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European Heart Journal 2002 23(2):133-138; doi:10.1053/euhj.2001.2708
Copyright © 2002 by the European Society of Cardiology.
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Flow velocity and predictors of a suboptimal coronary flow velocity reserve after coronary balloon angioplasty

M. Albertala, E. Regara, G. Van Langenhovea, S.G. Carliera, P. Serranoa, E. Boersmab, B. Bruynec, C. Di Mariod, J. Pieke and P.W. Serruysa,f1

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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