Related Experiment Videos
Detection of patients with restenosis after PTCA by dipyridamole-atropine-stress-echocardiography
A W Scherhag1, S Pfleger, A B Schreckenberger
1I Medical Clinic, University of Heidelberg, Mannheim, Germany.
Insights
High-dose dipyridamole stress echocardiography plus atropine (DASE) reliably detects restenosis after percutaneous coronary intervention (PTCA). This non-invasive method aids in identifying patients who may benefit from further interventions.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Interventional Cardiology
Background:
- Stress-echocardiography (SE) is crucial for diagnosing coronary artery disease.
- Pharmacological SE offers an alternative for patients unable to exercise.
- Limited data exists on dipyridamole-SE for detecting restenosis post-PTCA.
Purpose of the Study:
- To evaluate the diagnostic value of high-dose dipyridamole-SE plus atropine (DASE) for detecting restenosis after successful PTCA.
Main Methods:
- Sixty-five patients were studied 3-6 months post-PTCA.
- Restenosis was defined as >70% lumen narrowing by quantitative coronary angiography.
- DASE was performed to assess cardiovascular stress and detect wall motion abnormalities.
Main Results:
- DASE showed 74% sensitivity and 89% specificity for detecting restenosis.
- All patients with tight restenosis (>90%) were correctly identified.
- DASE accurately predicted restenosis in the LAD, LCX, and RCA.
Conclusions:
- DASE is a reliable non-invasive method for evaluating patients post-PTCA.
- DASE helps identify patients with significant restenosis who may need further interventions.
Abstract:
Stress-echocardiography (SE) has been proven to be a valuable method for the diagnosis of coronary artery disease. For patients who cannot exercise, pharmacological stress-echocardiography represents an alternative method for the induction of cardiovascular stress. Few studies exist concerning the value of dipyridamole-SE for the detection of restenosis in patients after primary successful PTCA. It has been demonstrated that the addition of atropine can significantly increase the diagnostic potential of dipyridamole-SE, especially in patients with 1- or 2-vessel disease. The purpose of our study was to investigate the diagnostic value of high-dose dipyridamole-SE plus atropine (DASE) for the detection of restenosis after primary successful PTCA. We investigated 65 patients 3-6 months after PTCA before a control angiography was performed. Restenosis was defined as > 70% lumen narrowing, determined by quantitative coronary angiography. In 20/27 patients with restenosis, the DASE was pathological (sensitivity 74%); in 34/38 patients without restenosis the DASE was normal or showed no induced WMA (specificity 89%). Patients with tight restenosis (> 90%) were always correctly detected by DASE. Concerning the different vessels, restenosis of the LAD was correctly predicted by DASE in 11/12 patients, restenosis of the LCX in 6/9 patients and restenosis of the RCA in 8/11 patients. From the results of our study we conclude that DASE is a reliable diagnostic method for the non-invasive evaluation of patients after PTCA. DASE can identify patients with relevant restenosis after PTCA and help to select those patients who will probably benefit from further coronary interventions, for repeat angiography.