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Quantitative flow ratio as a new tool for angiography-based physiological evaluation of coronary artery disease: a
Enrico Cerrato1, Hernan Mejía-Rentería2, Alfonso Franzè1
1Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano & Rivoli Infermi Hospital, Rivoli, Turin, Italy.
Insights
Quantitative flow ratio (QFR) offers a non-invasive method for assessing coronary artery blockages using only angiographic data. This technique aims to make functional stenosis evaluation more accessible in routine cardiac procedures.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Medical imaging analysis
Background:
- Functional evaluation of coronary stenoses is clinically important, with strong guideline recommendations.
- Current wire-based physiological assessments are not routine due to procedural complexity.
- Angiography-derived indexes are emerging to estimate stenosis significance from imaging data alone.
Purpose of the Study:
- To summarize the fundamentals of the quantitative flow ratio (QFR).
- To review validation studies supporting QFR.
- To discuss current and future applications of QFR in clinical practice.
Main Methods:
- Review of existing literature on QFR.
- Analysis of validation studies comparing QFR with invasive measurements.
- Discussion of clinical implementation and future research directions.
Main Results:
- Quantitative flow ratio (QFR) is the most studied and validated angiography-derived index for stenosis evaluation.
- QFR provides a reliable estimation of stenosis functional significance using only angiographic data.
- Studies confirm QFR's potential to overcome limitations of wire-based assessments.
Conclusions:
- QFR represents a significant advancement in non-invasive functional assessment of coronary stenoses.
- Its validation supports broader adoption in catheterization laboratories.
- Future applications may enhance routine clinical decision-making for coronary artery disease.
Abstract:
The functional evaluation of coronary stenoses has obtained important clinical results in recent years, resulting in strong guideline recommendations. Nonetheless, the use of coronary wire-based functional evaluation has not yet become part of the routine in catheterization laboratories for several reasons, including the need to advance a wire into the coronary vessel to interrogate the stenosis. Angiography-derived indexes have been introduced to expand the current use of physiology to estimate the functional meaning of a stenosis on the basis of angiographic data only. The most studied and validated angiography-derived index is certainly the quantitative flow ratio. This article will summarize the basics of the quantitative flow ratio, the related validation studies and its current and future applications.
