Pullback pressure gradient (PPG) characterizes pressure loss patterns on a continuous scale (1.0 for focal, 0 for diffuse disease) and predicts flow improvement and angina relief after PCI.
Does pullback pressure gradient (PPG) predict flow improvement and angina relief in patients with coronary artery disease?
The pullback pressure gradient is a novel physiological metric that characterizes the spatial distribution of coronary artery disease to differentiate focal from diffuse patterns and predict post-PCI outcomes.
Coronary artery disease (CAD) remains the leading cause of death worldwide. Integrating coronary physiology into treatment decision-making is essential to optimize outcomes. Fractional flow reserve (FFR) is the gold standard for assessing the severity of CAD (ischemia) and guiding percutaneous coronary intervention (PCI). However, a single value of FFR cannot capture the spatial distribution of CAD along the vessel. The pullback pressure gradient (PPG) obtained from manual FFR pullbacks is a novel metric for characterizing pressure loss patterns on a continuous scale: values approaching 1.0 represent a focal CAD pattern, whereas values close to 0 represent diffuse disease. PPG predicts flow improvement and angina relief after PCI. This review summarizes the current evidence on PPG and discusses the integration of this novel approach in CAD management.
Ikeda et al. (Sun,) conducted a review in Coronary artery disease. Pullback pressure gradient (PPG) was evaluated. Pullback pressure gradient (PPG) characterizes pressure loss patterns on a continuous scale (1.0 for focal, 0 for diffuse disease) and predicts flow improvement and angina relief after PCI.