Kao H L, Wu C C, Ho Y L, Chen W J, Lee C M, Chen M F, Liau C S, Lee Y T
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Am J Cardiol. 1995 Oct 1;76(10):652-6. doi: 10.1016/s0002-9149(99)80191-x.
In 24 patients with chronic coronary artery disease, dobutamine stress echocardiography (DSE) was performed within 2 days before and after successful elective percutaneous transluminal coronary angioplasty (PTCA) in a blinded fashion. Patients with ischemic response on DSE before PTCA had significant improvement in the global peak-dose DSE score index after PTCA (1.62 +/- 0.35 to 1.40 +/- 0.29, p < 0.001), whereas patients without ischemic response had no improvement. The positive and negative predictive values of pre-PTCA DSE on early myocardial ischemia relief after angioplasty were 93% and 80%, respectively. In patients showing contractility recruitment during low-dose dobutamine infusion in the DSE before PTCA, there was significant improvement in the global resting wall motion score index in the DSE after PTCA (1.48 +/- 0.43 to 1.34 +/- 0.33, p = 0.004), while patients without contractility recruitment showed no improvement. Again, the positive and negative predictive values of pre-PTCA DSE on early hibernation recovery following angioplasty were 80% and 89%, respectively. In conclusion, DSE in patients with chronic, stable coronary artery disease accurately predicts wall motion improvement after successful angioplasty, and the expected improvement is safely demonstrated early after the procedure.
对24例慢性冠状动脉疾病患者，在成功进行选择性经皮腔内冠状动脉成形术（PTCA）前后2天内，以盲法进行多巴酚丁胺负荷超声心动图（DSE）检查。PTCA术前DSE有缺血反应的患者，PTCA术后整体峰值剂量DSE评分指数有显著改善（从1.62±0.35降至1.40±0.29，p<0.001），而无缺血反应的患者则无改善。PTCA术前DSE对血管成形术后早期心肌缺血缓解的阳性和阴性预测值分别为93%和80%。在PTCA术前DSE中低剂量多巴酚丁胺输注期间出现收缩力增强的患者，PTCA术后DSE中整体静息壁运动评分指数有显著改善（从1.48±0.43降至1.34±0.33，p=0.004），而无收缩力增强的患者则无改善。同样，PTCA术前DSE对血管成形术后早期冬眠心肌恢复的阳性和阴性预测值分别为80%和89%。总之，慢性稳定型冠状动脉疾病患者的DSE能准确预测成功血管成形术后壁运动的改善情况，且术后早期就能安全地证实预期的改善情况。
