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Impact of Epicardial plaQUe Composition and geomeTry on Coronary hEmodynamics and Flow in Patients With Coronary Artery Disease (iEquate).
Catheter Cardiovasc Interv
September 2025
Royal North Shore Hospital, St Leonards, Australia.
Background: Invasive coronary physiology including fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and coronary flow reserve (CFR) are guideline-endorsed tools to guide the management of coronary artery disease (CAD). Complex factors impact and confound these assessments, and discordance between modalities complicates clinical management. iEquate is a prospective observational trial that combines multi-modality coronary physiology and optical coherence tomography (OCT) to identify the determinants of pressure-wire derived myocardial ischemia and iFR-FFR discordance.
View Article and Find Full Text PDFPhysiological Disease Pattern as Assessed by Pull Back Pressure Gradient Index in Vessels With FFR/iFR Discordance.
JACC Cardiovasc Interv
April 2025
CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland. Electronic address:
Background: Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are discordant in approximately 20% of cases, and it is unclear whether this is influenced by the physiological pattern of coronary artery disease (CAD). The pull back pressure gradient index (PPGi) can objectively characterize the physiological pattern of CADs.
Objectives: The aim of this study was to evaluate whether PPGi differed in discordant groups (FFR+/iFR- vs FFR-/iFR+).
Hemodynamic Insights into Combined Fractional Flow Reserve and Instantaneous Wave-Free Ratio Assessment Through Quantitative [O]HO PET Myocardial Perfusion Imaging.
J Nucl Med
February 2024
Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
In patients evaluated for obstructive coronary artery disease (CAD), guidelines recommend using either fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) to guide coronary revascularization decision-making. The hemodynamic significance of lesions with discordant FFR and iFR measurements is debated. This study compared [O]HO PET-derived absolute myocardial perfusion between vessels with concordant and discordant FFR and iFR measurements.
View Article and Find Full Text PDFImpact of stenosis resistance and coronary flow capacity on fractional flow reserve and instantaneous wave-free ratio discordance: a combined analysis of DEFINE-FLOW and IDEAL.
Neth Heart J
November 2023
Heart Centre, Amsterdam Cardiovascular Sciences, Amsterdam UMC-location AMC, Department of Cardiology, University of Amsterdam, Amsterdam, The Netherlands.
Background: The pressure-derived parameters fractional flow reserve (FFR) and the emerging instantaneous wave-free ratio (iFR) are the most widely applied invasive coronary physiology indices to guide revascularisation. However, approximately 15-20% of intermediate stenoses show discordant FFR and iFR, and therapeutical consensus is lacking.
Aims: We sought to associate hyperaemic stenosis resistance index, coronary flow reserve (CFR) and coronary flow capacity (CFC) to FFR/iFR discordance.