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Related Concept Videos

Coronary Circulation01:21

Coronary Circulation

The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...

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Related Experiment Video

Updated: Jul 3, 2026

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
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Rethinking the Bland-Altman plot when quantifying virtual coronary physiology.

Daniel J Taylor1,2,3, Harry Saxton2,4, Ian Halliday1,2

  • 1Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.

Frontiers in Cardiovascular Medicine
|November 10, 2025
PubMed
Summary
This summary is machine-generated.

Virtual fractional flow reserve (vFFR) shows questionable agreement with invasive methods, especially at lower values. A new quantile regression approach may improve accuracy and clinical application understanding.

Keywords:
Bland-AltmanFFRagreementcoronary artery diseasevirtual physiology

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Area of Science:

  • Cardiovascular imaging and intervention
  • Medical device validation
  • Biostatistics in clinical research

Background:

  • Virtual fractional flow reserve (vFFR) is increasingly used, but recent data question its accuracy compared to invasive assessment.
  • Existing validation methods like Bland-Altman analysis have limitations, particularly in characterizing agreement across different physiological ranges.
  • Discrepancies in vFFR accuracy hinder its optimal clinical implementation and comparison across studies.

Purpose of the Study:

  • To introduce a novel statistical approach using quantile regression for analyzing agreement between vFFR and invasive fractional flow reserve (FFR).
  • To address the limitations of traditional Bland-Altman analysis in assessing vFFR accuracy, especially at lower FFR values.
  • To improve the characterization of bias and limits of agreement for vFFR across the full spectrum of coronary artery disease.

Main Methods:

  • Application of quantile regression to derive bias and limits of agreement (LOA) from vFFR and invasive FFR data.
  • Comparison of the proposed quantile regression method with traditional Bland-Altman analysis.
  • Analysis of agreement across varying FFR values to identify potential discrepancies.

Main Results:

  • Quantile regression provides a more nuanced assessment of agreement between vFFR and invasive FFR compared to traditional methods.
  • The proposed method reveals how agreement characteristics change across the range of FFR values, highlighting issues at lower FFR.
  • This approach offers a more robust statistical framework for validating vFFR against invasive measurements.

Conclusions:

  • The novel quantile regression method offers improved statistical rigor for assessing vFFR accuracy.
  • Understanding agreement limitations, particularly at lower FFR values, is crucial for refining vFFR clinical utility.
  • This approach can enhance the validation practices for vFFR and guide its appropriate use in clinical settings.