{
  "abstract": "with lipid-rich or vulnerable plaque characteristics, including in non-flow-limiting non-culprit lesions of patients with MI. 3,4 Conversely, from a prognostic standpoint, lower PPG or diffuse disease patterns have also been associated with adverse vessel-related outcomes after PCI. 5 Thus, plaque vulnerability and clinical prognosis may represent related but distinct aspects of coronary disease.Our original discussion was intended to raise the hypothesis that a lower QFR-PPG phenotype may reflect a broader disease burden in AMI non-IRA lesions, rather than to establish a direct mechanistic link between low QFR-PPG and vulnerable plaque morphology.Further studies integrating coronary physiology with systematic intravascular imaging are needed to clarify the underlying plaque phenotype.Taken together, we agree that QFR-PPG <0.78 should be interpreted as a data-derived prognostic threshold rather than as a definitive biological definition of diffuse disease or plaque vulnerability.At the same time, the additional analyses demonstrate that QFR-PPG provides prognostic information not fully captured by QFR within the nonischemic range, particularly when combined with relatively lower QFR values.We therefore believe that the QFR/ QFR-PPG phenotype is best interpreted as a prognostic physiological risk-stratification tool for deferred, functionally insignificant intermediate non-IRA lesions after AMI.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "Sho Nakao"
    },
    {
      "name": "Takayuki Ishihara"
    },
    {
      "name": "Toshiaki Mano"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d466thwhekfpx.bib",
  "cited_by": 0,
  "doi": "10.1253/circj.cj-26-0652",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-26-0652/_article",
  "id": "d466thwhekfpx",
  "issns": [
    "1347-4820",
    "1346-9843"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-26-0652/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2746|Coronary Interventions and Diagnostics"
    ]
  ],
  "openalex": "W7172535467",
  "pdf_url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0652/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d466thwhekfpx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:24Z",
      "native_id": "10.1253/circj.cj-26-0652",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/circj/90/9/90_CJ-26-0652/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Coronary Interventions and Diagnostics",
      "subfield": "surgery"
    }
  ],
  "title": "Interpreting Low Pressure Pullback Gradient in Non-Culprit Lesions With Quantitative Flow Ratio ≥0.80 ― Reply ―",
  "title_text": "Interpreting Low Pressure Pullback Gradient in Non-Culprit Lesions With Quantitative Flow Ratio ≥0.80 ― Reply ―",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:24Z",
  "url": "https://research.draconitic.com/paper/d466thwhekfpx",
  "venue": "Circulation Journal",
  "versions": []
}