[Value of dipyridamole-atropine stress echocardiography for detection of patients with restenosis after PTCA].
Stress-Echocardiography has been proven to be a valuable method in the diagnosis of patients with suspected coronary artery disease. It has been demonstrated that the addition of atropine can increase the sensitivity of pharmacological stress-echocardiography-tests. The aim of our study was to evaluate the diagnostic potential of dipyridamole-atropine-echocardiography for the detection of restenosis after coronary angioplasty. We investigated 50 patients 3-6 months after primary successful coronary angioplasty. Restenosis was defined as recurrence of stenosis of > or = 70% at the site of dilatation determined by quantitative coronary angiography. All patients were investigated on antianginal medication and underwent control-coronary angiography within 1-3 days after the echocardiographic study. In 17/23 patients with restenosis, the dipyridamole-atropine-stress-test was pathologic (sensitivity 74%), in 25/27 patients without significant restenosis the echocardiography stress-test was normal (specificity 93%). In 6 patients with restenosis and an unsuspicious stress-test, the percent diameter of restenosis did not exceed > or = 90% lumen narrowing, restenosis of the LAD was correctly identified in all patients (n = 11). The diagnostic accuracy of the dipyridamole-atropine-stress-test for the detection of patients with restenosis after PTCA in our study was 84%, the positive predictive value of a pathologic echocardiography stress-test for the detection of significant restenosis was 89%, the negative predictive value was 81%.


CONCLUSIONS
Dipyridamole-atropine-echocardiography has diagnostic potential for non-invasive assessment of patients after coronary angioplasty. In patients with a normal echocardiographic stress-test, the probability of significant restenosis is considerably low, even if restenosis cannot be definitely excluded.
Scherhag
A
A
I. Medizinische Klinik Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.
Pfleger
S
S
Schreckenberger
A
A
Simonis
B
B
Staedt
U
U
Heene
D L
DL
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D001285:Atropine; D017023:Coronary Angiography / Q000187:drug effects; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D004176:Dipyridamole; D004452:Echocardiography / Q000187:drug effects; D004562:Electrocardiography / Q000187:drug effects; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012680:Sensitivity and Specificity
D004176:Dipyridamole; D001285:Atropine
Wertigkeit der Dipyridamol-Atropin-Stressechokardiographie für die Erkennung von Patienten mit Restenosen nach PTCA.