{
  "abstract": "AIMS: The quantitative flow ratio (QFR)-derived pullback pressure gradient (PPG) characterizes the pathophysiological patterns of coronary atherosclerosis. This study investigated the plaque morphologies associated with these disease patterns. METHODS: This study used the institutional QFR-PPG database registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000056097). Patients who underwent elective stenting with pre-procedural optical coherence tomography and near-infrared spectroscopy intravascular ultrasound were included. Offline QFR and QFR-PPG analyses were performed, and the lesions were stratified into tertiles. RESULTS: A total of 168 de novo lesions were analyzed in this study. The QFR tertiles were defined as severe (＜0.61), moderate (0.61-0.71), and mild (＞0.71); the QFR-PPG tertiles were defined as diffuse (＜0.66), intermediate (0.66-0.79), and focal (＞0.79). The Severe QFR tertiles exhibited a smaller minimum lumen area (MLA) and higher frequencies of thin-cap fibroatheroma (TCFA) and layered plaque. In contrast, across the QFR-PPG tertiles, MLA and TCFA frequencies were similar, whereas the diffuse group exhibited more layered plaques and larger calcium angles. The maximum lipid-core burden index did not vary across the QFR-PPG tertiles. A multivariable analysis identified MLA and TCFA as independent predictors of QFR, while layered plaque and calcium angle independently predicted QFR-PPG. However, the lipidic features were not independent predictors of QFR. CONCLUSION: Multimodal intracoronary imaging demonstrated that QFR reflects luminal narrowing and the features of vulnerable plaques. Conversely, QFR-PPG reflects disease diffuseness, characterized by layered plaques and calcium burden rather than lipid-rich features.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "name": "Eisuke Usui"
    },
    {
      "name": "Yoshihisa Kanaji"
    },
    {
      "name": "Masahiro Hada"
    },
    {
      "name": "Tatsuhiro Nagamine"
    },
    {
      "name": "Hiroki Ueno"
    },
    {
      "name": "Kodai Sayama"
    },
    {
      "name": "Takumi Watanabe"
    },
    {
      "name": "Takahiro Watanabe"
    },
    {
      "name": "Hikaru Shimosato"
    },
    {
      "name": "Takashi Mineo"
    },
    {
      "name": "Riko Murakami"
    },
    {
      "name": "Kaisei Hosokawa"
    },
    {
      "name": "Taishi Yonetsu"
    },
    {
      "name": "Tetsuo Sasano"
    },
    {
      "name": "Tsunekazu Kakuta"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1t9fbg8mkw49n.bib",
  "cited_by": 0,
  "doi": "10.5551/jat.66164",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/jat/33/11/33_66164/_article",
  "id": "1t9fbg8mkw49n",
  "issns": [
    "1880-3873",
    "1340-3478"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/jat/33/11/33_66164/_article",
  "language": null,
  "licence": "CC-BY-NC-SA",
  "licence_label": "CC BY-NC-SA",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2746|Coronary Interventions and Diagnostics"
    ]
  ],
  "openalex": "W7165905568",
  "pdf_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66164/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1t9fbg8mkw49n.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:20:49Z",
      "native_id": "10.5551/jat.66164",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/jat/33/11/33_66164/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Coronary Interventions and Diagnostics",
      "subfield": "surgery"
    }
  ],
  "title": "Association of Multimodal Intracoronary Imaging-Derived Plaque Morphology with the Pathophysiological Disease Patterns Assessed by the Quantitative Flow Ratio-Pullback Pressure Gradient",
  "title_text": "Association of Multimodal Intracoronary Imaging-Derived Plaque Morphology with the Pathophysiological Disease Patterns Assessed by the Quantitative Flow Ratio-Pullback Pressure Gradient",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:20:21Z",
  "url": "https://research.draconitic.com/paper/1t9fbg8mkw49n",
  "venue": "Journal of Atherosclerosis and Thrombosis",
  "versions": []
}