The detection and management of cardiovascular disease increasingly utilize non-invasive cardiac imaging in patients with suspected or known CAD. Non-invasive techniques can serve as a gatekeeper for invasive coronary angiographies in order to decrease the number of purely diagnostic invasive angiographies and associated morbidity and mortality. Therefore, there is a need for non-invasive imaging techniques for diagnosing and evaluating the hemodynamic significance of CAD. whether a coronary artery stenosis is leading to myocardial perfusion abnormalities. Furthermore, conventional catheter angiography without the advent of FFR measurements, is not able to provide information about the hemodynamic significance of a significant luminal stenosis (≥ 70%), i.e. Moreover, ICA provides only limited information on the presence of atherosclerotic plaques not associated with luminal stenosis. However, ICA is an invasive procedure which is associated with a low, though significant, complication rate including bleeding, coronary artery dissections, cerebral embolism, cardiac arrhythmias, myocardial infarction and death. ICA has superior spatial and temporal resolution compared with non-invasive imaging techniques. An FFR < 0.80 is considered abnormal, reflecting a hemodynamic significant coronary stenosis. FFR measurements during ICA are useful in determining whether a coronary stenosis is functionally important. Invasive coronary angiography (ICA), particularly in conjunction with fractional flow reserve (FFR) measurements, is considered the gold standard in diagnosing and evaluating the severity of CAD in the current era. In the Netherlands 80,000 invasive coronary angiographies are performed each year. Early detection of CAD allows optimal therapeutic management in order to decrease morbidity and mortality.
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