{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T14:15:18Z","timestamp":1793110518076,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"26","license":[{"start":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T00:00:00Z","timestamp":1480032000000},"content-version":"vor","delay-in-days":574,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Council"},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Institute for Cardiovascular Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Our understanding of human coronary physiological behaviour is derived from animal models. We sought to describe physiological behaviour across a large collection of invasive pressure and flow velocity measurements, to provide a better understanding of the relationships between these physiological parameters and to evaluate the rationale for resting stenosis assessment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Five hundred and sixty-seven simultaneous intracoronary pressure and flow velocity assessments from 301 patients were analysed for coronary flow velocity, trans-stenotic pressure gradient (TG), and microvascular resistance (MVR). Measurements were made during baseline and hyperaemic conditions. The whole cardiac cycle and the diastolic wave-free period were assessed. Stenoses were assessed according to fractional flow reserve (FFR) and quantitative coronary angiography DS%. With progressive worsening of stenoses, from unobstructed angiographic normal vessels to those with FFR \u2264 0.50, hyperaemic flow falls significantly from 45 to 19 cm\/s, Ptrend &amp;lt; 0.001 in a curvilinear pattern. Resting flow was unaffected by stenosis severity and was consistent across all strata of stenosis ( Ptrend &amp;gt; 0.05 for all). Trans-stenotic pressure gradient rose with stenosis severity for both rest and hyperaemic measures ( Ptrend &amp;lt; 0.001 for both). Microvascular resistance declines with stenosis severity under resting conditions ( Ptrend &amp;lt; 0.001), but was unchanged at hyperaemia (2.3 \u00b1 1.1 mmHg\/cm\/s; Ptrend = 0.19).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>With progressive stenosis severity, TG rises. However, while hyperaemic flow falls significantly, resting coronary flow is maintained by compensatory reduction of MVR, demonstrating coronary auto-regulation. These data support the translation of coronary physiological concepts derived from animals to patients with coronary artery disease and furthermore, suggest that resting pressure indices can be used to detect the haemodynamic significance of coronary artery stenoses.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehv626","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T01:58:21Z","timestamp":1448589501000},"page":"2069-2080","source":"Crossref","is-referenced-by-count":168,"title":["Coronary pressure and flow relationships in humans: phasic analysis of normal and pathological vessels and the implications for stenosis assessment: a report from the Iberian\u2013Dutch\u2013English (IDEAL) collaborators"],"prefix":"10.1093","volume":"37","author":[{"given":"Sukhjinder S.","family":"Nijjer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guus A.","family":"de Waard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayan","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim P.","family":"van de Hoef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Petraco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Echavarr\u00eda-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn A.","family":"van Lavieren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Meuwissen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Danad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Knaapen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Escaned","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J.","family":"Piek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin E.","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"van Royen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,11,26]]},"reference":[{"key":"2021061614095319500_EHV626C1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/0002-9149(74)90743-7","article-title":"Physiologic basis for assessing critical coronary stenosis: instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve","volume":"33","author":"Gould","year":"1974","journal-title":"Am J Cardiol"},{"key":"2021061614095319500_EHV626C2","first-page":"71","article-title":"The hemodynamics of coronary arterial stenosis","volume":"8","author":"Tyberg","year":"1977","journal-title":"Cardiovasc Clin"},{"key":"2021061614095319500_EHV626C3","doi-asserted-by":"crossref","first-page":"E4","DOI":"10.1016\/0002-9149(85)91169-5","article-title":"Hemodynamic principles in the control of coronary blood flow","volume":"56","author":"Epstein","year":"1985","journal-title":"Am J Cardiol"},{"key":"2021061614095319500_EHV626C4","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1056\/NEJM198403293101304","article-title":"Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis?","volume":"310","author":"White","year":"1984","journal-title":"N Engl J Med"},{"key":"2021061614095319500_EHV626C5","doi-asserted-by":"crossref","first-page":"10D","DOI":"10.1016\/0002-9149(93)90129-Z","article-title":"Clinical applications of Doppler coronary flow reserve measurements","volume":"71","author":"White","year":"1993","journal-title":"Am J Cardiol"},{"key":"2021061614095319500_EHV626C6","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1136\/hrt.74.5.485","article-title":"New concepts for interpretation of intracoronary velocity and pressure tracings","volume":"74","author":"Di Mario","year":"1995","journal-title":"Br Heart J"},{"key":"2021061614095319500_EHV626C7","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1161\/01.CIR.0000023041.26199.29","article-title":"Hyperemic stenosis resistance index for evaluation of functional coronary lesion severity","volume":"106","author":"Meuwissen","year":"2002","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C8","doi-asserted-by":"crossref","first-page":"H2194","DOI":"10.1152\/ajpheart.01021.2002","article-title":"Association between coronary lesion severity and distal microvascular resistance in patients with coronary artery disease","volume":"285","author":"Chamuleau","year":"2003","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2021061614095319500_EHV626C9","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1161\/01.CIR.103.2.184","article-title":"Role of variability in microvascular resistance on fractional flow reserve and coronary blood flow velocity reserve in intermediate coronary lesions","volume":"103","author":"Meuwissen","year":"2001","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C10","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.jacc.2013.01.034","article-title":"Diagnostic classification of the instantaneous wave-free ratio is equivalent to fractional flow reserve and is not improved with adenosine administration. Results of CLARIFY (Classification Accuracy of Pressure-Only Ratios Against Indices Using Flow Study)","volume":"61","author":"Sen","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2021061614095319500_EHV626C11","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1161\/CIRCULATIONAHA.113.006646","article-title":"Outcome impact of coronary revascularization strategy reclassification with fractional flow reserve at time of diagnostic angiography insights from a large French multicenter fractional flow reserve registry","volume":"129","author":"Van Belle","year":"2014","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C12","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1016\/j.jacc.2011.11.003","article-title":"Development and validation of a new adenosine-independent index of stenosis severity from coronary wave\u2013intensity analysis","volume":"59","author":"Sen","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2021061614095319500_EHV626C13","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1161\/CIRCINTERVENTIONS.111.965707","article-title":"Diagnostic accuracy of combined intracoronary pressure and flow velocity information during baseline conditions: adenosine-free assessment of functional coronary lesion severity","volume":"5","author":"van de Hoef","year":"2012","journal-title":"Circ Cardiovasc Interv"},{"key":"2021061614095319500_EHV626C14","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1161\/CIRCULATIONAHA.106.177276","article-title":"Physiological assessment of coronary artery disease in the cardiac catheterization laboratory a scientific statement from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology","volume":"114","author":"Kern","year":"2006","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C15","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1161\/01.RES.14.3.250","article-title":"Control of coronary blood flow by an autoregulatory mechanism","volume":"14","author":"Mosher","year":"1964","journal-title":"Circ Res"},{"key":"2021061614095319500_EHV626C16","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1038\/nrcardio.2013.86","article-title":"Fractional flow reserve as a surrogate for inducible myocardial ischaemia","volume":"10","author":"van de Hoef","year":"2013","journal-title":"Nat Rev Cardiol"},{"key":"2021061614095319500_EHV626C17","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1093\/eurheartj\/ehu170","article-title":"Impact of anatomical and functional severity of coronary atherosclerotic plaques on the transmural perfusion gradient: a [15O]H2O PET study","volume":"35","author":"Danad","year":"2014","journal-title":"Eur Heart J"},{"key":"2021061614095319500_EHV626C18","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1161\/CIRCINTERVENTIONS.113.000926","article-title":"Baseline instantaneous wave-free ratio as a pressure-only estimation of underlying coronary flow reserve: results of the JUSTIFY-CFR study (joined coronary pressure and flow analysis to determine diagnostic characteristics of basal and hyperemic indices of functional lesion severity-coronary flow reserve)","volume":"7","author":"Petraco","year":"2014","journal-title":"Circ Cardiovasc Interv"},{"key":"2021061614095319500_EHV626C19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1161\/CIRCINTERVENTIONS.113.001049","article-title":"Physiological basis and long-term clinical outcome of discordance between fractional flow reserve and coronary flow velocity reserve in coronary stenoses of intermediate severity","volume":"7","author":"van de Hoef","year":"2014","journal-title":"Circ Cardiovasc Interv"},{"key":"2021061614095319500_EHV626C20","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1161\/ATVBAHA.114.303929","article-title":"A brief etymology of the collateral circulation","volume":"34","author":"Faber","year":"2014","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2021061614095319500_EHV626C21","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1161\/01.CIR.0000143893.18451.0E","article-title":"Epicardial stenosis severity does not affect minimal microcirculatory resistance","volume":"110","author":"Aarnoudse","year":"2004","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C22","doi-asserted-by":"crossref","first-page":"H422","DOI":"10.1152\/ajpheart.00003.2012","article-title":"Minimal effect of collateral flow on coronary microvascular resistance in the presence of intermediate and noncritical coronary stenoses","volume":"303","author":"Verhoeff","year":"2012","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2021061614095319500_EHV626C23","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1161\/hc0902.104719","article-title":"Validation of collateral fractional flow reserve by myocardial perfusion imaging","volume":"105","author":"Matsuo","year":"2002","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C24","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1161\/01.CIR.82.5.1595","article-title":"Effects of adenosine on human coronary arterial circulation","volume":"82","author":"Wilson","year":"1990","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C25","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1016\/j.jacc.2012.11.083","article-title":"Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve: scientific basis","volume":"61","author":"Taylor","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2021061614095319500_EHV626C26","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1161\/01.CIR.85.6.1987","article-title":"Basic structure-function relations of the epicardial coronary vascular tree. Basis of quantitative coronary arteriography for diffuse coronary artery disease","volume":"85","author":"Seiler","year":"1992","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C27","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/eurheartj\/16.suppl_J.53","article-title":"Principles of interpretation of coronary velocity and pressure tracings","volume":"16","author":"Di Mario","year":"1995","journal-title":"Eur Heart J"},{"key":"2021061614095319500_EHV626C28","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/(SICI)1097-0304(199606)38:2<189::AID-CCD17>3.0.CO;2-E","article-title":"Utilization of translesional hemodynamics: comparison of pressure and flow methods in stenosis assessment in patients with coronary artery disease","volume":"38","author":"Di Mario","year":"1996","journal-title":"Cathet Cardiovasc Diagn"},{"key":"2021061614095319500_EHV626C29","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/0735-1097(95)00088-L","article-title":"Atherosclerosis in angiographically \u201cnormal\u201d coronary artery reference segments: an intravascular ultrasound study with clinical correlations","volume":"25","author":"Mintz","year":"1995","journal-title":"J Am Coll Cardiol"},{"key":"2021061614095319500_EHV626C30","first-page":"951","article-title":"Impact of hyperaemic microvascular resistance on fractional flow reserve measurements in patients with stable coronary artery disease: insights from combined stenosis and microvascular resistance assessment","volume":"100","author":"van de Hoef","year":"2014","journal-title":"Heart Br Card Soc"},{"key":"2021061614095319500_EHV626C31","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jcmg.2011.09.020","article-title":"Is discordance of coronary flow reserve and fractional flow reserve due to methodology or clinically relevant coronary pathophysiology?","volume":"5","author":"Johnson","year":"2012","journal-title":"JACC Cardiovasc Imaging"},{"key":"2021061614095319500_EHV626C32","doi-asserted-by":"crossref","first-page":"2557","DOI":"10.1161\/CIRCULATIONAHA.112.001345","article-title":"Disturbed coronary hemodynamics in vessels with intermediate stenoses evaluated with fractional flow reserve a combined analysis of epicardial and microcirculatory involvement in ischemic heart disease","volume":"128","author":"Echavarria-Pinto","year":"2013","journal-title":"Circulation"},{"key":"2021061614095319500_EHV626C33","article-title":"Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation (DEFINE-FLAIR)","author":"Imperial College London","year":"2013"},{"key":"2021061614095319500_EHV626C34","article-title":"Evaluation of iFR vs FFR in stable angina or acute coronary syndrome (iFR Swedeheart)","author":"Uppsala University","year":"2014"}],"container-title":["European Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/eurheartj\/article-pdf\/37\/26\/2069\/38660408\/eurheartj_37_26_2069.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/eurheartj\/article-pdf\/37\/26\/2069\/38660408\/eurheartj_37_26_2069.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T14:10:26Z","timestamp":1623852626000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartj\/article\/37\/26\/2069\/2594973"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,1]]},"references-count":34,"journal-issue":{"issue":"26","published-online":{"date-parts":[[2015,11,26]]},"published-print":{"date-parts":[[2015,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/ehv626","relation":{},"ISSN":["0195-668X","1522-9645"],"issn-type":[{"value":"0195-668X","type":"print"},{"value":"1522-9645","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,5,1]]},"published":{"date-parts":[[2015,5,1]]}}}