Periprocedural Doppler coronary blood flow predictors of myocardial perfusion abnormalities and cardiac events after successful coronary interventions

D. Douglas Miller, Jose Esparza-Negrete, Thomas J. Donohue, Carol Mechem, Leslee J. Shaw, Sheila Byers, Morton J. Kern

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Thirty-four consecutive patients had coronary flow velocity assessed under basal and hyperemic conditions in the proximal and distal coronary artery, followed by rest-stress technetium 99m sestamibi myocardial tomography within 3 months of successful coronary angioplasty. In spite of significant angiographic improvement, 29% of patients had a persistent reversible myocardial perfusion defect associated with a residual abnormality of the proximal-to-distal coronary average peak velocity ratio (p/d APV = 2.2 ± 1.5 vs 1.1 ± 0.6; p = 0.02). Patients with an abnormal p/d APV ratio (>1.7) had more numerous angioplasty-zone perfusion defects (4.2 ± 3.3 vs 0.8 ± 2.0; p = 0.005). Multivariable analysis of clinical, angiographic, coronary flow, and scintigraphic data demonstrated that the relative risk of cardiac events (n = 11) was greatest in patients with a reversible angioplasty-zone perfusion defect (relative risk, 5.5), poststenotic coronary flow reserve <2.0 (relative risk, 8.3) and p/d APV ratio >1.7 (relative risk, 6.2). Residual basal coronary flow-velocity abnormalities are significant physiologic correlates of stress-induced myocardial perfusion defects and are a prognostic covariable associated with future ischemic cardiac events.

Original languageEnglish (US)
Pages (from-to)1058-1066
Number of pages9
JournalAmerican Heart Journal
Volume131
Issue number6
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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