Comparison of diagnostic performance between quantitative flow ratio, non-hyperemic pressure indices and fractional flow reserve

Quantitative flow ratio (QFR) is an estimate of fractional flow reserve (FFR) and is derived from 3-dimensional quantitative coronary angiography. The DILEMMA score is an angiographic technique developed to predict FFR. Unlike other diastolic indices such as instantaneous wave-free ratio (iFR), diastolic pressure ratio (dPR) and dPR , neither QFR nor DILEMMA score require pressure wires. This study sought to compare the diagnostic performance of QFR, diastolic indices and DILEMMA score to predict FFR. Between January 2010 and December 2013, patients who underwent invasive coronary angiography and FFR assessments were retrospectively studied. iFR and dPR were derived from FFR pressure tracings. QFR was computed using commercial software. Eighty-five lesions (25% FFR significant) were included in this study. Median FFR was 0.88 (0.81-0.92). QFR (r =0.801), iFR (r =0.710), dPR (r =0.716), dPR (r =0.715) and DILEMMA score (r =-0.623) significantly correlated with FFR (P