Impact of physiologically diffuse versus focal pattern of coronary disease on quantitative flow reserve diagnostic accuracy

• DOI: 10.1002/ccd.30007
• Publication Date: 2021-11-11T06:51:44Z
• Authors: Roberto Scarsini; Simone Fezzi; Gabriele Pesarini; Paolo Alberto Del...; Gabriele Venturi; Concetta Mammone; Michele Marcoli; Alessia Gambaro; Domenico Tavella; Michele Pighi; Flavio Ribichini
• Keywords: Coronary flow reserve; Fractional Flow Reserve

Abstract Background Fractional flow reserve (FFR) and instantaneous wave‐free ratio (iFR) disagree in about 20% of intermediate coronary lesions. As the physiological pattern artery disease has a significant influence on FFR‐iFR discordance, we sought to assess it may impact diagnostic accuracy quantitative (QFR). Methods One hundred ninety‐four patients with 224 lesions were investigated iFR, FFR, QFR. The was assessed iFR Scout pullback QFR virtual all cases. Results A predominantly physiologically focal observed 81 (36.2%) lesions, whereas diffuse 143 (63.8%) demonstrated correlation ( r = 0.581, p < 0.001) substantial agreement both (AUC 0.798) 0.812) disease. Discordance between 51 (22.8%) consisting iFR+/QFR− (64.7%) iFR−/QFR+ (35.3%). Notably, only variable significantly associated iFR/QFR discordance. an excellent (83.9%) classifying Conclusions good assessing myocardial ischemia independently However, QFR/iFR which occurs ~20% correctly defined majority cases using as reference.