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Volume 14
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10.3390/jcm14134503
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Validation of a Novel Coronary Angiography-Derived Quantitative Functional Assessment Compared with Wire-Based FFR and IMR: The Prospective Multicenter FAIR Study

by
Changwu Xu
1,†,
Qiang Xue
2,†,
Jianwen Liang
3,†,
Guosheng Fu
4,
Qiang Wu
5,
Qing Jin
2,
Wenbin Wei
3,
Fuyu Qiu
4,
Huali Yao
5 and
Hong Jiang
1,*
1
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
2
Department of Cardiology, Yan’an Hospital of Kunming City (Yan’an Hospital Affiliated to Kunming Medical University), Kunming 650051, China
3
Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China
4
Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 311500, China
5
Department of Cardiology, Jieyang People’s Hospital, Jieyang 522091, China
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2025, 14(13), 4503; https://doi.org/10.3390/jcm14134503 (registering DOI)
Submission received: 15 May 2025 / Revised: 16 June 2025 / Accepted: 23 June 2025 / Published: 25 June 2025
(This article belongs to the Section Cardiology)
Versions Notes

Abstract

Background: Synchronous computation of coronary angiography-derived fractional flow reserve (CAG-FFR) and coronary angiography-derived index of microcirculatory resistance (CAG-IMR) is a novel coronary angiography-based method for on-site assessment of suspected myocardial ischemia in patients with coronary artery disease (CAD). Methods: This trial is a prospective, multicenter, controlled study designed to assess the diagnostic performance of CAG-FFR and CAG-IMR in patients with suspected myocardial ischemia using wire-based FFR and IMR as reference standards. The functional parameters were calculated using a reduced order computational fluid dynamics solver that incorporates thrombolysis in myocardial infarction (TIMI) frame count and aortic pressure recorded by a disposable invasive pressure sensor. Results: CAG-FFR was computed in 325 patients, demonstrating a patient-level diagnostic accuracy of 95.4%, sensitivity of 95.9%, and specificity of 95.1%. The area under the receiver operating characteristic curve (AUC) of CAG-FFR was 0.977. Patient-specific aortic pressure adoption significantly improved the accuracy of CAG-FFR in the “gray zone” compared to fixed-pressure models. In addition, CAG-IMR was successfully computed in 180 patients, showing a patient-level diagnostic accuracy of 95.5%, sensitivity of 96.4%, and specificity of 95.2%. The AUC of CAG-IMR in diagnosing abnormal coronary microcirculatory dysfunction was 0.973. Conclusions: Synchronous computation of CAG-FFR and CAG-IMR demonstrated higher feasibility and excellent diagnostic accuracy compared to wire-based FFR and IMR, highlighting its clinical potential for CAD evaluation.
Keywords: myocardial ischemia; fractional flow reserve; index of microcirculatory resistance; patient-specific pressure myocardial ischemia; fractional flow reserve; index of microcirculatory resistance; patient-specific pressure

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MDPI and ACS Style

Xu, C.; Xue, Q.; Liang, J.; Fu, G.; Wu, Q.; Jin, Q.; Wei, W.; Qiu, F.; Yao, H.; Jiang, H. Validation of a Novel Coronary Angiography-Derived Quantitative Functional Assessment Compared with Wire-Based FFR and IMR: The Prospective Multicenter FAIR Study. J. Clin. Med. 2025, 14, 4503. https://doi.org/10.3390/jcm14134503

AMA Style

Xu C, Xue Q, Liang J, Fu G, Wu Q, Jin Q, Wei W, Qiu F, Yao H, Jiang H. Validation of a Novel Coronary Angiography-Derived Quantitative Functional Assessment Compared with Wire-Based FFR and IMR: The Prospective Multicenter FAIR Study. Journal of Clinical Medicine. 2025; 14(13):4503. https://doi.org/10.3390/jcm14134503

Chicago/Turabian Style

Xu, Changwu, Qiang Xue, Jianwen Liang, Guosheng Fu, Qiang Wu, Qing Jin, Wenbin Wei, Fuyu Qiu, Huali Yao, and Hong Jiang. 2025. "Validation of a Novel Coronary Angiography-Derived Quantitative Functional Assessment Compared with Wire-Based FFR and IMR: The Prospective Multicenter FAIR Study" Journal of Clinical Medicine 14, no. 13: 4503. https://doi.org/10.3390/jcm14134503

APA Style

Xu, C., Xue, Q., Liang, J., Fu, G., Wu, Q., Jin, Q., Wei, W., Qiu, F., Yao, H., & Jiang, H. (2025). Validation of a Novel Coronary Angiography-Derived Quantitative Functional Assessment Compared with Wire-Based FFR and IMR: The Prospective Multicenter FAIR Study. Journal of Clinical Medicine, 14(13), 4503. https://doi.org/10.3390/jcm14134503

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