title: Usefulness of supine bicycle stress echocardiography for detection of restenosis after percutaneous transluminal coronary angioplasty.
abstract: The role of supine bicycle stress echocardiography (SBSE) for detecting restenosis after percutaneous transluminal coronary angioplasty (PTCA) was evaluated in 80 patients: 41 (51%) with single and 39 (49%) with multivessel PTCA (total 129 dilated vessels). Total revascularization was performed in 54 (68%) and partial revascularization in 26 (32%) patients. Restenosis was angiographically demonstrated in 60 patients (75%) and in 72 vessels (56%) 6.1 +/- 2.9 months after PTCA. The results for detecting restenosis were: (1) SBSE versus exercise electrocardiographic sensitivity, 87 versus 55% (p < 0.001); (2) specificity, 95 versus 79%; and (3) accuracy, 89 versus 61% (p < 0.001). SBSE was 83% sensitive, 95% specific and 88% accurate for restenosis detection in specific vessels with comparable results for single versus multivessel PTCA and total versus partial revascularization. Sensitivity, specificity and accuracy were: 91, 93 and 91% for the left anterior descending coronary artery; 77, 94 and 85% for the right coronary artery; and 76, 96 and 88% for the left circumflex coronary artery. Ninety-four percent of the nondilated diseased vessels were correctly identified. It is concluded that SBSE is an excellent tool for identifying restenosis after PTCA.
authors.affiliation: San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015.
authors.forename: H S
authors.initials: HS
authors.lastname: Hecht
authors.forename: L
authors.initials: L
authors.lastname: DeBord
authors.forename: R
authors.initials: R
authors.lastname: Shaw
authors.forename: R
authors.initials: R
authors.lastname: Dunlap
authors.forename: C
authors.initials: C
authors.lastname: Ryan
authors.forename: S H
authors.initials: SH
authors.lastname: Stertzer
authors.forename: R K
authors.initials: RK
authors.lastname: Myler
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D005080:Exercise Test / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012008:Recurrence; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D016683:Supine Position / Q000502:physiology