Dobutamine stress echocardiography predicts early wall motion improvement after elective percutaneous transluminal coronary angioplasty.
In 24 patients with chronic coronary artery disease, dobutamine stress echocardiography (DSE) was performed within 2 days before and after successful elective percutaneous transluminal coronary angioplasty (PTCA) in a blinded fashion. Patients with ischemic response on DSE before PTCA had significant improvement in the global peak-dose DSE score index after PTCA (1.62 +/- 0.35 to 1.40 +/- 0.29, p < 0.001), whereas patients without ischemic response had no improvement. The positive and negative predictive values of pre-PTCA DSE on early myocardial ischemia relief after angioplasty were 93% and 80%, respectively. In patients showing contractility recruitment during low-dose dobutamine infusion in the DSE before PTCA, there was significant improvement in the global resting wall motion score index in the DSE after PTCA (1.48 +/- 0.43 to 1.34 +/- 0.33, p = 0.004), while patients without contractility recruitment showed no improvement. Again, the positive and negative predictive values of pre-PTCA DSE on early hibernation recovery following angioplasty were 80% and 89%, respectively. In conclusion, DSE in patients with chronic, stable coronary artery disease accurately predicts wall motion improvement after successful angioplasty, and the expected improvement is safely demonstrated early after the procedure.
Kao
H L
HL
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Wu
C C
CC
Ho
Y L
YL
Chen
W J
WJ
Lee
C M
CM
Chen
M F
MF
Liau
C S
CS
Lee
Y T
YT
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D004280:Dobutamine; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D011446:Prospective Studies
D004280:Dobutamine