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). |
