Imperial College London

Dr Ricardo Petraco

Faculty of MedicineNational Heart & Lung Institute

Senior Clinical Research Fellow



+44 (0)20 7594 3386r.petraco




Block B Hammersmith HospitalHammersmith Campus





Ricardo Petraco is a National Heart and Lung Institute Senior Clinical Research Fellow at Imperial College London and a Consultant Cardiologist at Imperial College NHS Trust and Buckinghamshire NHS Trust. 

Dr Petraco’s research interests lies at the interface between coronary physiology and biomedical engineering. He is internationally recognised as one of the lead researchers responsible for developing the Instantaneous Wave-Free Ratio (iFR, a novel index of coronary stenosis severity which has revolutionised the field of coronary physiology). Having authored extensively in the field and as a regular faculty member of international meetings and teaching events, Ricardo is a well-known proctor of coronary physiology and intravascular imaging.

Dr Petraco has received multiple awards during his academic career to date, including a Junior British Hear Foundation (BHF) Clinical Research Training Fellowship in 2011, a National Institute for Health Research Walport Lectureship in 2015 and, recently, a National Heart and Lung Institute Senior Research Fellowship in 2018. Ricardo has successfully secured multiple research grants from funders such as BHF, Imperial College Charity, Academy of Medical Sciences as well as from industry partners. He is also the Editor of the novel and upcoming Oxford Specialist Handbook of Coronary Physiology and Intravascular Imaging.

Ricardo has a particular interest and expertise in medical informatics and computer coding, and he has pioneered an advanced haemodynamic software platform which has been used by multiple research units around the world for the analysis and interpretation of coronary haemodynamic signals.

His work has led to the proposition of the ECG-free iFR. He has also developed new statistical approaches to deal with the influence of disease severity distribution on the accuracy of quantitative diagnostic methods (the V-plot of accuracies).

Dr Petraco’s current work focusses on the development of new methods to reliably quantify stenosis severity in situations of coronary haemodynamic instability. He also works closely in partnership with bioengineering to improve the quality of intravascular flow signals and ultrasound imaging. Ricardo is also interested in how biological processes, including cardiovascular drugs, affect coronary microvascular function and is will be the Chief Investigator a study which will for the first time evaluate the effects of PCSK9 inhibition on coronary flow.

Since completing medical school in Brazil, Dr Petraco went on to complete his higher specialist cardiology training at leading university hospitals across London, including the Royal Brompton, St Marys and Hammersmith Hospitals. His clinical work focus on coronary interventions and on the clinical implementation of invasive investigative methodologies, so that developments in coronary physiology and imaging research can translate rapidly into clinical practice and benefit patients worldwide.

Selected Publications

Journal Articles

Petraco R, Sen S, Nijjer S, et al., 2013, Fractional flow reserve-guided revascularization: practical implications of a diagnostic gray zone and measurement variability on clinical decisions, Jacc. Cardiovascular Interventions, Vol:6, ISSN:1876-7605, Pages:222-225

Sen S, Asrress KN, Nijjer S, et al., 2013, Diagnostic Classification of the Instantaneous Wave-Free Ratio Is Equivalent to Fractional Flow Reserve and Is Not Improved With Adenosine Administration, Journal of the American College of Cardiology, Vol:61, ISSN:0735-1097, Pages:1409-1420

Petraco R, Park JJ, Sen S, et al., 2013, Hybrid iFR-FFR decision-making strategy: implications for enhancing universal adoption of physiology-guided coronary revascularisation, Eurointervention: Journal of Europcr in Collaboration With the Working Group on Interventional Cardiology of the European Society of Cardiology, Vol:8, ISSN:1969-6213, Pages:1157-1165

Sen S, Escaned J, Malik IS, et al., 2012, Development and Validation of a New Adenosine-Independent Index of Stenosis Severity From Coronary Wave–Intensity Analysis, Journal of the American College of Cardiology, Vol:59, ISSN:0735-1097, Pages:1392-1402

Petraco R, Escaned J, Sen S, et al., 2012, Classification performance of instantaneous wave-free ratio (iFR) and fractional flow reserve in a clinical population of intermediate coronary stenoses: results of the ADVISE registry, Eurointervention: Journal of Europcr in Collaboration With the Working Group on Interventional Cardiology of the European Society of Cardiology, ISSN:1969-6213

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