{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:16:18Z","timestamp":1790622978818,"version":"4.1.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,8,20]]},"abstract":"\n Background<\/jats:title>\n \n Quantitative flow ratio (\n QFR<\/jats:styled-content>\n ), a novel functional angiography technique, computes fractional flow reserve (\n FFR<\/jats:styled-content>\n ) without pressure wires or adenosine. We investigated interindividual variations in the adenosine\u2010induced hemodynamics during\n FFR<\/jats:styled-content>\n assessment and their influence on\n QFR<\/jats:styled-content>\n diagnostic performance.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Patients with coronary stenoses who underwent intracoronary pressure and flow assessment were analyzed. Adenosine\u2010induced hemodynamics during\n FFR<\/jats:styled-content>\n measurement were determined by the percentage change in mean aortic pressure (%\u0394Pa) and the resistive reserve ratio (\n RRR<\/jats:styled-content>\n ). The diagnostic performance of\n QFR<\/jats:styled-content>\n was evaluated and compared in each tertile of %\u0394Pa and\n RRR<\/jats:styled-content>\n using\n FFR<\/jats:styled-content>\n as reference. A total of 294 vessels (245 patients) were analyzed. Mean\n FFR<\/jats:styled-content>\n was 0.80\u00b10.11. Individuals showed a wide variation in the adenosine response in terms of %\u0394Pa (ranging from \u221275% to 43%; median, \u22129% [interquartile range, \u22123% to \u221217%]) and the\n RRR<\/jats:styled-content>\n (ranging from 0.45 to 20.15; median, 3.1 [interquartile range, 2.1\u20134.9]). No significant differences for diagnostic efficiency of\n QFR<\/jats:styled-content>\n were found between tertiles of %\u0394Pa (area under the curve for the receiver\u2010operating characteristic analysis, 0.950 in tertile 1, 0.929 in tertile 2, and 0.910 in tertile 3;\n P<\/jats:italic>\n =0.270) or between tertiles of the\n RRR<\/jats:styled-content>\n (area under the curve for the receiver\u2010operating characteristic analysis, 0.909 in tertile 1, 0.923 in tertile 2, and 0.959 in tertile 3;\n P<\/jats:italic>\n =0.167). The classification agreement between\n QFR<\/jats:styled-content>\n and\n FFR<\/jats:styled-content>\n was not significantly modified by %\u0394Pa (tertile 1, 89%; tertile 2, 87%; and tertile 3, 86%;\n P<\/jats:italic>\n =0.827) or by the\n RRR<\/jats:styled-content>\n (tertile 1, 86%; tertile 2, 85%; and tertile 3, 91%;\n P<\/jats:italic>\n =0.398).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Patients undergoing\n FFR<\/jats:styled-content>\n assessment show large interindividual variations in the magnitude of adenosine\u2010induced hemodynamics. However, such variations do not affect the diagnostic performance of\n QFR<\/jats:styled-content>\n in assessing the functional relevance of observed stenoses.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.012906","type":"journal-article","created":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T09:00:19Z","timestamp":1565341219000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Interindividual Variations in the Adenosine\u2010Induced Hemodynamics During Fractional Flow Reserve Evaluation: Implications for the Use of Quantitative Flow Ratio in Assessing Intermediate Coronary Stenoses"],"prefix":"10.1161","volume":"8","author":[{"given":"Hern\u00e1n","family":"Mej\u00eda\u2010Renter\u00eda","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Mar\u00eda","family":"Lauri","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Heart Vascular Stroke Institute Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"McInerney","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina W.","family":"van der Hoeven","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"},{"name":"Department of Cardiology VU University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guus A.","family":"de Waard","sequence":"additional","affiliation":[{"name":"Department of Cardiology VU University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Fern\u00e1ndez\u2010Ortiz","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Macaya","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Knaapen","sequence":"additional","affiliation":[{"name":"Department of Cardiology VU University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"van Royen","sequence":"additional","affiliation":[{"name":"Department of Cardiology VU University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bon\u2010Kwon","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Korea"},{"name":"Institute on Aging Seoul National University Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Escaned","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos IDISSC and Universidad Complutense de Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu283"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.03.004"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.035"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009603"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.603522"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.08.019"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.112.000180"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.000659"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.116.005259"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.08.024"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.066"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2011.08.004"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037350"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.012906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:38:37Z","timestamp":1715600317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.012906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,20]]},"references-count":13,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2019,8,20]]}},"alternative-id":["10.1161\/JAHA.119.012906"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.012906","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,20]]},"assertion":[{"value":"2019-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e012906"}}