Transoesophageal pacing echocardiography for detection of restenosis after percutaneous transluminal coronary angioplasty

• Published in: European heart journal 1994-06, Vol.15 (6), p.823-831
• Main Authors: HOFFMANN, R., KLEINHANS, E., LAMBERTZ, H., FLACHSKAMPF, F. A., UEBIS, R., BUELL, U., HANRATH, P.
• Format: Article
• Language: English
• Subjects: Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiac Pacing, Artificial - methods; Coronary Angiography; Coronary angioplasty; Coronary Disease - diagnosis; Coronary Disease - diagnostic imaging; Coronary Disease - epidemiology; Coronary Disease - therapy; Diseases of the cardiovascular system; Echocardiography, Transesophageal; Electrocardiography; Exercise Test; Female; Follow-Up Studies; Heart - diagnostic imaging; Humans; Male; Medical sciences; MIBI-SPECT; Middle Aged; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; restenosis; Technetium Tc 99m Sestamibi; Time Factors; Tomography, Emission-Computed, Single-Photon; transoesophageal pacing echocardiography
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/oxfordjournals.eurheartj.a060591

Non-invasive documentation of restenosis after successful percutaneous transluminal coronary angioplasty (PTCA) remains a problem. Thus, transoesophageal pacing echocardiography (TPE) with simultaneous rapid atrial pacing via the same probe, a recently validated method for detection of coronary artery disease, was used in 60 patients for detection of restenosis after successful PTCA (54 patients with one and six patients with multivessel PTCA). The patients came for routine follow-up angiography 5.4 ± 3.7 months after PTCA regardless of clinical status. Restenosis (diameter stenosis ≥ 50%) was demonstrated in 22 patients. Disease progression in previously normal vessels was noted in three additional patients. Results for detection of restenosis and disease progression were compared to exercise ECG and in 40 patients to Tc-99m methoxy-isobutyl-isonitrile (MIBI)-radionuclide perfusion imaging. Diagnostic standard exercise ECG could be performed in only 38 patients, due to peripheral vascular disease, joint disease or premature exhaustion in the rest of patients. TPE was non-diagnostic in two patients due to ineffective pacing or patient discomfort. Sensitivity of TPE for detection of restenosis and disease progression after PTCA was 84% compared with 50% and 86% for exercise ECG and Tc-99m MIBI-SPECT (P