Coronary Physiology: iFR and FFR, when and why?

Prof Javier Escaned is Head of Section (Interventional Cardiology Section) at Hospital Clinico San Carlos / Complutense University (Madrid, Spain). He trained in the United Kingdom as Specialist in Cardiology and obtained his PhD in The Netherlands. Author of >700 indexed scientific articles on interventional cardiology, imaging and physiology (h-index 100) and over 30 years of experience as PCI operator, he regularly lectures and performs live cases at major scientific and educational meetings. He is a recipient of the European Society of Cardiology (ESC) Silver Medal and the Andreas Grüntzig Award for his contributions to the fiedl fo Interventional Cardiology. Main areas of expertise include complex PCI, intracoronary diagnostics and functional coronary angiography. His track record in coronary physiology comprises being investigator on pioneer FFR trials like DEFER (1998), collaborator with Justin Davies in the validation and clinical implementation of iFR, and developer of new tools for the assessment of coronary microcirculation. Editorial roles include Deputy Editor EHJ, Advisory Editor Eurointervention, editor of the textbooks “Coronary Stenosis: Imaging, Structure and Physiology” and “Physiological Assessment of Coronary Stenoses and the Microcirculation". Recent board positions include EAPCI board / Education Committee Chair, ESC WG Coronary Pathophysiology and Microcirculation, EuroCTO Board. Recent trials as Principal Investigator include ADVISE II, DEFINE FLAIR, SYNTAX II, PIONEER IV, Cerebral-Coronary-Connection (C3), DCR4Contrast, INOCA LongCovid and AID ANGIO. Additional interests are philosophy and music.

Dr Justin Davies is a board member of Monaco Cardio at the Princess Grace Hospital, Monaco, and an interventional cardiologist with over 15 years of experience as a leading educator in the field. His clinical and academic career was established at Hammersmith Hospital, Imperial College London, where he built an international reputation for innovation in cardiovascular medicine. Over the course of his career, he has successfully mentored 15 PhD students, published more than 500 peer-reviewed papers — including landmark studies in the New England Journal of Medicine and The Lancet — and holds 20 patents in cardiovascular medicine and technology. He was the co-principal investigator of the DEFINE-FLAIR study, which helped establish iFR (Instantaneous Wave-Free Ratio), a diagnostic technique he invented, as a globally adopted standard in coronary physiology. His work reflects a unique blend of scientific innovation, academic leadership, and clinical excellence. In addition to his research and academic commitments, Justin is CEO of Cerebria AI, where he leads the development of next-generation AI-powered cardiovascular imaging and physiology tools. Under his leadership, Cerebria AI is advancing cutting-edge solutions that integrate artificial intelligence with frontline cardiology to enhance clinical decision-making and patient outcomes. Combining deep clinical expertise with entrepreneurial vision, he continues to guide international ventures through funding, regulatory pathways, and commercialization, while remaining committed to transforming cardiovascular care on a global scale.

Dr. Karim Al-Azizi is an Interventional Cardiologist and Structural Heart Disease specialist at Baylor Scott & White Health - The Heart Hospital in Plano, TX. He is the Medical Director of the Cardiac Catheterization Laboratories and the Associate Program Director of the Cardiovascular disease fellowship and a clinical assistant professor at the Texas A and M College of Medicine. His clinical and research interests include complex coronary interventions, ultra-low contrast, physiology and imaging-guided PCI, and transcatheter interventions for valvular heart disease. He speaks at national and international conferences on these subjects and serves as a principal investigator on multiple clinical trials in the field of structural and coronary interventions.