Observational studyClinical research in cardiology : official journal of the German Cardiac Society2018
Quantitative flow ratio derived from diagnostic coronary angiography in assessment of patients with intermediate coronary stenosis: a wire-free fractional flow reserve study.
Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Diagnostic Performance of Angiography-Derived Quantitative Flow Ratio: A Systematic Review and Meta-Analysis.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Diffuseness of coronary artery disease impacts on immediate hemodynamic and predicted clinical outcomes.Scientific reports · 2025Trial
- The Contemporary Role of Intracoronary Physiological Assessment: Fractional Flow Reserve, Non-Hyperemic Pressure Ratios, Wireless Technologies, and Microcirculation.Journal of cardiovascular development and disease · 2026Review
- Diagnostic performance of target vs. vessel μFR in stable coronary artery disease.BMC cardiovascular disorders · 2025Article
- Survey and perspective on verification, validation, and uncertainty quantification of digital twins for precision medicine.NPJ digital medicine · 2025Review
- Enhancing cardiac assessments: accurate and efficient prediction of quantitative fractional flow reserve.Frontiers in bioengineering and biotechnology · 2025Article
- An Overview of Computational Coronary Physiology Technologies Based on Medical Imaging and Artificial Intelligence.Reviews in cardiovascular medicine · 2024Review
- Exploring the Predictors of the Discrepancy Between Quantitative Flow Ratio and Fractional Flow Reserve Measurements.Anatolian journal of cardiology · 2023Observational
- Functional coronary angiography for the assessment of the epicardial vessels and the microcirculation.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Non-invasive Angiographic-based Fractional Flow Reserve: Technical Development, Clinical Implications, and Future Perspectives.Current medical science · 2023Review
- Validity and Diagnostic Performance of Computing Fractional Flow Reserve From 2-Dimensional Coronary Angiography Images.Texas Heart Institute journal · 2023Article
- The effects of cardiac structure, valvular regurgitation, and left ventricular diastolic dysfunction on the diagnostic accuracy of Murray law-based quantitative flow ratio.Frontiers in cardiovascular medicine · 2023Article
- Reproducibility of quantitative flow ratio: the QREP study.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022Article
- Angiographic Lesion Morphology Provides Incremental Value to Generalize Quantitative Flow Ratio for Predicting Myocardial Ischemia.Frontiers in cardiovascular medicine · 2022Article
- Diagnostic Performance of Angiography-Based Fractional Flow Reserve for Functional Evaluation of Coronary Artery Stenosis.Frontiers in cardiovascular medicine · 2021Article
- Coronary Blood Flow Measurement in Conventional Coronary Angiograms by a New Method Based on Contrast Density Detection. A Physiological Insight.Arquivos brasileiros de cardiologia · 2020Article
- Comparison of diagnostic performance between quantitative flow ratio, non-hyperemic pressure indices and fractional flow reserve.Cardiovascular diagnosis and therapy · 2020Article
- QFR Predicts the Incidence of Long-Term Adverse Events in Patients with Suspected CAD: Feasibility and Reproducibility of the Method.Journal of clinical medicine · 2020Article
- Alternative methods for functional assessment of intermediate coronary lesions.Cardiology journal · 2020Review
- Combining anatomy and physiology: New angiography-based and computed tomography coronary angiography-derived fractional flow reserve indices.Cardiology journal · 2020Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo evaluate diagnostic accuracy of quantitative flow ratio (QFR). A novel method was used for non-invasive functional assessment of intermediate coronary lesions. Fractional flow reserve (FFR) is the gold standard for functional assessment of intermediate lesions. However, interrogating a stenosis with pressure wire prolongs the procedure, increases costs and carries a risk of procedure-related adverse events. QFR is a wire-free method for computation of FFR based on 3D reconstruction of angiographic images and modified TIMI frame count. METHODS AND
resultsWe retrospectively computed QFR (Medis Suite XA/QAngio XA 3D/QFR, Medis/Netherlands) in suitable cases with corresponding FFR (PressureWire™, Abbott, US/). Four QFR measures were tested against FFR: (1) fixed-flow QFR (fQFR), (2) vessel QFR (vQFR), (3) lesion QFR (lQFR) and (4) index QFR (iQFR). 857 lesions (740 patients) were reviewed, 306 (268 patients) met technical inclusion criteria for QFR (two optimal angiographic projections > 25° apart; no ostial location, no overlapping/shortening, frame-rate ≥ 15 fps). Mean angiographic percentage diameter stenosis was 51.3 ± 10.18%. Wire-based FFR ≤ 0.80 was found in 130 lesions (42.5%). Strong Pearson correlation was identified for iQFR (r = 0.85), fQFR (r = 0.73), vQFR (r = 0.78) and lQFR (r = 0.70). The optimal QFR decision values corresponding to FFR = 0.80 were iQFR = 0.79 (AUC = 0.94), fQFR = 0.73 (AUC = 0.87), vQFR = 0.77 (AUC = 0.90), and lQFR = 0.83 (AUC = 0.82). Sensitivity and specificity > 95% were identified for iQFR ≤ 0.74 (n = 89, 29%) and > 0.83 (n = 116, 38%), respectively.
conclusionsThe QFR value at the pressure transducer position (iQFR) was the best corresponding QFR model. iQFR is characterised by high diagnostic accuracy and used in a hybrid model with FFR which may reduce the number of procedures requiring pressure-wire by two-thirds.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.