Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Cardiol. Apr 26, 2026; 18(4): 116033
Published online Apr 26, 2026. doi: 10.4330/wjc.v18.i4.116033
Published online Apr 26, 2026. doi: 10.4330/wjc.v18.i4.116033
Quantitative flow ratio virtual pullback index predicts focal coronary artery disease identified on wire-based pullback pressure gradient
Zhi Hao Teoh, Tom Wardill, Michael Zhang, Joseph O’Brien, Derek P Chew, Brian Ko, Dennis T L Wong, Monash Heart, Victorian Heart Hospital, Monash Health, Melbourne 3168, Victoria, Australia
Joseph O’Brien, Derek P Chew, Brian Ko, Dennis T L Wong, Victorian Heart Institute, Monash University, Melbourne 3168, Victoria, Australia
Author contributions: Teoh Z, Wardill T, and Zhang M contributed to data acquisition, performed data analyses and wrote the manuscript; Teoh Z and Wong DTL designed the study; O’Brien J, Chew DP, Ko B, and Wong DTL critically reviewed the manuscript and gave critical suggestions on revision; Wong DTL was responsible for the overall contact and acts as the guarantor; all authors read and approved the final manuscript and agreed to submit it for consideration for publication.
Institutional review board statement: The study protocol was approved by the Local Human Research Ethics Committee (No. RES-22-0000-067Q-83745).
Informed consent statement: Informed consent was waived due to the retrospective design of the study and the use of anonymized clinical data, in accordance with institutional and ethical guidelines.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. All authors confirm accountability for all aspects of the work, including full data access upon reasonable request, integrity of the data, and accuracy of the data analysis, and ensure that any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Corresponding author: Zhi Hao Teoh, MRCP, Monash Heart, Victorian Heart Hospital, Monash Health, 631 Blackburn Road, Melbourne 3168, Victoria, Australia. zhteoh20@gmail.com
Received: November 3, 2025
Revised: December 29, 2025
Accepted: February 27, 2026
Published online: April 26, 2026
Processing time: 164 Days and 19.6 Hours
Revised: December 29, 2025
Accepted: February 27, 2026
Published online: April 26, 2026
Processing time: 164 Days and 19.6 Hours
Core Tip
Core Tip: Quantitative flow ratio virtual pullback index is a non-invasive, high-sensitivity tool that accurately predicts focal coronary artery disease, offering an alternative to pressure pullback gradient for percutaneous coronary intervention decision-making without the need for hyperemia or further invasive procedures.