ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2022
Impact of physiologically diffuse versus focal pattern of coronary disease on quantitative flow reserve diagnostic accuracy.
Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 29 citations in OpenAlex.
- The association between angiographic stenosis characteristics and surgical treatment in diffuse LAD disease.International journal of cardiology. Heart & vasculature · 2026Article
- An Imaging Informatics Workflow for Angiography-Derived Coronary Physiology Profiling and Virtual PCI Simulation.Journal of imaging informatics in medicine · 2026Article
- Angiography-Derived Physiology for Coronary Artery Disease Assessment: Expert Opinion From a SCAI Roundtable.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Review
- Dynamic Changes of 3D Bending Angle Through the Cardiac Cycle: Implications With Bioresorbable Scaffold Performance.JACC. Asia · 2025Article
- From Evidence to Practice: The Growing Role of Angiography-Derived Physiology.Journal of clinical medicine · 2025Review
- Novel Non-Hyperemic Coronary Physiology Indices for Vessel Longitudinal Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Observational
- 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
- Angiography-Derived Microcirculatory Resistance in Detecting Microvascular Obstruction and Predicting Heart Failure After STEMI.Circulation. Cardiovascular imaging · 2025Article
- Illusion of revascularization: does anyone achieve optimal revascularization during percutaneous coronary intervention?Nature reviews. Cardiology · 2024Review
- Angiography-derived physiological assessment after percutaneous coronary intervention of chronic total occlusions.The international journal of cardiovascular imaging · 2024Article
- Practical Application of Coronary Physiologic Assessment: Asia-Pacific Expert Consensus Document: Part 1.JACC. Asia · 2023Review
- Intracoronary physiology-guided percutaneous coronary intervention in patients with diabetes.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Article
- Applied coronary physiology for planning and guidance of percutaneous coronary interventions. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the European Society of Cardiology.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Sex Differences in Murray Law-Based Quantitative Flow Ratio Among Patients With Intermediate Coronary Lesions.Journal of the American Heart Association · 2023Article
- Exploring the Predictors of the Discrepancy Between Quantitative Flow Ratio and Fractional Flow Reserve Measurements.Anatolian journal of cardiology · 2023Observational
- Angiography-derived index of microvascular resistance in takotsubo syndrome.The international journal of cardiovascular imaging · 2023Article
- In Vivo Validation of a Novel Computational Approach to Assess Microcirculatory Resistance Based on a Single Angiographic View.Journal of personalized medicine · 2022Article
- Coronary physiology in the catheterisation laboratory: an A to Z practical guide.AsiaIntervention · 2022Review
- Angiography-Based Fractional Flow Reserve: State of the Art.Current cardiology reports · 2022Review
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) disagree in about 20% of intermediate coronary lesions. As the physiological pattern of coronary artery disease has a significant influence on FFR-iFR discordance, we sought to assess it may impact on the diagnostic accuracy of quantitative flow reserve (QFR).
methodsOne hundred and ninety-four patients with 224 intermediate coronary lesions were investigated with iFR, FFR, and QFR. The physiological pattern of disease was assessed with iFR Scout pullback and QFR virtual pullback in all the cases.
resultsA predominantly physiologically focal pattern was observed in 81 (36.2%) lesions, whereas a predominantly physiologically diffuse was observed in 143 (63.8%) cases. QFR demonstrated a significant correlation (r = 0.581, p < 0.001) and a substantial agreement with iFR, both in diffuse (AUC = 0.798) and in focal (AUC = 0.812) pattern of disease. Discordance between QFR and iFR was observed in 51 (22.8%) lesions, consisting of iFR+/QFR- (64.7%) and iFR-/QFR+ (35.3%). Notably, the physiological pattern of disease was the only variable significantly associated with iFR/QFR discordance. QFR virtual pullback demonstrated an excellent agreement (83.9%) with iFR Scout pullback in classifying the physiological pattern of disease.
conclusionsQFR has a good diagnostic accuracy in assessing myocardial ischemia independently of the pattern of coronary disease. However, the physiological pattern of disease has an influence on the QFR/iFR discordance, which occurs in ~20% of the cases. The QFR virtual pullback correctly defined the physiological pattern of disease in the majority of the cases using the iFR pullback as reference.
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