ArticleJournal of the American Heart Association2019
Diagnostic Agreement of Quantitative Flow Ratio With Fractional Flow Reserve and Instantaneous Wave-Free Ratio.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Comparison of Coronary Angiographic-Derived and Intracoronary Imaging-Based Fractional Flow Reserve in Assessing Coronary Artery Stenosis Severity: A Systematic Review and Network Meta-Analysis.Journal of evidence-based medicine · 2025Pooled it
- Accelerated stress CMR for the detection of significant coronary artery disease: a prospective randomized diagnostic accuracy study.European heart journal. Cardiovascular Imaging · 2026Trial
- Quantitative Flow Ratio to Predict Nontarget Vessel-Related Events at 5 Years in Patients With ST-Segment-Elevation Myocardial Infarction Undergoing Angiography-Guided Revascularization.Journal of the American Heart Association · 2021Trial
- Limited performance questions retrospective use of quantitative flow ratio in coronary artery bypass grafting.Frontiers in cardiovascular medicine · 2026Article
- QFR measurements post CTO percutaneous coronary intervention: Can the long term outcome be predicted?International journal of cardiology. Heart & vasculature · 2025Article
- Association between carotid ultrasound features and the detection of functionally significant coronary artery stenosis: a prospective study based on quantitative flow ratio.Quantitative imaging in medicine and surgery · 2025Article
- Ultrasonic flow ratio measured immediately after successful rotational atherectomy with stent implantation predicts major adverse cardiovascular events.Frontiers in cardiovascular medicine · 2025Article
- Advances in the Computational Assessment of Disturbed Coronary Flow and Wall Shear Stress: A Contemporary Review.Journal of the American Heart Association · 2024Review
- Validation of resting full-cycle ratio and diastolic pressure ratio with [Heart and vessels · 2024Article
- Diagnostic performance of quantitative flow ratio in non-ST elevation acute coronary syndromes in comparison to non-hyperemic pressure ratios: a prospective study.The international journal of cardiovascular imaging · 2023Article
- Predictive value of intravascular ultrasound for the function of intermediate coronary lesions.BMC cardiovascular disorders · 2023Article
- 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
- The Differences of Quantitative Flow Ratio in Coronary Artery Stenosis with or without Atrial Fibrillation.Journal of interventional cardiology · 2023Article
- The Inhibition of Evolocumab on Non-Infarct-Related Artery Disease in Patients with ST-Elevation Myocardial Infarction.International journal of general medicine · 2023Article
- Angiographic quantitative flow ratio in acute coronary syndrome: beyond a tool to define ischemia-causing stenosis-a literature review.Cardiovascular diagnosis and therapy · 2022Review
- Angiography-Based Fractional Flow Reserve: State of the Art.Current cardiology reports · 2022Review
- Impact of physiologically diffuse versus focal pattern of coronary disease on quantitative flow reserve diagnostic accuracy.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2022Article
- Coronary CT angiography-based estimation of myocardial perfusion territories for coronary artery FFR and wall shear stress simulation.Scientific reports · 2021Article
- Performance of Integrated Near-Infrared Spectroscopy and Intravascular Ultrasound (NIRS-IVUS) System against Quantitative Flow Ratio (QFR).Diagnostics (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
23 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Quantitative flow ratio ( QFR ) has a high diagnostic accuracy in assessing functional stenoses relevance, as judged by fractional flow reserve ( FFR ). However, its diagnostic performance has not been thoroughly evaluated using instantaneous wave-free ratio ( iFR ) or coronary flow reserve as the reference standard. This study sought to evaluate the diagnostic performance of QFR using other reference standards beyond FFR . Methods and Results We analyzed 182 patients (253 vessels) with stable ischemic heart disease and 82 patients (105 nonculprit vessels) with acute myocardial infarction in whom coronary stenoses were assessed with FFR , iFR, and coronary flow reserve. Contrast QFR analysis of interrogated vessels was performed in blinded fashion by a core laboratory, and its diagnostic performance was evaluated with respect to the other invasive physiological indices. Mean percentage diameter stenosis, FFR , iFR , coronary flow reserve, and QFR were 53.1±19.0%, 0.80±0.13, 0.88±0.12, 3.14±1.30, and 0.81±0.14, respectively. QFR showed higher correlation ( r=0.863 with FFR versus 0.740 with iFR , P<0.001), diagnostic accuracy (90.8% versus 81.3%, P<0.001), and discriminant function (area under the curve=0.953 versus 0.880, P<0.001) when FFR was used as a reference standard than when iFR was used as the reference standard. However, when coronary flow reserve was used as an independent reference standard, FFR , iFR , and QFR showed modest discriminant function (area under the curve=0.682, 0.765, and 0.677, respectively) and there were no significant differences in diagnostic accuracy among FFR , iFR , and QFR (65.4%, 70.6%, and 64.9%; all P values in pairwise comparisons >0.05, overall comparison P=0.061). Conclusions QFR has a high correlation and agreement with respect to both FFR and iFR , although it is better when FFR is used as the comparator. As a pressure-derived index not depending on wire or adenosine, QFR might be a promising tool for improving the adoption rate of physiology-based revascularization in clinical practice.
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