DETECTION OF PATIENTS WITH RESTENOSIS AFTER PTCA BY DIPYRIDAMOLE-ATROPINE-STRESS-ECHOCARDIOGRAPHY

Stress-echocardiography (SE) has been proven to be a valuable method f or the diagnosis of coronary artery disease. For patients who cannot e xercise, pharmacological stress-echocardiography represents an alterna tive method for the induction of cardiovascular stress. Few studies ex ist concerning the value of dipyridamole-SE for the detection of reste nosis in patients after primary successful PTCA. It has been demonstra ted that the addition of atropine can significantly increase the diagn ostic potential of dipyridamole-SE, especially in patients with 1- or 2-vessel disease. The purpose of our study was to investigate the diag nostic value of high-dose dipyridamole-SE plus atropine (DASE) for the detection of restenosis after primary successful PTCA. We investigate d 65 patients 3-6 months after PTCA before a control angiography was p erformed. Restenosis was defined as > 70% lumen narrowing, determined by quantitative coronary angiography. In 20/27 patients with restenosi s, the DASE was pathological (sensitivity 74%); in 34/38 patients with out restenosis the DASE was normal or showed no induced WMA (specifici ty 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 t he LCX in 6/9 patients and restenosis of the RCA in 8/11 patients. Fro m the results of our study we conclude that DASE is a reliable diagnos tic method for the non-invasive evaluation of patients after PTCA. DAS E can identify patients with relevant restenosis after PTCA and help t o select those patients who will probably benefit from further coronar y interventions, for repeat angiography.