Exercise myocardial perfusion and wall motion imaging to predict recurrence of angina pectoris after successful angioplasty.
OBJECTIVE
This study investigates the predictive value of concurrent exercise radionuclide ventriculography and myocardial perfusion scintigraphy obtained six weeks after successful percutaneous transluminal coronary angioplasty for the recurrence of angina.


METHODS
Both studies were obtained simultaneously with a single injection of technetium-99m sestamibi using the first-pass technique and the computerized tomographic technique, respectively. Ninety-five patients were investigated at rest and at maximal exercise 6 weeks after technically successful coronary angioplasty.


RESULTS
Exercise-induced left ventricular dysfunction was present in 44 patients (46%). Exercise-induced myocardial perfusion defects were noted in 29 patients (30%). All patients underwent a six months follow-up. Seventeen patients (18%) had recurrent angina pectoris. Exercise-induced left ventricular dysfunction at six weeks after angioplasty was significantly associated with the recurrence of angina (p = 0.002), but exercise-induced perfusion defects were not. An abnormal left ventricular response to exercise was more sensitive than exercise-induced perfusion defects (82% versus 47%) to identify those patients with recurrent angina. The combination of both tests allows to select patients at a very high (40%) and very low (7%) risk of recurrent angina.


CONCLUSIONS
Exercise-induced left ventricular dysfunction is more strongly associated with the recurrence of angina pectoris during a 6 month follow-up than are exercise-induced myocardial perfusion defects.
Dendale
P A
PA
Department of Cardiology, University Hospital, Free University of Brussels, Belgium.
Franken
P R
PR
Van Den Heuvel
P
P
Van den Branden
F
F
Bossuyt
A
A
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015635:Radionuclide Ventriculography; D012008:Recurrence; D012306:Risk; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*