Hecht H S, DeBord L, Shaw R, Dunlap R, Ryan C, Stertzer S H, Myler R K
San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015.
Am J Cardiol. 1993 Feb 1;71(4):293-6. doi: 10.1016/0002-9149(93)90793-c.
The role of supine bicycle stress echocardiography (SBSE) for detecting restenosis after percutaneous transluminal coronary angioplasty (PTCA) was evaluated in 80 patients: 41 (51%) with single and 39 (49%) with multivessel PTCA (total 129 dilated vessels). Total revascularization was performed in 54 (68%) and partial revascularization in 26 (32%) patients. Restenosis was angiographically demonstrated in 60 patients (75%) and in 72 vessels (56%) 6.1 +/- 2.9 months after PTCA. The results for detecting restenosis were: (1) SBSE versus exercise electrocardiographic sensitivity, 87 versus 55% (p < 0.001); (2) specificity, 95 versus 79%; and (3) accuracy, 89 versus 61% (p < 0.001). SBSE was 83% sensitive, 95% specific and 88% accurate for restenosis detection in specific vessels with comparable results for single versus multivessel PTCA and total versus partial revascularization. Sensitivity, specificity and accuracy were: 91, 93 and 91% for the left anterior descending coronary artery; 77, 94 and 85% for the right coronary artery; and 76, 96 and 88% for the left circumflex coronary artery. Ninety-four percent of the nondilated diseased vessels were correctly identified. It is concluded that SBSE is an excellent tool for identifying restenosis after PTCA.
对80例患者评估了仰卧位踏车负荷超声心动图（SBSE）在检测经皮腔内冠状动脉成形术（PTCA）后再狭窄中的作用：41例（51%）为单支血管PTCA，39例（49%）为多支血管PTCA（共扩张129支血管）。54例（68%）患者进行了完全血运重建，26例（32%）患者进行了部分血运重建。在PTCA术后6.1±2.9个月，60例患者（75%）和72支血管（56%）经血管造影证实存在再狭窄。检测再狭窄的结果如下：（1）SBSE与运动心电图的敏感性分别为87%和55%（p<0.001）；（2）特异性分别为95%和79%；（3）准确性分别为89%和61%（p<0.001）。SBSE对特定血管再狭窄检测的敏感性为83%，特异性为95%，准确性为88%，单支血管与多支血管PTCA以及完全与部分血运重建的结果相当。左前降支冠状动脉的敏感性、特异性和准确性分别为91%、93%和91%；右冠状动脉分别为77%、94%和85%；左旋支冠状动脉分别为76%、96%和88%。94%的未扩张病变血管被正确识别。结论是，SBSE是识别PTCA术后再狭窄的极佳工具。
