Background and Objectives: The aims of this study were (1) to examine the diagnostic accuracy of resting time-averaged distal coronary pressure (Pd) to mean aortic pressure (Pa) ratio to predict hyperemic fractional flow reserve (FFR) and (2) to identify a resting Pd/Pa value that can preclude the need for hyperemic FFR assessed with use of a monorail pressure catheter. Methods: A total of 191 stenoses were assessed. After exclusions, 157 FFR data sets from 103 patients were analyzed. Results: Resting Pd/Pa showed poor agreement with hyperemic FFR (r=0.619, P<0.001). The receiver operating characteristic curve for resting Pd/Pa with reference to hyperemic FFR of 0.80 or less showed an area under the curve of 0.800 (95% confidence interval 0.732–0.868, P<0.001), with the greatest diagnostic accuracy of 74.5% for resting Pd/Pa of less than 0.85. Resting Pd/Pa of 0.96 or greater had a sensitivity of 100% and a negative predictive value of 100%, and resting Pd/Pa of 0.82 or less had a specificity of 98.9% and a positive predictive value of 94.1% to predict abnormal FFR of 0.80 or less. These results were consistent regardless of the vessels studied, the location of lesions, and the severity of stenosis. Conclusions: Resting Pd/Pa showed poor agreement with hyperemic FFR assessed with use of a monorail pressure microcatheter. However, resting Pd/Pa of 0.96 or greater had excellent sensitivity and negative predictive value to predict normal hyperemic FFR, and resting Pd/Pa of 0.82 or less had excellent specificity and positive predictive value to predict abnormal hyperemic FFR.

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(4286.14) ng/ml, 2.21 (2.24) ms and 61.8 (7.8) % respectively. 6.0% had isolated cardiac siderosis without liver involvement and 85.5% of those with cardiac siderosis had normal LVEF. Liver siderosis prevalence was 83.0% (38.7% severe, 35.6% moderate and 25.7% mild) but only 15.8% had co-morbid cardiac siderosis. Overall, only liver T2* had statistically proven association with cardiac siderosis (p b 0.001). Conclusion: The prevalence of cardiac siderosis among transfusion-dependent Thalassaemia patients was 16.8%; 6.0% cases of isolated cardiac siderosis without liver iron overload was seen in the study population. A significant association between cardiac siderosis and liver T2* emphasised the importance of CMR as a screening and surveillance tool to rule out cardiac and liver siderosis, and monitor disease progression.