ArticleCirculation1995
Fractional flow reserve. A useful index to evaluate the influence of an epicardial coronary stenosis on myocardial blood flow.
Article in Circulation, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 179 papers, 3 of them syntheses 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.
Effect of the Antidiabetic Drug DAPAgliflozin on the Coronary Macrovascular and MICROvascular Function in Type 2 Diabetic Patients
Utilization of Lexiscan (Regadenoson)in the Cardiac Catheterization Lab to Achieve Maximal Hyperemia for Coronary Physiologic Assessment With Fractional Flow Reserve
Who cites it
179 citing papers in PubMed, 3 syntheses or guidelines pooled it, 736 citations in OpenAlex.
- Artificial intelligence in estimating fractional flow reserve: a systematic literature review of techniques.BMC cardiovascular disorders · 2023Pooled it
- Consensus document for invasive coronary physiologic assessment in Asia-Pacific countries.Cardiology journal · 2019Guideline
- Fractional flow reserve versus angiography for guiding percutaneous coronary intervention: a meta-analysis.Heart (British Cardiac Society) · 2015Pooled it
- Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study.Circulation · 2026Trial
- Coronary revascularisation deferral based on quantitative flow ratio or fractional flow reserve: a post hoc analysis of the FAVOR III Europe trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Trial
- Angiography-Based Machine Learning for Predicting Fractional Flow Reserve in Intermediate Coronary Artery Lesions.Journal of the American Heart Association · 2019Trial
- The role of FFR in clinical decision making in patients with moderate coronary lesions: a pilot study.Acta bio-medica : Atenei Parmensis · 2018Trial
- Assessment of increasing intravenous adenosine dose in fractional flow reserve.BMC cardiovascular disorders · 2017Trial
- Trial
- Impact of irrigated energy application on the right coronary artery hemodynamics: FFR measurement in patients who underwent ablation of common type atrial flutter.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2008Trial
- The effect of electrical neurostimulation on collateral perfusion during acute coronary occlusion.BMC cardiovascular disorders · 2007Trial
- Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: results of the ADVANCE phase 3 multicenter international trial.Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyTrial
- Beyond Angiography: Redefining The Gold Standard for Coronary Atherosclerosis.Current cardiology reports · 2026Review
- Fractional Flow Reserve Measurement Using Dynamic CT Perfusion Imaging in Patients with Heavy Coronary Calcification and Stent.Diagnostics (Basel, Switzerland) · 2026Article
- Radial Wall Strain as an Angiography-Derived Biomarker for Plaque Vulnerability Assessment: Pathophysiology, Clinical Applications, and Prognostic Implications.Journal of clinical medicine · 2026Review
- The Contemporary Role of Intracoronary Physiological Assessment: Fractional Flow Reserve, Non-Hyperemic Pressure Ratios, Wireless Technologies, and Microcirculation.Journal of cardiovascular development and disease · 2026Review
- Intravascular Imaging Versus Physiology Assessment for Intermediate Lesions During PCI.Biomedicines · 2026Review
- Fractional Flow Reserve-Guided Submaximal Balloon Angioplasty for Symptomatic Intracranial Stenosis.Neurosurgery practice · 2026Article
- Correlation between intravascular pressure gradients and ultrasound velocities in carotid artery stenosis: An exploratory study.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Absolute coronary blood flow measurement and the principle of microvascular resistance reserve.Cardiovascular intervention and therapeutics · 2026Review
119 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFractional flow reserve (FFR), defined as the ratio of maximum flow in the presence of a stenosis to normal maximum flow, is a lesion-specific index of stenosis severity that can be calculated by simultaneous measurement of mean arterial, distal coronary, and central venous pressure (Pa, Pd, and Pv, respectively), during pharmacological vasodilation. The aims of this study were to define ranges of FFR values, whether associated with inducible ischemia or not, and to investigate FFR in normal coronary arteries. METHODS AND
resultsIn 60 patients accepted for percutaneous transluminal coronary angioplasty (PTCA) of single-vessel disease, with a positive exercise test (ET) < 24 hours before PTCA, FFR was determined during adenosine-induced hyperemia just before and 15 minutes after angioplasty. Pa was measured by the guiding catheter, Pd by an 0.018-in fiber-optic pressure-monitoring wire, and Pv, by a multipurpose catheter. The ET was repeated after 5 to 7 days, and only if this second ET had reverted to normal was the pre-PTCA value of FFR definitely considered to be associated with inducible ischemia and the post-PTCA value not. Myocardial FFR (FFRmyo) increased from 0.53 +/- 0.15 before PTCA to 0.88 +/- 0.07 after PTCA. Coronary FFR increased from 0.38 +/- 0.19 to 0.83 +/- 0.12. In all patients, values of FFRmyo definitely associated with ischemia were < or = 0.74, whereas all except two values not associated with inducible ischemia exceeded 0.74. Moreover, FFRmyo in 18 coronary arteries in 5 normal patients equaled 0.98 +/- 0.03.
conclusionsA value of FFRmyo of 0.74 reliably discriminates coronary stenosis, whether associated with inducible ischemia or not. Therefore, FFRmyo is a useful index to determine the functional significance of an epicardial coronary stenosis and may facilitate clinical decision making in patients with an equivocal coronary stenosis.
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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.