Value of coronary stenotic flow velocity acceleration on the prediction of long-term improvement in functional status after angioplasty.
Background The coronary flow velocity acceleration at the stenotic site (SVA), defined as a ≥50% increase in resting stenotic velocity when compared with the reference segment, has been shown to be highly sensitive and specific for the diagnosis of a hemodynamically significant stenosis. In this study, we describe the value of postprocedural SVA for the prediction of a lack of improvement in functional activity at long-term follow-up balloon angioplasty (BA). Methods We investigated the improvement in functional activity in patients undergoing single native vessel angioplasty and intracoronary Doppler (before BA, after BA, and again at 6-month follow-up) as part of the Doppler Endpoints Balloon Angioplasty Trial Europe (DEBATE) I trial. Lack of improvement was defined as no change in Duke Activity Status Index (DASI) at 6-month follow-up, whereas SVA was defined as ≥50% elevation in resting velocity at the treated area compared with the distal measurement. Results SVA was found more frequently in patients without improvement in DASI (45% vs 31%, P = .03). Similar percent diameter stenosis and coronary flow velocity reserve were observed in patients with and those without improvement in DASI at follow-up. By multivariate regression analysis, the presence of SVA (P = .029; odds ratio, 1.97; 95% confidence interval, 1.07 to 3.63) and an elevated DASI at baseline (P < .001; odds ratio, 1.05; 95% confidence interval, 1.03 to 1.07) were associated with a lack of improvement at follow-up. Conclusions The detection of SVA was associated with failure of improvement in functional activity at follow-up after coronary intervention.
|Keywords||angioplasty, cardiology, coronary stent|
|Sponsor||Doppler Endpoints Balloon Angioplasty Trial Europe (DEBATE) Study Group.|
|Persistent URL||dx.doi.org/10.1067/mhj.2001.115590, hdl.handle.net/1765/4831|
|Journal||American Heart Journal|
Albertal, M, Regar, E.S, Piek, J.J, van Langenhove, G.J.J, Carlier, S.G, Thury, A, … Serruys, P.W.J.C. (2001). Value of coronary stenotic flow velocity acceleration on the prediction of long-term improvement in functional status after angioplasty. American Heart Journal, 142(1), 81–86. doi:10.1067/mhj.2001.115590