{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T20:25:14Z","timestamp":1785011114639,"version":"3.55.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,4,21]]},"abstract":"\n Background<\/jats:title>\n \n Resistive reserve ratio is a thermodilution\u2010based index which integrates both coronary flow and pressure. Resistive reserve ratio represents the vasodilatory capacity of interrogated vessels including both epicardial coronary artery and microvascular circulation. We evaluated the prognostic potential of resistive reserve ratio compared with pressure\u2010derived index (fractional flow reserve [\n FFR<\/jats:styled-content>\n ]) or flow\u2010derived index (coronary flow reserve [\n CFR<\/jats:styled-content>\n ]).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A total of 1245 patients underwent coronary pressure and flow measurement using pressure\u2010temperature wire. Resistive reserve ratio was calculated by\n CFR<\/jats:styled-content>\n adjusted using the ratio between resting and hyperemic distal coronary pressure ([resting mean transit time\/hyperemic mean transit time]\u00d7[resting distal coronary pressure\/hyperemic distal coronary pressure]). Clinical outcome was assessed by patient\u2010oriented composite outcome (\n POCO<\/jats:styled-content>\n ), a composite of any death, myocardial infarction, and revascularization at 5\u00a0years. At 5\u00a0years, the cumulative incidence of\n POCO<\/jats:styled-content>\n was significantly different according to quartiles of resistive reserve ratio (9.9%, 11.3%, 17.2%, and 22.7% in quartiles 1 to 4, respectively, log rank\n P<\/jats:italic>\n <0.001). Among patients with deferred revascularization, those with depressed resistive reserve ratio (<3.5) showed a significantly higher risk of\n POCO<\/jats:styled-content>\n than those with preserved resistive reserve ratio (\u22653.5) in patients with\n FFR<\/jats:styled-content>\n >0.80 or patients with\n CFR<\/jats:styled-content>\n >2.0. (\n FFR<\/jats:styled-content>\n >0.80 group: 14.8% versus 6.0%; log rank\n P<\/jats:italic>\n =0.001;\n CFR<\/jats:styled-content>\n >2.0 group: 13.5% versus 7.1%; log rank\n P<\/jats:italic>\n =0.045). Adding resistive reserve ratio into the model for 5\u2010year\n POCO<\/jats:styled-content>\n showed significantly higher global Chi square value than\n FFR<\/jats:styled-content>\n or\n CFR<\/jats:styled-content>\n (\n P<\/jats:italic>\n <0.001, respectively, for\n FFR<\/jats:styled-content>\n and\n CFR<\/jats:styled-content>\n ). Resistive reserve ratio <3.5 was significantly associated with the risk of\n POCO<\/jats:styled-content>\n at 5\u00a0years in multivariable model (adjusted hazard ratio 1.597, 95%\n CI<\/jats:styled-content>\n , 1.098\u20132.271,\n P<\/jats:italic>\n =0.014).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Resistive reserve ratio, which integrated both coronary flow and pressure, showed incremental prognostic implications in patients with coronary artery disease undergoing elective percutaneous coronary intervention guided by invasive physiologic evaluation.<\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n https:\/\/www.clini\u200bcaltr\u200bials.gov<\/jats:ext-link>\n ; Unique identifier:\n NCT<\/jats:styled-content>\n 03690713.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.015846","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T09:02:30Z","timestamp":1587200550000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Prognostic Implications of Resistive Reserve Ratio in Patients With Coronary Artery Disease"],"prefix":"10.1161","volume":"9","author":[{"given":"Seung Hun","family":"Lee","sequence":"first","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-4014","authenticated-orcid":false,"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":"Jonghanne","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul Korea"},{"name":"Developmental Therapeutics Program of Division of Hematology Oncology Northwestern University Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Hong","family":"Choi","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":"Doyeon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center Seoul National University Hospital Seoul 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