ArticleCirculation. Cardiovascular interventions2019
Physiological Pattern of Disease Assessed by Pressure-Wire Pullback Has an Influence on Fractional Flow Reserve/Instantaneous Wave-Free Ratio Discordance.
Article in Circulation. Cardiovascular interventions, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04857762 (Anatomical Assessment Versus Pull Back REsting Full-cycle rAtio), which is not on this map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Anatomical Assessment Versus Pull Back REsting Full-cycle rAtio (RFR) Measurement for Evaluation of Focal and Diffuse Coronary Disease
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic Performance of Non-Hyperemic Pressure Ratios Versus Fractional Flow Reserve Stratified by Coronary Artery: A Systematic Review and Meta-Analysis of Individual Patient Data.Journal of the American Heart Association · 2026Pooled it
- Clinical Impact of Concordant and Discordant Physiology Parameters Post-Percutaneous Coronary Intervention in the EASY-PREDICT Study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Trial
- The association between angiographic stenosis characteristics and surgical treatment in diffuse LAD disease.International journal of cardiology. Heart & vasculature · 2026Article
- Association of physiological discordance between fractional flow reserve and non-hyperaemic pressure ratios with lipid-rich plaque burden.European heart journal open · 2026Article
- Clinical Validation of a Novel Pressure Microcatheter-Based Nonhyperemic Pressure Ratio (SUPREME II Study).Journal of the American Heart Association · 2026Article
- Influence of Pullback Pressure Gradient on Residual Angina at One Year.Circulation. Cardiovascular interventions · 2026Article
- Impact of coronary revascularization on clinical outcomes in vessels with discordant results of fractional flow reserve and resting full-cycle ratio.Heart and vessels · 2026Article
- The Pullback Pressure Gradient: Transforming Invasive Coronary Physiology from Lesion Assessment to Disease Pattern Characterization-A Perspective.Medicina (Kaunas, Lithuania) · 2025Review
- Reproducibility, Accuracy, and Treatment Impact of Ischemia Severity Assessment From Coronary Angiography - An ORBITA Study Analysis.Circulation reports · 2025Article
- Interpretation of Discordance Between Non-Hyperemic Pressure Ratios and Fractional Flow Reserve: Potential Mechanisms and Clinical Implications.Reviews in cardiovascular medicine · 2025Review
- Validation of machine learning angiography-derived physiological pattern of coronary artery disease.European heart journal. Digital health · 2025Article
- Imaging and physiologic characteristics of coronary kinks.Future cardiology · 2025Review
- Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting.Journal of cardiovascular development and disease · 2025Review
- State-of-the-art percutaneous coronary intervention for left main coronary artery disease in Japan.Cardiovascular intervention and therapeutics · 2024Review
- Change in Pd/Pa: Clinical Implications for Predicting Future Cardiac Events at Deferred Coronary Lesions.Circulation. Cardiovascular interventions · 2024Article
- Physiological Assessment with iFR prior to FFR Measurement in Left Main Disease.Cardiovascular intervention and therapeutics · 2024Article
- Preprocedural physiological assessment of coronary disease patterns to predict haemodynamic outcomes post-PCI.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Practical Application of Coronary Physiologic Assessment: Asia-Pacific Expert Consensus Document: Part 1.JACC. Asia · 2023Review
- Hyperemic and non-hyperemic indexes in coronary physiology. Causes and implications of discordant results.International journal of cardiology. Heart & vasculature · 2023Article
- 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
Corrections and comments
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Authors and funding
21 authors.
Funding
Abstract
backgroundFractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) disagree on the hemodynamic significance of a coronary lesion in ≈20% of cases. It is unknown whether the physiological pattern of disease is an influencing factor for this. This study assessed whether the physiological pattern of coronary artery disease influences discordance between FFR and iFR measurement. METHODS AND
resultsThree-hundred and sixty intermediate coronary lesions (345 patients; mean age, 64.4±10.3 years; 76% men) with combined FFR, iFR, and iFR pressure-wire pullback were included for analysis from an international multicenter registry. Cut points for hemodynamic significance were FFR ≤0.80 and iFR ≤0.89, respectively. Lesions were classified into FFR+/iFR+ (n=154; 42.7%), FFR-/iFR+ (n=38; 10.6%), FFR+/iFR- (n=41; 11.4%), and FFR-/iFR- (n=127; 35.3%) groups. The physiological pattern of disease was classified according to the iFR pullback recordings as predominantly physiologically focal (n=171; 47.5%) or predominantly physiologically diffuse (n=189; 52.5%). Median FFR and iFR were 0.80 (interquartile range, 0.75-0.85) and 0.89 (interquartile range, 0.86-0.92), respectively. FFR disagreed with iFR in 22% (79 of 360). The physiological pattern of disease was the only influencing factor relating to FFR/iFR discordance: predominantly physiologically focal was significantly associated with FFR+/iFR- (58.5% [24 of 41]), and predominantly physiologically diffuse was significantly associated with FFR-/iFR+ (81.6% [31 of 38]; P<0.001 for pattern of disease between FFR+/iFR- and FFR-/iFR+ groups).
conclusionsThe physiological pattern of coronary artery disease was an important influencing factor for FFR/iFR discordance.
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