\/div>\n<div><\/div>\n<div>CMR vs. FFR \u2013 Complement or Replacement?<\/div>\n<div><span> \u2022 For 40\u201370% lesions, quantitative perfusion CMR can match or surpass invasive FFR in detecting flow limitation.<\/span><\/div>\n<div><span> \u2022 CMR assesses the effect of stenosis, not just its degree.<\/span><\/div>\n<div><span> \u2022 Particularly valuable in multivessel or microvascular disease where FFR may miss global ischemia.<\/span><\/div>\n<div><\/div>\n<div>Clinical Takeaways<\/div>\n<div><span> 1. Stress + LGE CMR is the noninvasive gold standard for diagnosing ischemia and viability.<\/span><\/div>\n<div><span> 2. It answers: Is the myocardium alive? Is it suffering?<\/span><\/div>\n<div><span> 3. Quantitative CMR perfusion = a \u201cvirtual FFR\u201d without a wire.<\/span><\/div>\n<div><span> 4. The future lies in imaging the impact of disease, not its geometry.<\/span><\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jcmg.2025.08.016\">https:\/\/www.jacc.org\/doi\/10.1016\/j.jcmg.2025.08.016<\/a><\/div>\n<div><\/div>\n<div><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40317465\/?utm_source=chatgpt.com\">https:\/\/pubmed.ncbi.nlm.nih.gov\/40317465\/?utm_source=chatgpt.com<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Cardiac imaging for the detection of ischemia: current status and future perspectives \u2013 When \u201c50\u201360% Stenosis\u201d Isn\u2019t the Full Story: Can Imaging Replace the Functional FFR? Source: ,JACC , October 2025. Background: Intermediate coronary stenosis (\u224850\u201360%) remains a daily challenge in cardiology. Angiography shows anatomy, not ischemia, while traditional FFR and stress tests can be [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8918","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8918","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=8918"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8918\/revisions"}],"predecessor-version":[{"id":8919,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/8918\/revisions\/8919"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=8918"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=8918"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=8918"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}