ArticleEuropean heart journal open2026
Association of physiological discordance between fractional flow reserve and non-hyperaemic pressure ratios with lipid-rich plaque burden.
Article in European heart journal open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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18 authors.
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Abstract
Aims: Fractional flow reserve (FFR) and non-hyperaemic 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). This study aimed to investigate whether physiological discordance between FFR and NHPR is associated with increased lipid burden. Methods and results: We retrospectively analysed 217 intermediate coronary lesions from 189 patients who underwent FFR, NHPR, and near-infrared spectroscopy with intravascular ultrasound imaging. Lesions were classified using established cut-offs for FFR (0.80) and NHPR (0.89). Lipid burden was quantified by the maximum lipid core burden index within any 4-mm segment (maxLCBI Conclusion: FFR+/NHPR- lesions exhibit markedly greater lipid burden, suggesting that hyperaemia-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.
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