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.

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Keywords angioplasty, cardiology, coronary stent
Sponsor Doppler Endpoints Balloon Angioplasty Trial Europe (DEBATE) Study Group.
Persistent URL,
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