ArticleJACC. Cardiovascular interventions2018
Instantaneous Wave-Free Ratio for the Assessment of Intermediate Coronary Artery Stenosis in Patients With Severe Aortic Valve Stenosis: Comparison With Myocardial Perfusion Scintigraphy.
Article in JACC. Cardiovascular interventions, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- Differential Effect of Aortic Valve Replacement for Severe Aortic Stenosis on Hyperemic and Resting Epicardial Coronary Pressure Indices.Journal of the American Heart Association · 2024Pooled it
- Co-Occurrence of Aortic Stenosis and Coronary Artery Disease: Facing Challenges Before, During, and After Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2025Review
- Coronary Artery Disease and Transcatheter Aortic Valve Replacement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Review
- Practical Application of Coronary Physiologic Assessment: Asia-Pacific Expert Consensus Document: Part 2.JACC. Asia · 2023Review
- Contemporary Use of Coronary Physiology in Cardiology.Cardiology and therapy · 2023Review
- The Management of Coronary Artery Disease in TAVR Patients.Journal of clinical medicine · 2023Review
- Invasive Functional Assessment of Coronary Artery Disease in Patients with Severe Aortic Stenosis in the TAVI Era.Journal of clinical medicine · 2023Review
- Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions in collaboration with the ESC Working Group on Cardiovascular Surgery.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Unravelling the Fate of Coronary Artery Disease in Patients Undergoing Valve Replacement for Severe Aortic Valve Stenosis.Reviews in cardiovascular medicine · 2023Review
- Management of coronary artery disease in patients with aortic stenosis in the era of transcatheter aortic valve replacement.Frontiers in cardiovascular medicine · 2023Review
- Myocardial Perfusion and Coronary Physiology Assessment of Microvascular Dysfunction in Patients Undergoing Transcatheter Aortic Valve Implantation-Rationale and Design.Biomimetics (Basel, Switzerland) · 2022Article
- Unmet Needs in TAVR: Conduction Disturbances and Management of Coronary Artery Disease.Journal of clinical medicine · 2022Review
- Coronary Artery Disease and Revascularization in Patients Undergoing Transcatheter Aortic Valve Replacement.Reviews in cardiovascular medicine · 2022Review
- Clinical use of physiological lesion assessment using pressure guidewires: an expert consensus document of the Japanese association of cardiovascular intervention and therapeutics-update 2022.Cardiovascular intervention and therapeutics · 2022Review
- Feasibility and Comparison of Resting Full-Cycle Ratio and Computed Tomography Fractional Flow Reserve in Patients with Severe Aortic Valve Stenosis.Journal of cardiovascular development and disease · 2022Article
- Coronary Artery Disease in Patients Undergoing Transvalvular Aortic Valve Implantation.Interventional cardiology (London, England) · 2022Review
- Challenges in Diagnosis and Functional Assessment of Coronary Artery Disease in Patients With Severe Aortic Stenosis.Frontiers in cardiovascular medicine · 2022Review
- Diagnostic Work-Up of the Aortic Patient: An Integrated Approach toward the Best Therapeutic Option.Journal of clinical medicine · 2021Review
- Pathophysiology, Diagnosis, and Treatment of Patients with Concomitant Severe Aortic Stenosis and Coronary Artery Disease: A Closer Look to the Unresolved Perplexity.Journal of clinical medicine · 2021Review
- Aortic Valve Disease and Associated Complex CAD: The Interventional Approach.Journal of clinical medicine · 2021Review
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study investigated the diagnostic performance of instantaneous wave-free ratio (iFR) in patients with aortic valve stenosis (AS).
backgroundThe iFR was introduced as a new, nonpharmacologic stress index of coronary stenosis severity. However, the diagnostic performance of iFR has not been sufficiently explored in patients with severe AS.
methodsWe analyzed 95 consecutive patients with AS (57 women) demonstrating intermediate coronary artery stenosis (116 vessels), and compared the iFR values with fractional flow reserve (FFR) values and with adenosine-stress myocardial perfusion imaging as indicators of myocardial ischemia.
resultsThe median value and interquartile range (first quartile [Q1], third quartile [Q3]) of the iFR was 0.86 (Q1 to Q3 range, 0.76 to 0.93), and that of the FFR was 0.84 (Q1 to Q3 range, 0.76 to 0.91). The iFR values correlated well with the FFR values (R = 0.854; p < 0.0001). A receiver operating characteristic analysis demonstrated an optimal cutoff of 0.82 for the iFR to indicate an FFR ≤0.75, with an area under the curve of 0.92. The optimal iFR cutoff value indicating myocardial ischemia on perfusion scintigraphy was 0.82 (area under the curve: 0.84).
conclusionsIn patients with severe AS, a good correlation exists between iFR and FFR. Both the iFR and FFR values exhibit good correlation with perfusion scintigraphy-identified myocardial ischemia. The iFR could be a safe diagnostic tool for patients with severe AS. (The Impact of FFR and iFR in Patients with Severe Aortic Stenosis; UMIN000024479).
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