USEFULNESS OF DOBUTAMINE ECHOCARDIOGRAPHY FOR DETECTION OF RESTENOSIS AFTER TRANSLUMINAL CORONARY ANGIOPLASTY
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To determine the usefulness of dobutamirte stress echocardiography (DSE) as a non invasive way for detecting restenosis after percutaneous transluminal coronary angioplasty (PTCA), the results of coronary angiography and DSE were compared 6 months after PICA in 40 patients (28 males & 12 females, mean age49.7 +10.2 years). DSE were obtained on the same day or within 24 hours prior to or after the coronary angiograms. Angiographic restenosis occurred in 22 patients (55%) by visual estimates of stenosis. Restenosis increased significantly in left anterior descending artery (LAD) (73.7%) and in proximal segment (82.4%) lesions. There was positive correlation between the difference of total wall motion score index ( dtWMSI ) and the difference of regional wall motion score index (dr WMS/) and the severity (percentage) of restenosis. Concordance between DSE and coronary angiography in detecting restenosis was (75%). The mean (percentage) of restenosis was (92.3 + 5.996) in concordant vs (78.6+8.5%) in disconcordant cases. Sensitivity, specificity and accuracy were (68.2. 83.3 & 75%) respectively There was significant increase in sensitivity, specificity and diagnostic accuracy of DSE for LAD lesions (85.7, 100 & 89.5%) respectively while there was significant decrease in sensitivity of left circumfier (LCX and right coronary artery (RCA) lesions (25 & 50%) respectively. Also, there was significant increase in sensitivity and accuracy in proximal segment lesions (92.9 & 88.2%) respectively while, significant increase in specificity had been shown in mid - segment lesions (90.9%) (P <0.01).