Fractional Flow Reserve (FFR) / (iFR)

What are FFR and iFR?

Coronary angiography provides detailed images of the coronary arteries and helps identify areas of narrowing or blockage. However, angiography alone may not always determine whether a blockage is significantly affecting blood flow to the heart.

FFR and iFR are specialized pressure-based measurements performed during coronary angiography. A thin pressure-sensitive guidewire is passed across the narrowed artery to measure blood pressure before and after the blockage.

FFR measures blood flow under maximum blood vessel dilation, while iFR measures blood flow during a specific resting phase of the cardiac cycle without requiring additional medication. Both methods help determine whether a coronary blockage is functionally significant and requires treatment.

When is FFR / iFR Recommended?

FFR and iFR are recommended when coronary angiography shows a blockage but additional information is needed to determine its impact on blood flow. These tests help cardiologists make more accurate treatment decisions and avoid unnecessary interventions.

Your cardiologist may recommend FFR or iFR if:

• Coronary angiography shows moderate artery narrowing
• The severity of blockage is uncertain
• Chest pain symptoms do not match angiography findings
• Multiple coronary artery blockages are present
• Further evaluation is required before angioplasty
• Coronary artery disease is suspected despite unclear imaging results
• Treatment planning requires precise blood flow assessment

Symptoms That May Require FFR / iFR Evaluation

Chest Pain (Angina)

Persistent chest pain, pressure, or discomfort during physical activity may indicate reduced blood flow to the heart due to coronary artery disease.

Shortness of Breath

Difficulty breathing during exercise or routine daily activities can occur when the heart muscle is not receiving adequate oxygen-rich blood.

Fatigue During Physical Activity

Unexplained tiredness, reduced stamina, and exercise intolerance may be signs of impaired coronary circulation.

Abnormal Stress Test Results

Patients with positive, borderline, or inconclusive stress test findings may benefit from FFR or iFR evaluation for a more accurate assessment of coronary artery disease.

Ongoing Cardiac Symptoms

Individuals who continue to experience symptoms despite medical treatment may require further investigation of coronary blood flow.

Multiple Coronary Artery Blockages

FFR and iFR help identify which blockages are actually restricting blood flow and require angioplasty or stent placement.

Recovery After FFR / iFR

Recovery following FFR or iFR assessment is usually quick because the procedure is performed during coronary angiography. Most patients can resume normal activities within a day, depending on their overall condition and whether additional treatment such as angioplasty is performed.