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Updated: Jan 31, 2026

Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
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Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus

Published on: December 7, 2013

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Vessel-Oriented Analysis on the Relationship Between Quantitative-Flow Ratio and Mortality in Patients With Severe

Iginio Colaiori1, Luca Paolucci2, Fabio Mangiacapra3

  • 1Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 29, 2026
PubMed

Insights

Quantitative flow ratio (QFR) reclassifies coronary artery disease (CAD) in transcatheter aortic valve replacement (TAVR) patients, identifying significant mortality risks. This functional assessment improves upon traditional angiography for predicting patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Diagnostic Imaging

Background:

  • Quantitative flow ratio (QFR) is established for predicting mortality in patients undergoing transcatheter aortic valve replacement (TAVR).
  • The impact of QFR-based reclassification of coronary artery disease (CAD) at the vessel level, compared to standard angiography, on mortality risk remains unclear.

Purpose of the Study:

  • To evaluate how QFR reclassifies CAD at the vessel level compared to angiography in TAVR patients.
  • To determine the influence of this QFR-based reclassification on the risk of all-cause mortality at 3 years.

Main Methods:

  • A cohort of 280 TAVR patients with bystander coronary stenoses was analyzed.
  • Coronary artery disease (CAD) was defined by angiography (diameter stenosis ≥50%) and functionally by QFR (≤0.80).
  • All lesions were managed conservatively, and 3-year mortality was the primary outcome.

Main Results:

  • Functional CAD (QFR ≤0.80) was identified in 11.2% of lesions, significantly lower than angiographic CAD (26.0%), indicating substantial reclassification (p<0.001).
  • Angiography/QFR mismatch occurred in 22.5% of lesions, particularly in large vessels and proximal LAD lesions.
  • QFR ≤0.80 independently predicted mortality (HR 2.91), with progressively higher risk for lower QFR values and positive QFR at the LAD site.

Conclusions:

  • QFR significantly reclassifies CAD rates at the vessel level in TAVR patients compared to angiography.
  • Functional assessment using QFR provides significant prognostic value for predicting mortality in this patient population.
Abstract

Keywords:
coronary artery diseasequantitative flow ratiotranscatheter aortic valve replacement

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