on March 11, 2002
Published online before print March 11, 2002, doi: 10.1161/01.CIR.0000012514.15806.DD
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on October 23, 2001
From Thoraxcenter, Rotterdam, the Netherlands (M.A., G.V.L., P.I.K., M.A.C., E.B., T.B., P.W.S.); the Academic Medical Center, Amsterdam, the Netherlands (M.V., J.J.P.); Onze Lieve Vrouwe Kliniek, Aalst, Belgium (B.d.B.); institutop Dante Pazzanesse de Cardiologia, San Pablo, Brasil (J.E.S.); and the Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina (J.A.B.). * To whom correspondence should be addressed. E-mail: serruys{at}card.azr.nl.
Background—Because heterogeneous results have been reported, we assessed coronary flow velocity changes in individuals who underwent percutaneous transluminal coronary angioplasty (PTCA) and examined their impact on clinical outcome. Methods and Results—As part of the Doppler Endpoints Balloon Angioplasty Trial Europe (DEBATE) II study, 379 patients underwent Doppler flow--guided angioplasty. All patients were evaluated according to their coronary flow velocity reserve (CFVR) results ( Conclusions—A low postprocedural CFVR was associated with a worse periprocedural outcome (which was related to microcirculatory disturbances), but there was no significant difference at late follow-up.
Revised on January 23, 2002
Accepted on January 24, 2002
Coronary Flow Velocity Reserve After
Percutaneous Interventions Is Predictive of
Periprocedural Outcome
M. Albertal MD,
2.5 or <2.5) at the end of the procedure. A CFVR <2.5 after angioplasty was associated with an elevated baseline blood flow velocity in both the target artery and reference artery. CFVR before PTCA and CFVR in the reference artery were independent predictors of an optimal CFVR after balloon angioplasty (CFVR before PTCA: odds ratio [OR], 2.26; 95% confidence interval [CI], 1.57 to 3.24; CFVR in reference artery: OR, 1.90; 95% CI, 1.21 to 2.98; both P<0.001) and stent implantation (before PTCA: OR, 2.54; 95% CI, 1.47 to 4.36; reference artery: OR, 1.97; 95% CI, 1.07 to 3.87; both P<0.05). A low CFVR at the end of the procedure was an independent predictor of major adverse cardiac events (MACE) at 30 days (OR, 4.71; 95% CI, 1.14 to 25.92; P=0.034) and at 1 year (OR, 2.06; 95% CI, 1.16 to 3.66; P=0.014). After excluding MACE at 30 days, no difference in MACE at 1 year was observed between the patients with and without a CFVR <2.5 at the end of the procedure.
Key words: angiography • imaging • microcirculation
This article has been cited by other articles:
 |
|
 |
|
  L Cortigiani, F Rigo, R Sicari, S Gherardi, F Bovenzi, and E Picano Prognostic correlates of combined coronary flow reserve assessment on left anterior descending and right coronary artery in patients with negative stress echocardiography by wall motion criteria Heart, September 1, 2009; 95(17): 1423 - 1428. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Rigo, R. Sicari, S. Gherardi, A. Djordjevic-Dikic, L. Cortigiani, and E. Picano The additive prognostic value of wall motion abnormalities and coronary flow reserve during dipyridamole stress echo Eur. Heart J., January 1, 2008; 29(1): 79 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kawamoto, H. Okura, Y. Koyama, I. Toda, H. Taguchi, K. Tamita, A. Yamamuro, Y. Yoshimura, Y. Neishi, E. Toyota, et al. The Relationship Between Coronary Plaque Characteristics and Small Embolic Particles During Coronary Stent Implantation J. Am. Coll. Cardiol., October 23, 2007; 50(17): 1635 - 1640. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Cortigiani, F. Rigo, S. Gherardi, R. Sicari, M. Galderisi, F. Bovenzi, and E. Picano Additional Prognostic Value of Coronary Flow Reserve in Diabetic and Nondiabetic Patients With Negative Dipyridamole Stress Echocardiography by Wall Motion Criteria J. Am. Coll. Cardiol., October 2, 2007; 50(14): 1354 - 1361. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Selvanayagam, A. S.H. Cheng, M. Jerosch-Herold, K. Rahimi, I. Porto, W. van Gaal, K. M. Channon, S. Neubauer, and A. P. Banning Effect of Distal Embolization on Myocardial Perfusion Reserve After Percutaneous Coronary Intervention: A Quantitative Magnetic Resonance Perfusion Study Circulation, September 25, 2007; 116(13): 1458 - 1464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Lerman, D. R. Holmes, J. Herrmann, and B. J. Gersh Microcirculatory dysfunction in ST-elevation myocardial infarction: cause, consequence, or both? Eur. Heart J., April 1, 2007; 28(7): 788 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bahrmann, G. S. Werner, G. Heusch, M. Ferrari, T. C. Poerner, A. Voss, and H. R. Figulla Detection of Coronary Microembolization by Doppler Ultrasound in Patients With Stable Angina Pectoris Undergoing Elective Percutaneous Coronary Interventions Circulation, February 6, 2007; 115(5): 600 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Herrmann Peri-procedural myocardial injury: 2005 update Eur. Heart J., December 1, 2005; 26(23): 2493 - 2519. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Hagg, B. Wandt, G. Bergstrom, R. Volkmann, and L.-m. Gan Physical exercise capacity is associated with coronary and peripheral vascular function in healthy young adults Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1627 - H1634. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Poston, J. Gu, D. Prastein, F. Gage, J. W. Hoffman, M. Kwon, A. Azimzadeh, R. N. Pierson III, and B. P. Griffith Optimizing Donor Heart Outcome After Prolonged Storage With Endothelial Function Analysis and Continuous Perfusion Ann. Thorac. Surg., October 1, 2004; 78(4): 1362 - 1370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Cox, G. W. Stone, C. L. Grines, T. Stuckey, D. J. Cohen, J. E. Tcheng, E. Garcia, G. Guagliumi, R. S. Iwaoka, M. Fahy, et al. Outcomes of optimal or "stent-like"balloon angioplasty in acutemyocardial infarction: the CADILLAC trial J. Am. Coll. Cardiol., September 17, 2003; 42(6): 971 - 977. [Abstract] [Full Text] [PDF]
|
|