Copyright © 2002 by the European Society of Cardiology.
Flow velocity and predictors of a suboptimal coronary flow velocity reserve after coronary balloon angioplasty
a Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands
b Cardialysis CV, Rotterdam, The Netherlands
c O.L.V. Hospital, Aalst, Belgium
d Centro Cuore Columbus, Milan, Italy
e Academic Medical Center, Amsterdam, The Netherlands
revised March 27, 2001; accepted March 28, 2001
Abstract
Aims This study was conducted to analyse flow velocity parameters and predictors of a suboptimal coronary flow reserve (<2·5) following balloon angioplasty.
Methods 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.
Results 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.
Conclusion 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.
Key Words: Angioplasty, blood flow, intracoronary Doppler
f1 Correspondence: P. W. Serruys, MD, PhD, FACC, FESC, Prof. of Interventional Cardiology, Erasmus University, Head of Interventional Department, Heartcenter Rotterdam, Thoraxcenter, Bd. 418, University hospital Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
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