Value of exercise electrocardiography in the detection of restenosis after coronary angioplasty in patients with one-vessel disease
| Autor: | Jacques Lespérance, Josep Rodés, Raoul Bonan, A. Couturier, Martin Juneau, Jean-Claude Tardif, Mehrdad Malekianpour, Gilles Côté |
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| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Artery Disease Coronary Angiography Sensitivity and Specificity Restenosis Recurrence Internal medicine Angioplasty Intravascular ultrasound medicine Humans In patient cardiovascular diseases Angioplasty Balloon Coronary Ultrasonography Interventional Aged medicine.diagnostic_test business.industry Middle Aged medicine.disease Exercise electrocardiography Coronary Vessels surgical procedures operative Angiography Cardiology Exercise Test Female Radiology Cardiology and Cardiovascular Medicine business Complication Electrocardiography |
| Zdroj: | The American journal of cardiology. 84(3) |
| ISSN: | 0002-9149 |
| Popis: | Exercise treadmill testing (ETT) is considered an unreliable method for detection of restenosis after percutaneous transluminal coronary angioplasty (PTCA). The studies on which this belief is based have used quantitative coronary angiography (QCA) as a reference. The inherent limitations of angiography have been demonstrated by intravascular ultrasound (IVUS). To determine the value of ETT for detecting restenosis when IVUS criteria are used to define restenosis, we studied 29 patients with angiographically documented 1-vessel coronary disease (35% stenosis in all nondilated segments) who underwent angioplasty. ETT was performedor =2 weeks before follow-up angiography and IVUS imaging. Only patients without any abnormalities precluding an accurate reading of the ST segment during ETT were included. Restenosis was defined as aor =50% diameter stenosis by QCA criteria and as a cross-sectional area narrowing ofor =75% by IVUS. The ETT was positive in 12 patients and restenosis was documented by QCA and IVUS in 38% and 48% of cases, respectively. Sensitivity, specificity, and positive and negative predictive values of ETT when QCA was used as a reference were 55%, 67%, 50%, and 71%, respectively. This corresponded to an accuracy of 62% when compared with QCA. Sensitivity, specificity, and positive and negative predictive values were 79%, 93%, 92%, and 82% when ETT was compared with IVUS, with an accuracy of 86% (p = 0.002). Thus, ETT is a reliable noninvasive method for detecting the presence of restenosis after PTCA in patients with 1-vessel coronary artery disease. The presence ofor =75% cross-sectional narrowing shown by IVUS is well correlated withor =1-mm ST-segment depression at follow-up ETT after PTCA. |
| Databáze: | OpenAIRE |
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