title: Flow velocity and predictors of a suboptimal coronary flow velocity reserve after coronary balloon angioplasty.
abstract: OBJECTIVE
  This study was conducted to analyse flow velocity parameters and predictors of a suboptimal coronary flow reserve (<2.5) following balloon angioplasty.
  
  
  METHODS
  Two hundred and twenty-five patients underwent sequential intracoronary Doppler as part of the DEBATE I study. Of these, 183, with complete angiography and Doppler at the 6-month follow-up, were included. Univariate and multivariate logistic analysis was performed to identify independent predictors of post-procedural suboptimal coronary flow reserve, defined as coronary flow reserve <2.5.
  
  
  RESULTS
  Forty-eight per cent (n=88) of the patients achieved a suboptimal coronary flow reserve. These patients had higher baseline velocities (cm.s(-1)) before balloon angioplasty (18+/-9 vs 14+/-6, P=0.004), after balloon angioplasty (22+/-11 vs 14+/-5, P<0.001) and at follow-up (19+/-9 vs 16+/-6, P=0.011) than the optimal coronary flow reserve group. Although the suboptimal group had lower hyperaemic velocities (cm.s(-1)) after balloon angioplasty than the optimal group (42+/-17 vs 49+/-16, P=0.008), these velocities became similar at follow-up. Increasing age (odds ratio, OR 1.071, P=0.0002), female gender (OR 2.52, P=0.014) and increasing pre-procedural baseline average peak velocities (OR 1.056, P<0.001) were found to be independent predictors of a suboptimal coronary flow reserve following balloon angioplasty.
  
  
  CONCLUSIONS
  A suboptimal coronary flow reserve was associated with (1) a chronically elevated baseline average peak velocity (2) a transient deficit in the hyperaemic average peak velocity (3) the elderly, and female gender.
authors.affiliation: Thoraxcentre, Erasmus Medical Centre Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Albertal
authors.forename: E
authors.initials: E
authors.lastname: Regar
authors.forename: G
authors.initials: G
authors.lastname: Van Langenhove
authors.forename: S G
authors.initials: SG
authors.lastname: Carlier
authors.forename: P
authors.initials: P
authors.lastname: Serrano
authors.forename: E
authors.initials: E
authors.lastname: Boersma
authors.forename: B
authors.initials: B
authors.lastname: Bruyne
authors.forename: C
authors.initials: C
authors.lastname: Di Mario
authors.forename: J
authors.initials: J
authors.lastname: Piek
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000800:Angioplasty, Balloon; D001783:Blood Flow Velocity; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018608:Ultrasonography, Doppler