{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T11:57:43Z","timestamp":1772798263763,"version":"3.50.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,5,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Post\u2013percutaneous coronary intervention (PCI) fractional flow reserve \u22650.90 is an accepted marker of procedural success, and a cutoff of \u22650.95 has recently been proposed for post\u2010PCI instantaneous wave\u2010free ratio. However, stability of nonhyperemic pressure ratios (NHPRs) post\u2010PCI is not well characterized, and transient reactive submaximal hyperemia post\u2010PCI may affect their precision. We performed this study to assess stability and reproducibility of NHPRs post\u2010PCI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Fifty\u2010seven patients (age, 63.77\u00b110.67\u00a0years; men, 71%) underwent hemodynamic assessment immediately post\u2010PCI and then after a recovery period of 10, 20, and 30\u00a0minutes and repeated at 3\u00a0months. Manual offline analysis was performed to derive resting and hyperemic pressure indexes (Pd\/Pa resting pressure gradient, mathematically derived instantaneous wave\u2010free ratio, resting full cycle ratio, and fractional flow reserve) and microcirculatory resistances (basal microvascular resistance and index of microvascular resistance).<\/jats:p>\n            <jats:p xml:lang=\"en\">\n              Transient submaximal hyperemia occurring post\u2010PCI was demonstrated by longer thermodilution time at 30\u00a0minutes compared with immediately post\u2010PCI; mean difference of thermodilution time was 0.17\u00a0seconds (95% CI, 0.07\u20130.26 seconds;\n              <jats:italic>P<\/jats:italic>\n              =0.04). Basal microcirculatory resistance was also higher at 30\u00a0minutes than immediately post\u2010PCI; mean difference of basal microvascular resistance was 10.89\u00a0mm\u00a0Hg.s (95% CI, 2.25\u201319.52\u00a0mm\u00a0Hg.s;\n              <jats:italic>P<\/jats:italic>\n              =0.04). Despite this, group analysis confirmed no significant differences in the values of resting whole cycle pressure ratios (Pd\/Pa and resting full cycle ratio) as well as diastolic pressure ratios (diastolic pressure ratio and mathematically derived instantaneous wave\u2010free ratio). Whole cardiac cycle NHPRs demonstrated the best overall stability post\u2010PCI, and 1 in 5 repeated diastolic NHPRs crossed the clinical decision threshold.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Whole cycle NHPRs demonstrate better reproducibility and clinical precision post\u2010PCI than diastolic NHPRs, possibly because of less perturbation from predominantly diastolic reactive hyperemia and left ventricular stunning.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03502083\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03502083<\/jats:ext-link>\n              ; Unique identifier: NCT03502083 and URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03076476\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03076476<\/jats:ext-link>\n              ; Unique identifier: NCT03076476.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023554","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T09:42:57Z","timestamp":1650966177000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Coronary Flow Variations Following Percutaneous Coronary Intervention Affect Diastolic Nonhyperemic Pressure Ratios More Than the Whole Cycle Ratios"],"prefix":"10.1161","volume":"11","author":[{"given":"Muhammad","family":"Aetesam\u2010ur\u2010Rahman","sequence":"first","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-5255","authenticated-orcid":false,"given":"Tian X.","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kitty","family":"Paques","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8723-670X","authenticated-orcid":false,"given":"Joana","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0841-2969","authenticated-orcid":false,"given":"Bharat","family":"Khialani","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Kyranis","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise M.","family":"Braganza","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah C.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-1825","authenticated-orcid":false,"given":"Martin R.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick E. J.","family":"West","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3530-3808","authenticated-orcid":false,"given":"Stephen P.","family":"Hoole","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199606273342604"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.008"},{"key":"e_1_3_2_4_2","first-page":"e354","article-title":"2012 ACCF\/AHA\/ACP\/AATS\/PCNA\/SCAI\/STS guideline for the diagnosis and management of patients with stable ischemic heart disease","volume":"126","author":"Fihn SD","year":"2012","unstructured":"Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, et al. 2012 ACCF\/AHA\/ACP\/AATS\/PCNA\/SCAI\/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. 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