Quantitative contrast stress echocardiography in assessment of restenosis after percutaneous coronary intervention in stable coronary artery disease.
OBJECTIVE
Quantitative contrast stress echocardiography (CSE) can assess regional myocardial perfusion. The aim of this study was to evaluate the performance of quantitative CSE in the detection of restenosis after percutaneous coronary intervention (PCI).


RESULTS
Thirty-three patients with stable coronary artery disease, scheduled for PCI, underwent CSE and quantitative coronary angiography (QCA) before and 9 months after PCI. Regional myocardial perfusion was analysed blinded to QCA results. QCA identified 38 significant stenoses (> or =50% diameter reduction). Before PCI, perfusion during stress was significantly reduced in regions supplied by stenotic arteries; blood flow velocity (Deltabeta) -3.9 (-9.0 to 0.5) s(-1), perfusion rate (DeltaA x beta) -175.0 (-518.0 to 58.5) s(-1), and refilling time (Deltart) 210 (-22 to 452)ms, compared with the perfusion increase seen in regions supplied by non-stenotic arteries; Deltabeta 1.6 (-0.7 to 4.4) s(-1), DeltaA x beta 151.7 (-67.0 to 300.5) s(-1), and Deltart -47 (-195 to 89) ms, all P < 0.05. At follow-up, regional stress-induced perfusion improved in 29 regions with successful PCI; Deltabeta 0.1 (-2.7 to 3.6), DeltaA x beta 30.5 (-133.3 to 232.1), and Deltart -99 (-247 to 125), all P < or = 0.01, although there was no improvement in nine regions with restenosis; Deltabeta 0.9 (-1.5 to 5.3), DeltaAxbeta 65.7 (-40.8 to 412.6), and Deltart -79 (-268 to 163), P = NS.


CONCLUSIONS
Quantitative CSE has the potential to detect angiographically significant coronary artery stenoses as well as angiographic success after PCI.
Lønnebakken
Mai Tone
MT
Department of Heart Disease, Institute of Medicine, Haukeland University Hospital, University of Bergen, Bergen 5021, Norway. mai.tone.lonnebakken@helse-bergen.no
Staal
Eva M
EM
Bleie
Øyvind
Ø
Strand
Elin
E
Nygård
Ottar K
OK
Gerdts
Eva
E
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D018450:Disease Progression; D004452:Echocardiography; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged