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Instantaneous wave-free ratio to guide coronary revascularization: physiological framework, validation and differences with fractional flow reserve


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1. NETHERLANDS; 2. NIHR Cardiovascular BRU, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, London, United Kingdom; 3. Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo College of Medicine, Rochester, Minnesota, United States; 4. Imperial College, London, United Kingdom; 5. VU University Medical Center, Cardiology, Amsterdam, NETHERLANDS


Determining the optimal treatment strategy for revascularization of coronary artery stenosis involves the use of fractional flow reserve (FFR). To improve the low clinical uptake of physiological lesion assessment to guide revascularization, the instantaneous wave-free period (iFR) was proposed as a simpler alternative to FFR that does not require adenosine administration. iFR is calculated as the ratio of blood pressure distal and proximal to a coronary artery stenosis during the diastolic wave-free period. The wave-free period is a part of the cardiac cycle where generation of…

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