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Updated: May 13, 2026
Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Tissue Doppler Imaging Provides Incremental Value in Predicting Six Months In-Stent Restenosis in Patients with
Jih-Kai Yeh1, Victor Chien-Chia Wu1, Fen-Chiung Lin1,2,3
1Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 33305, Taiwan.
Insights
Tissue Doppler Imaging (TDI) can detect in-stent restenosis (ISR) six months after percutaneous coronary intervention (PCI). A specific time-to-peak velocity measurement shows promise for identifying ISR in coronary artery disease patients.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Invasive coronary angiography is the standard for in-stent restenosis (ISR) assessment.
- Non-invasive Tissue Doppler Imaging (TDI) has limited study for ISR prediction.
Purpose of the Study:
- To evaluate the predictive value of pulse-wave TDI for detecting ISR.
- To assess TDI's utility in patients with coronary artery disease post-percutaneous coronary intervention (PCI).
Main Methods:
- 41 patients undergoing PCI were studied.
- Pulse-wave TDI measured left ventricular time-to-peak velocities (TpV) pre-PCI and 6 months post-PCI.
- 12 non-apical segments were analyzed.
Main Results:
- A 12-segmental mean TpV ≥ 279.6 ms at 6 months post-PCI detected ISR (OR: 2.09, p=0.049).
- Patients without ISR showed a significant decrease in TpV standard deviation (p=0.001).
- No significant change in TpV standard deviation was observed in patients with ISR (p=0.57).
Conclusions:
- Pulse-wave TDI is a promising non-invasive tool for ISR detection.
- TDI can identify ISR six months after PCI in coronary artery disease patients.
Abstract:
Background: Invasive coronary angiography is the gold standard for assessing in-stent restenosis (ISR) in patients with coronary artery disease. However, the predictive value of non-invasive Tissue Doppler Imaging (TDI) to evaluate patients with ISR has not been studied extensively. Methods: A total of 41 patients (19 with acute myocardial infarction and 22 with stable angina pectoris) who received percutaneous coronary intervention (PCI) were enrolled in the study. Time-to-peak velocities (TpV) of 12 non-apical segments of the left ventricle, by pulse wave TDI echocardiography, were obtained within two days prior to the PCI and six months later. Results: A 12-segmental mean TpV ≥ 279.6 ms at six months after PCI was able to detect ISR (odds ratio: 2.09, 95% CI 1.004-4.352, p = 0.049). Moreover, a significant decrease in the standard deviation of TpV was demonstrated in patients without ISR (85.8 ± 44.8 vs. 60.3 ± 31.7 ms, p = 0.001), but not in patients with ISR (97.7 ± 53.3 vs. 91.2 ± 52.6 ms, p = 0.57). Conclusions: Pulse-wave TDI echocardiography is a promising tool in the detection of ISR six months after PCI in patients with coronary artery disease.
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