Computational quantitative flow ratio to assess functional severity of coronary artery stenosis

Daan Ties, Randy van Dijk, Gabija Pundziute, Erik Lipsic, Ton E Vonck, Ad F M van den Heuvel, Rozemarijn Vliegenthart, Matthijs Oudkerk, Pim van der Harst*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Computational quantitative flow ratio (QFR) based on 3-dimensional quantitative coronary angiography (3D QCA) analysis offers the opportunity to assess the significance of coronary artery disease (CAD) without using an invasive pressure wire or inducing hyperemia. This study aimed to evaluate the diagnostic performance of QFR compared to wire-based fractional flow reserve (FFR) and to validate the previously reported QFR cut-off value of >0.90 to safely rule out functionally significant CAD.

Methods: QFR was retrospectively derived from standard-care coronary angiograms. Correlation and agreement of fixed-flow QFR (fQFR) and contrast-flow QFR (cQFR) models with invasive wire-based FFR was calculated. Diagnostic performance of QFR was evaluated at different QFR cut-off values defining significant CAD (FFR

Results: 101 vessels in 96 patients who underwent FFR were studied. Mean FFR was 0.87 +/- 0.08 and 21 of 101 (21%) vessels had an FFR 0.80 defining non-significant CAD, respectively. fQFR > 0.90 was present in 34 (34%) and cQFR > 0.90 in 39 (39%) vessels. For both QFR models, none of the vessels with QFR >0.90 had an FFR = 0.80.

Conclusions: QFR appears to be a safe and effective gatekeeper to wire-based FFR when applying a QFR threshold of >0.90 to rule out significant CAD. Further prospective research is required to establish QFR in the real-life setting of functional CAD assessment in the catheterization laboratory. (c) 2018 The Authors. Published by Elsevier B.V.

Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalInternational Journal of Cardiology
Early online date18-Aug-2018
Publication statusPublished - 15-Nov-2018


  • Quantitative flow ratio
  • Fractional flow reserve
  • Coronary artery disease
  • Coronary artery stenosis
  • Quantitative coronary angiography
  • PCI

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