CORONARY FLOW RESERVE IN THE CONTRALATERAL ARTERY INCREASES AFTER SUCCESSFUL CORONARY ANGIOPLASTY IN PATIENTS WITH SPONTANEOUSLY VISIBLE COLLATERAL VESSELS

Objective-To test the hypothesis that coronary flow reserve could incr ease in the angiographically normal contralateral artery after success ful coronary angioplasty of an ipsilateral coronary artery. Design-Cor onary flow reserve was estimated using a Doppler flow guide wire, by g iving intracoronary adenosine in the contralateral artery, before and 15 minutes after the end of angioplasty. Setting-Tertiary referral cen tre. Patients-31 patients, mean (SD) age 56 (11) years, with stable an gina and single vessel disease, undergoing angioplasty of the right co ronary or the left anterior descending artery. Results-In the contrala teral artery baseline average peak velocity was 21 (9) cm/s before ang ioplasty and decreased to 12 (6) cm/s after (p < 0.005), while hyperae mic 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 con tralateral artery was 2.4 (0.7) before angioplasty and increased to 2. 9 (0.6) after (p < 0.05). The contralateral coronary flow reserve afte r angioplasty increased by 0.8 (0.4) in 11 patients with visible colla terals before angioplasty and by 0.3 (0.6) in the remaining patients w ithout visible collaterals (p < 0.05). Blood pressure and heart rate w ere unchanged after the procedure. Conclusions-Coronary flow reserve i n an angiographically normal contralateral artery increases after succ essful coronary angioplasty of the ipsilateral artery in patients with spontaneously visible collateral vessels before the procedure.