Quantitative Flow Ratio versus Fractional Flow Reserve: Comparative Assessment of Coronary Physiological Evaluation in Contemporary Interventional Cardiology

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2023, Volume 1, Issue 2 : 1-5

Research Article

Quantitative Flow Ratio versus Fractional Flow Reserve: Comparative Assessment of Coronary Physiological Evaluation in Contemporary Interventional Cardiology

Jonathan M. Carter

Priyanka Rao

Ahmed S. Karim

Elena Petrović

⁴

Department of Interventional Cardiology, Heart and Vascular Institute, Boston, USA

Division of Cardiovascular Sciences, All India Institute of Medical Sciences, New Delhi, India

Department of Cardiology, Gulf Heart Centre, Dubai, UAE

⁴

European Centre for Coronary Physiology Research, Belgrade, Serbia

Abstract

Background

Accurate physiological assessment of coronary artery stenosis is essential for determining the need for revascularization. Fractional Flow Reserve (FFR) has long been regarded as the gold standard for invasive physiological assessment of coronary lesions. Quantitative Flow Ratio (QFR), a novel angiography-based physiological index, has emerged as a less invasive alternative that eliminates the need for pressure wires and pharmacological hyperemia. This study compares diagnostic performance, procedural efficiency, clinical outcomes, and economic implications of QFR and FFR.

Methods

A retrospective comparative analysis was conducted involving 320 patients with intermediate coronary lesions who underwent physiological assessment using either QFR or FFR. Diagnostic accuracy, procedural characteristics, treatment decisions, and one-year clinical outcomes were evaluated.

Results

QFR demonstrated excellent correlation with FFR (r = 0.87, p < 0.001). Diagnostic agreement reached 92.8%. QFR significantly reduced procedural time (18.5 ± 4.7 vs. 34.2 ± 8.1 minutes, p < 0.001) and contrast volume usage. One-year major adverse cardiovascular event (MACE) rates were comparable between groups (QFR 5.6% vs. FFR 5.2%; p = 0.84).

Conclusion

QFR provides a reliable, efficient, and cost-effective alternative to FFR for evaluating intermediate coronary lesions. Its non-wire-based approach may facilitate wider adoption of physiology-guided coronary interventions.

Keywords

Quantitative Flow Ratio

Fractional Flow Reserve

Coronary Physiology

Percutaneous Coronary Intervention

Coronary Artery Disease

Functional Assessment

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