Association of Physiological Discordance Between Fractional Flow Reserve and Nonhyperemic Pressure Ratios With Lipid-Rich Plaque Burden

Clicks: 13
ID: 329061
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Steady

Ranked #50 of 80 articles by views in European Heart Journal Open

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Aims Fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs) frequently yield discordant results in clinical practice, yet the mechanisms underlying this mismatch remain uncertain. Plaque composition has been suggested to influence FFR, raising the possibility that discordance reflects the features of lipid-rich plaque (LRP). To investigate whether physiological discordance between FFR and NHPR is associated with increased lipid burden. Methods and Results We retrospectively analyzed 217 intermediate coronary lesions from 189 patients who underwent FFR, NHPR, and near-infrared spectroscopy with intravascular ultrasound imaging. Lesions were classified using established cutoffs for FFR (0.80) and NHPR (0.89). Lipid burden was quantified by the maximum lipid core burden index within any 4-mm segment (maxLCBI4mm). LRP was defined as maxLCBI4mm >400. The clinical endpoint was 3-year target vessel failure (TVF). Physiological discordance occurred in 24.0% of lesions, predominantly as an FFR+/NHPR− pattern (19.8%). FFR was independently associated with maxLCBI4mm (β, 65.2; 95%CI, 29.0–101.5; P < 0.001), whereas NHPR was not (β, 16.5; 95%CI, −15.9–49.0; P = 0.316). The FFR+/NHPR− group demonstrated the highest maxLCBI4mm (525 ± 201) and the greatest prevalence of LRP (65.1%; both P < 0.001). In multivariable analysis, the FFR+/NHPR− pattern independently predicted LRP (adjusted OR, 6.12; 95%C, : 1.20–31.28; P = 0.030). TVF occurrences did not differ significantly across physiological groups. Conclusion FFR+/NHPR− lesions exhibit markedly greater lipid burden, suggesting that hyperemia-based indices better capture plaque vulnerability than resting physiology. This pattern may serve as a marker of plaque vulnerability, suggesting that deferral of FFR+/NHPR− lesions could warrant caution given their higher lipid burden. (250/250 words)
Reference Key
openalex_W7213539817 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Hirohiko Aikawa, Kota Murai, Yu Kataoka, Yuriko Nakaoku, Soshiro Ogata, Kentaro Mitsui, Takamasa Iwai, Kenichiro Sawada, Hideo Matama, Hiroyuki Miura, Satoshi Honda, Masashi Fujino, Shuichi Yoneda, Kazuhiro Nakao, Kensuke Takagi, Yasuhide Asaumi, Kunihiro Nishimura, Teruo Noguchi
Are you one of these authors? Claim your profile
Journal European Heart Journal Open
Year 2026
DOI
10.1093/ehjopen/oeag155
URL
https://doi.org/10.1093/ehjopen/oeag155
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.