Trial reportEuropean heart journal2019
Diastolic pressure ratio: new approach and validation vs. the instantaneous wave-free ratio.
Trial report in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 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
- Coronary Flow Variations Following Percutaneous Coronary Intervention Affect Diastolic Nonhyperemic Pressure Ratios More Than the Whole Cycle Ratios.Journal of the American Heart Association · 2022Trial
- Clinical Validation of a Novel Pressure Microcatheter-Based Nonhyperemic Pressure Ratio (SUPREME II Study).Journal of the American Heart Association · 2026Article
- Coronary Physiology Across the Whole Spectrum of Ischemic Heart Disease.Journal of clinical medicine · 2026Review
- Negative expansion resistance (NER) phenomenon predicts hemodynamically non-significant coronary lesions.Scientific reports · 2025Article
- When Functional Assessment Meets Intravascular Imaging in Patients with Coronary Artery Disease.Journal of cardiovascular development and disease · 2025Review
- Diastolic Hyperemia-Free Ratio in Patients With Coronary Artery Disease: A Prospective Observational Study.Korean circulation journal · 2025Article
- DFR Shows Promise-But Can It Replace FFR?Korean circulation journal · 2025Article
- Validation of resting full-cycle ratio and diastolic pressure ratio with [Heart and vessels · 2024Article
- Utility of FFRCT in Patients with Chest Pain.Current atherosclerosis reports · 2023Review
- Coronary microcirculatory dysfunction can be assessed by positive dicrotic wave and amplitude index on resting distal coronary pressure waveform, a newly developed index.European heart journal open · 2023Article
- Fractional flow reserve and non-hyperemic indices: Essential tools for percutaneous coronary interventions.World journal of clinical cases · 2023Review
- Evolving Diagnostic and Management Advances in Coronary Heart Disease.Life (Basel, Switzerland) · 2023Review
- Improved Diagnosis through Diastolic Hyperemia-Free Ratio (DFR) over Fractional Flow Reserve (FFR) in Intermediate Coronary Lesions.Cardiology and cardiovascular medicine · 2023Article
- Non-hyperaemic assessment of coronary ischaemia: application of machine learning techniques.European heart journal. Digital health · 2022Article
- Physiologic Lesion Assessment to Optimize Multivessel Disease.Current cardiology reports · 2022Review
- Phasic flow patterns of right versus left coronary arteries in patients undergoing clinical physiological assessment.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2022Article
- Fractional Flow Reserve and Instantaneous Wave-Free Ratio Predict Pathological Wall Shear Stress in Coronary Arteries: Implications for Understanding the Pathophysiological Impact of Functionally Significant Coronary Stenoses.Journal of the American Heart Association · 2022Article
- Coronary functional assessment in non-obstructive coronary artery disease: Present situation and future direction.Frontiers in cardiovascular medicine · 2022Review
- Standardizing the Definition and Analysis Methodology for Complete Coronary Artery Revascularization.Journal of the American Heart Association · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
aimsThe instantaneous wave-free ratio (iFR) and whole-cycle Pd/Pa investigate coronary physiology during non-hyperaemic conditions. To test for unique physiologic properties of the wave-free period when making resting coronary pressure measurements, we compared post hoc a diastolic pressure ratio (dPR) and Pd/Pa against iFR for numerical similarity and test/retest repeatability. METHODS AND
resultsEight hundred and ninety-three lesions from 833 subjects were included from the VERIFY 2 and CONTRAST studies. Diastolic pressure ratio and a linear transform of Pd/Pa were compared against iFR for diagnostic performance. Mean difference between dPR and iFR [Δ = -0.006 ± 0.011, r2 = 0.993, area under receiver operating characteristic (ROC) curve (AUC) = 0.997] mirrored the difference of two iFR measurements repeated immediately (Δ = <0.001 ± 0.004, r2 = 0.998, AUC = 1.00). Minor variations in the definition of dPR changed its value by <1-2% over a broad range of the cardiac cycle. A linear transform of Pd/Pa showed very good diagnostic performance (Δ = -0.012 ± 0.031, r2 = 0.927, AUC = 0.979). Post hoc iFR values were validated against real-time iFR values and matched almost exactly (average Δ = <0.001 ± 0.004, 99.6% within ±0.01).
conclusionsOur dPR offers numerical equivalency to iFR. Despite different technical approaches for identifying the relevant period of diastole, the agreement between dPR and iFR and the insensitivity of dPR to minor variations in its definition further confirm numerical equivalency among resting metrics.
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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.