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- Title
The immediate and long-term effect of optimal balloon angioplasty on the absolute coronary blood flow velocity reserve. A subanalysis of the DEBATE study.
- Authors
Piek, J.J; Boersma, E; Voskuil, M; di Mario, C; Schroeder, E; Vrints, C; Probst, P; de Bruyne, B; Hanet, C; Fleck, E; Haude, M; Verna, E; Voudris, V; Geschwind, H; Emanuelsson, H; Mühlberger, V; Peels, H.O; Serruys, on behalf of the DEBATE study group, P.W
- Abstract
Background There are limited data regarding the immediate and long-term effect of balloon angioplasty on the coronary flow reserve evaluated in a multicentre setting.Methods and Results A total of 86 patients with one-vessel disease and normal left ventricular function were analysed before and after optimal balloon angioplasty (diameter stenosis <35%) and at 6-month follow-up. Coronary flow reserve was assessed with a Doppler guide wire. A low coronary flow reserve (≤2·5) after PTCA, due to an increased baseline blood flow velocity, was encountered in 42 of the 86 patients (49%). Recurrence of angina and target lesion revascularization were more frequent in these patients than in patients with a coronary flow reserve >2·5 (46% vs 23% and 36% vs 16%, respectively;P<0·05) due to a trend towards restenosis (29% vs 16%;P=0·15) or a low coronary flow reserve at follow-up due to persistent elevated baseline blood flow velocity. Patients without restenosis showed a decrease or increase of coronary flow reserve during follow-up, determined by alterations of hyperaemic blood flow velocity.Conclusions Patients with an impaired coronary flow reserve directly after optimal balloon angioplasty showed a higher target lesion revascularization rate compared to patients with a coronary flow reserve >2·5. This patient group consists of patients prone to develop restenosis, while other patients are characterized by a persistently low coronary flow reserve, probably secondary to disturbed autoregulation and/or diffuse mild coronary atherosclerosis. Coronary flow reserve alterations in patients without restenosis were related to changes in hyperaemic blood flow velocity, suggesting that this phenomenon relates to epicardial remodelling.
- Publication
European Heart Journal, 2001, Vol 22, Issue 18, p1725
- ISSN
0195-668X
- Publication type
Article
- DOI
10.1053/euhj.2000.2587