Flow velocity and predictors of a suboptimal coronary flow velocity reserve after coronary balloon angioplasty

M. Albertal, E. Regar, G. van Langenhove, S. G. Carlier, P. Serrano, E. Boersma, B. Bruyne, C. di Mario, J. Piek, P. W. Serruys

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Abstract

This study was conducted to analyse flow velocity parameters and predictors of a suboptimal coronary flow reserve ( <2.5) following balloon angioplasty. Two hundred and twenty-five patients underwent sequential intracoronary Doppler as part of the DEBATE I study. Of these, 183, with complete angiography and Doppler at the 6-month follow-up, were included. Univariate and multivariate logistic analysis was performed to identify independent predictors of post-procedural suboptimal coronary flow reserve, defined as coronary flow reserve <2.5. Forty-eight per cent (n=88) of the patients achieved a suboptimal coronary flow reserve. These patients had higher baseline velocities (cm.s(-1)) before balloon angioplasty (18+/-9 vs 14+/-6, P=0.004), after balloon angioplasty (22+/-11 vs 14+/-5, P <0.001) and at follow-up (19+/-9 vs 16+/-6, P=0.011) than the optimal coronary flow reserve group. Although the suboptimal group had lower hyperaemic velocities (cm.s(-1)) after balloon angioplasty than the optimal group (42+/-17 vs 49+/-16, P=0.008), these velocities became similar at follow-up. Increasing age (odds ratio, OR 1.071, P=0.0002), female gender (OR 2.52, P=0.014) and increasing pre-procedural baseline average peak velocities (OR 1.056, P <0.001) were found to be independent predictors of a suboptimal coronary flow reserve following balloon angioplasty. A suboptimal coronary flow reserve was associated with (1) a chronically elevated baseline average peak velocity (2) a transient deficit in the hyperaemic average peak velocity (3) the elderly, and female gender
Original languageEnglish
Pages (from-to)133-138
JournalEuropean Heart journal
Volume23
Issue number2
DOIs
Publication statusPublished - 2002

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