Evidence map›Paper›PMID 34761492›Full record

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.

Roberto Scarsini, Simone Fezzi, Gabriele Pesarini, Paolo Alberto Del Sole, Gabriele Venturi, Concetta Mammone, Michele Marcoli, Alessia Gambaro, Domenico Tavella, Michele Pighi and 1 more

Open access · hybridAbstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 29 citations in OpenAlex.

  1. Article
  2. Article
  3. Angiography-Derived Physiology for Coronary Artery Disease Assessment: Expert Opinion From a SCAI Roundtable.Journal of the Society for Cardiovascular Angiography & Interventions · 2026
    Review
  4. Article
  5. Review
  6. Novel Non-Hyperemic Coronary Physiology Indices for Vessel Longitudinal Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Observational
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Intracoronary physiology-guided percutaneous coronary intervention in patients with diabetes.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
    Article
  14. Article
  15. Article
  16. Observational
  17. Angiography-derived index of microvascular resistance in takotsubo syndrome.The international journal of cardiovascular imaging · 2023
    Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Roberto ScarsiniDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Simone FezziDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.ORCID 0000-0003-2755-2094
Gabriele PesariniDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Paolo Alberto Del SoleDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Gabriele VenturiDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Concetta MammoneDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Michele MarcoliDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.ORCID 0000-0002-8432-7881
Alessia GambaroDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Domenico TavellaDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Michele PighiDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Flavio RibichiniDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
University of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Coronary Artery DiseaseCoronary StenosisFractional Flow Reserve, MyocardialCardiac CatheterizationCoronary AngiographyCoronary VesselsHumansPredictive Value of TestsReproducibility of ResultsSeverity of Illness IndexTreatment Outcomecoronary artery diseasefractional flow reservequantitative coronary angiography

Identifiers

PMID34761492
PMCPMC9544909
OpenAlexW3213674992

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.