Usefulness of early dobutamine stress echocardiography for the assessment of risk of restenosis after percutaneous coronary interventions.
BACKGROUND
The increasing role of percutaneous coronary interventions (PCI) in the treatment of coronary artery disease and relatively high restenosis rate following PCI require the introduction of available, easy to perform and cost-effective tests that would enable detection of restenosis after PTCA and identification of patients at particularly high risk of restenosis.


OBJECTIVE
To estimate the predictive value of early dobutamine stress echocardiography (DSE) for the assessment of risk of coronary restenosis.


METHODS
Thirty-nine patients with a single coronary vessel disease after PCI were enrolled in this study. DSE was performed twice--2 to 3 days after the procedure and repeated after 8 to 12 months. All patients underwent coronary angiography after one-year follow-up.


RESULTS
Data analysis of direct pre- and postprocedural echocardiography showed that the wall motion score index decreased significantly (p <0.0001), whereas ejection fraction increased significantly after the intervention when compared with baseline (p <0.0001). Restenosis was detected in 8 out of 10 subjects with positive DSE test and in 3 out of 29 subjects with negative DSE test. In a group of 11 patients with restenosis confirmed in the coronary angiography, one-year follow-up DSE was found positive in 9 patients (80% test sensitivity) but in two cases results were false negative. Negative test was observed in 27 out of 28 individuals without restenosis (90% test specificity).


CONCLUSIONS
DSE is highly sensitive and specific in prediction and detection of restenosis after PCI. DSE performed early after PCI is safe.
Kossuth
Irmina
I
Department of Cardiology, Pomeranian Medical University, Szczecin, Poland. kossuth@tlen.pl
Kornacewicz-Jach
Zdzisława
Z
Płońska
Edyta
E
Wojtarowicz
Andrzej
A
Goracy
Jarosław
J
Przybycień
Krzysztof
K
Lewandowski
Maciej
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000628:therapy*; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D012307:Risk Factors