Discordant Diagnostics: A Case Series of iFR and FFR Discrepancies

Am J Cardiol. 2025 Jun 15:245:81-86. doi: 10.1016/j.amjcard.2025.02.029. Epub 2025 Mar 13.

Abstract

Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are 2 methods used to detect hemodynamically significant lesions and guide revascularization. Discrepancies between FFR and iFR values can complicate revascularization decisions. We present a series of 6 cases with discrepant FFR and iFR results. Among them, 5 were men, 5 had lesions in the right coronary artery, and one had left anterior descending disease, with an average age of 61.7 ± 11.1 years. All patients were iFR negative (mean iFR 0.94 ± 0.02) and FFR positive (mean FFR 0.75 ± 0.04). Consequently, all patients underwent revascularization.

Keywords: coronary angiography; coronary interventions; fractional flow reserve; instantaneous wave-free ratio; intravascular diagnostics.

MeSH terms

  • Aged
  • Cardiac Catheterization
  • Coronary Angiography
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / physiopathology
  • Coronary Artery Disease* / surgery
  • Coronary Stenosis* / diagnosis
  • Coronary Stenosis* / physiopathology
  • Coronary Vessels* / diagnostic imaging
  • Coronary Vessels* / physiopathology
  • Female
  • Fractional Flow Reserve, Myocardial* / physiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Revascularization