Value of coronary stenotic flow velocity acceleration in prediction of angiographic restenosis following balloon angioplasty
INTRODUCTION: Quantitative angiographic assessment after balloon angioplasty is a poor predictor of immediate and long-term outcome. However, the measurement of blood flow velocity during angioplasty has been proved clinically useful. AIMS: To analyse the value of the maximal stenotic flow velocity and the presence of stenotic flow velocity acceleration (aSV) for the long-term outcome after balloon angioplasty. METHODS AND RESULTS: Patients undergoing single lesion angioplasty within the DEBATE trial were included. aSV was defined as acceleration in the stenotic coronary flow velocity >50% baseline velocity assessed at a reference site of the target vessel. After balloon angioplasty diameter stenosis, minimal lumen diameter (MLD) and coronary flow velocity reserve were similar between the aSV (n=54) and non-aSV group (n=125). At follow-up, the aSV group had a higher restenosis rate (52% vs 30%, P=0.006) The presence of aSV was the strongest independent predictor of restenosis (OR 3.08, 95% CI 1.35 to 7.05, P=0.008). The best predictive cut-off value of SV was 101cm.s(-1) (sensitivity of 46%, specificity of 81%, positive predictive value of 85% and a negative predictive value of 58%). CONCLUSION: Following angioplasty, SV appears to be exquisitely sensitive to the changes experienced at the treated area without depending on the status of the microcirculation.
|Keywords||Angioplasty, Balloon/*methods, Blood Flow Velocity/physiology, Coronary Circulation/*physiology, Coronary Restenosis/diagnosis/physiopathology, Coronary Stenosis/physiopathology/*therapy, Female, Humans, Male, Middle aged, Predictive Value of Tests, Research Support, Non-U.S. Gov't, Treatment Outcome, Ultrasonography, Doppler|
|Persistent URL||dx.doi.org/10.1053/euhj.2002.3265, hdl.handle.net/1765/10021|
van Langenhove, G.J.J., Carlier, S.G., Piek, J.J., de Bruyne, B., di Mario, C., Kozuma, K., … Albertal, M.. (2002). Value of coronary stenotic flow velocity acceleration in prediction of angiographic restenosis following balloon angioplasty. European Heart Journal, 23(23), 1849–1853. doi:10.1053/euhj.2002.3265