ASSESSMENT OF DIPYRIDAMOLE-ATROPINE-ECHOC ARDIOGRAPHY FOR THE DETECTION OF RESTENOSIS IN PATIENTS AFTER CORONARY ANGIOPLASTY

tress-echocardiography has been proven to be a valuable method in the diagnosis of patients with suspected coronary artery disease. It has b een demonstrated that the addition of atropine can increase the sensit ivity of pharmacological stress-echocardiography-tests. The aim of our study was to evaluate the diagnostic potential of dipyridamole-atropi ne-echocardiography for the detection of restenosis after coronary ang ioplasty. We investigated 50 patients 3-6 months after primary success ful coronary angioplasty. Restenosis was defined as recurrence of sten osis of greater than or equal to 70% at the site of dilatation determi ned by quantitative coronary angiography. All patients were investigat ed on antianginal medication and underwent control-coronary angiograph y within 1-3 days after the echocardiographic study. In 17/23 patients with restenosis, the dipyridamole-atropine-stress-test was pathologic (sensitivity 74%), in 25/27 patients without significant restenosis t he echocardiography stress-test was normal (specificity 93%). In 6 pat ients with restenosis and an unsuspicious stress-test, the percent dia meter of restenosis did not exceed greater than or equal to 90% lumen narrowing, restenosis of the LAD was correctly identified in all patie nts (n = 11). The diagnostic accuracy of the dipyridamole-atropine-str ess-test for the detection of patients with restenosis after PTCA in o ur study was 84%: the positive predictive value of a pathologic echoca rdiography stress-test for the detection of significant restenosis was 89%, the negative predictive value was 81%. Conclusions: Dipyridamole -atropine-echocardiography has diagnostic potential for non-invasive a ssessment of patients after coronary angioplasty. In patients with a n ormal echocardiographic stress-test, the probability of significant re stenosis is considerably low, even if restenosis cannot be definitely excluded.