Heart 1998;80:493-498 ( November )
Coronary flow reserve in the contralateral artery increases after successful coronary angioplasty in patients with spontaneously visible collateral vessels
Second Department of Cardiology,
Onassis Cardiac Surgery Centre, Athens, Greece
Correspondence to: Dr Z S Kyriakides, Onassis Cardiac Surgery Centre, 356 Sygrou Ave, 17674 Athens, Greece. email: elbee{at}ath.forthnet.gr
Accepted for publication 24 June 1998
Objective
To test the hypothesis that coronary
flow reserve could increase in the angiographically normal
contralateral artery after successful coronary angioplasty of an
ipsilateral coronary artery.
DesignCoronary flow reserve was estimated
using a Doppler flow guide wire, by giving intracoronary adenosine in
the contralateral artery, before and 15 minutes after the end of angioplasty.
SettingTertiary referral centre.
Patients31 patients, mean (SD) age 56 (11) years,
with stable angina and single vessel disease, undergoing angioplasty of
the right coronary or the left anterior descending artery.
ResultsIn the contralateral artery baseline
average peak velocity was 21 (9) cm/s before angioplasty and decreased
to 12 (6) cm/s after (p < 0.005), while hyperaemic average peak
velocity was 47 (19) cm/s before and decreased to 34 (15) cm/s after
(p < 0.005). However, coronary flow reserve in the contralateral
artery was 2.4 (0.7) before angioplasty and increased to 2.9 (0.6)
after (p < 0.05). The contralateral coronary flow reserve after
angioplasty increased by 0.8 (0.4) in 11 patients with visible
collaterals before angioplasty and by 0.3 (0.6) in the remaining
patients without visible collaterals (p < 0.05). Blood pressure and
heart rate were unchanged after the procedure.
ConclusionsCoronary flow reserve in an
angiographically normal contralateral artery increases after successful
coronary angioplasty of the ipsilateral artery in patients with
spontaneously visible collateral vessels before the procedure.
© 1998 by Heart
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