Key result
Pressure guide wires in computational models consistently lower FFR vs wire-free states, particularly in severe stenoses.
Why the study?
Most computational FFR models neglect the pressure guide wire used in invasive measurements, potentially introducing a bias relative to clinical measurements.
Does the inclusion of a pressure guide wire in computational fluid dynamics models impact virtual fractional flow reserve (FFR) and coronary flow reserve (CFR) assessments compared to wire-free models?
Does the inclusion of a pressure guide wire in computational fluid dynamics models impact virtual fractional flow reserve (FFR) and coronary flow reserve (CFR) assessments compared to wire-free models?
Accounting for pressure guide wire effects in non-invasive computational FFR frameworks is necessary to improve the accuracy and reliability of physiological assessments, as the wire consistently reduces FFR values.
Wire effects may bias virtual FFR in complex lesions; leaves open need for model adjustments in clinical CFD use.
Fractional flow reserve (FFR) is the clinical gold standard for assessing the functional severity of coronary artery stenosis. Invasive FFR measurements require the use of a pressure guide wire, which may alter coronary hemodynamics relative to the wire-free state. Yet most computational FFR models neglect the guide wire in the computations, potentially introducing a bias relative to clinical measurements. In this study, we used an image-based geometrically multi-scale computational fluid dynamics (CFD) model to systematically quantify the impact of pressure guide wires on FFR and coronary flow reserve (CFR) across varying stenosis severities, lesion configurations, and anatomical locations. Key novelties of this work include: i) assessment of the role of distal microvascular resistance in modulating FFR measurements, and ii) assessment of guide wire effects on CFR, including comparison with classical experimental data. Our findings demonstrate that the pressure guide wire consistently reduces FFR values, with the effect becoming more pronounced in severe, serial, and diffuse subtypes of stenoses. In addition, larger microvascular resistance attenuates the sensitivity of FFR to guide wire effects. These findings highlight the clinical significance of guide wire effects and emphasize the need to account for them in non-invasive FFR frameworks, thereby improving the accuracy and reliability of CFD-based physiological assessments.
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Zhang et al. (2026) studied Coronary artery stenosis. Pressure guide wire vs. Wire-free state was evaluated on Fractional flow reserve (FFR) and coronary flow reserve (CFR). The presence of a pressure guide wire in computational models consistently reduces FFR values compared to the wire-free state, particularly in severe, serial, and diffuse stenoses.
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