Exercise electrocardiography versus dipyridamole echocardiography testing in coronary angioplasty. Early functional evaluation and prediction of angina recurrence.

Recently, we have shown the usefulness of high-dose dipyridamole echocardiography testing (DET) as an exercise-independent method for the evaluation of patients having coronary angioplasty. The purpose of the present study was to determine the value of DET compared with exercise testing in the early functional evaluation after successful percutaneous transluminal coronary angioplasty (PTCA) and in the prediction of late recurrence of angina. We performed DET and exercise testing in 52 consecutive patients both before and after successful PTCA. Criteria of positivity for DET were transient dyssynergy absent or negligible in the baseline examination and exercise testing for an ST segment shift greater than 0.1 mV from baseline. All patients had an angiographically successful PTCA: the percent stenosis went from 78 +/- 7% before to 30 +/- 7% after PTCA. Exercise testing was positive in 49 and 29 patients, respectively, before and after PTCA (94% versus 44%, p less than 0.001). DET was positive in 47 patients before and in 10 after PTCA (90% versus 19%, p less than 0.001). Recurrence of angina was found in 18 patients: 14 of 23 with positive and four of 29 with negative exercise testing after PTCA. With DET, recurrence of angina was found in eight of 10 patients with positive and 10 of 42 with negative DET after PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)