[Usefulness of stress echocardiography in the evaluation of clinical and functional success of coronary angioplasty and prognostic stratification].
The present study, selecting 39 patients undergoing elective coronary angioplasty (PTCA) with signs of myocardial ischemia during supine bicycle exercise stress test (EST) before PTCA and on medical therapy, was designed: to evaluate the efficacy of angiographically successful PTCA on functional capacity, in terms of work load, time of exercise and rate-pressure product (RPP), by comparing pre- and post-PTCA-EST performed in patients with post-PTCA disappearance (Group I, 44%) or persistence (Group II, 56%) of myocardial ischemia, and in the latter, to evaluate the effects of medical therapy, by repeating EST after its addition; to investigate the influence of PTCA on regional function, assessed by a 11 segment model and graded as usual, in the 25 patients group with pre-PTCA exercise-induced wall motion abnormalities, disappearing (Group A, 64%) or persisting (Group B, 36%) after the interventional procedure; to examine by a 12-month follow-up the eventuality of recurrent anginal symptoms, in the presence of myocardial ischemic signs in the territory supplied by the dilated vessel and/or of angiographic restenosis, in relation to the result of post-PTCA-EST. The results of our study showed a significant improvement in functional capacity after PTCA only in Group I patients, whereas in Group II patients effort tolerance significantly increased only after medical therapy, which was associated with the disappearance of myocardial ischemia. With regard to follow-up, exercise echocardiography showed a positive and negative predictive value for angina recurrence with angiographic restenosis of 78 and 92%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Dagianti
A
A
Dipartimento di Scienze Cardiovascolari e Respiratorie, Università degli Studi La Sapienza, Roma.
Agati
L
L
Rosanio
S
S
Dagianti
A
A
Penco
M
M
Tocchi
M
M
Fedele
F
F
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D004562:Electrocardiography; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging; D011379:Prognosis; D013997:Time Factors
Utilità dell'ecocardiografia da sforzo per la valutazione del successo clinico e funzionale dell'angioplastica coronarica e per la stratificazione prognostica.