Exercise echocardiography follow-up in percutaneous transluminal coronary angioplasty

Exercise echocardiography has emerged as an excellent tool in the diagnosis of coronary artery disease and has proven to correlate very closely with the distribution and extent of coronary stenoses. In this report we describe our experience with the use of this noninvasive technique in evaluating patients at various stages before, shortly after, and later after percutaneous transluminal coronary angioplasty (PTCA). Coronary restenosis following PTCA occurs at rates between 25% and 40% and currently available screening tests including clinical history, routine exercise electrocardiography, and thallium scintigraphy have proven disappointing correlating with the presence or absence of restenosis. We have found that exercise echocardiography is useful not only in identifying patients who have coronary disease and in predicting the extent and distribution of this disease, but also in demonstrating even very early after angioplasty left ventricular functional improvement both at rest and with exercise. Once patients are discharged from the hospital and followed serially over 5 years, we have found that this tool is extremely valuable in predicting not only coronary restenosis at the site(s) of angioplasty but is also highly predictive of the development of new coronary stenoses. The capabilities of exercise echocardiography to predict restenosis and new disease far exceed the reliability of exercise electrocardiography or the presence or absence of symptoms as indicators of these problems. We have found exercise echocardiography to be an unexcelled screening test in the management of angioplasty patients.