Prediction of restenosis after successful percutaneous coronary angioplasty by dobutamine thallium-201 scintigraphy

We evaluated the accuracy of dobutamine thallium-201 myocardial perfusion scintigraphy in predicting restenosis after successful percutaneous coronary angioplasty. Restenosis is one of the most important problems in patients who have undergone percutaneous coronary angioplasty. Exercise thallium-201 myocardial perfusion scintigraphy has been a well accepted non-invasive method to predict the restenosis of the dilated vessel after percutaneous coronary angioplasty, however, the role of thallium-201 myocardial perfusion using dobutamine, as a substitute for exercise in patients unable to exercise, in predicting restenosis is not well known. Therefore, 34 consecutive patients underwent dobutamine tomographic (single photon emission computed tomography) thallium-201 myocardial perfusion scintigraphy following a total of 37 successful angioplasties. No serious side effects during dobutamine infusion occured. The interval between percutaneous coronary angioplasty and scintigraphy ranged between 8 weeks to 2 years. All patients underwent control angiography within one month following myocardial perfusion scintigraphy. Sensitivity, specificity and accuracy of dobutamine myocardial imaging for predicting restenosis were 76%, 79% and 77%, respectively. Sensitivity and specificity related to the vascular territories were: left anterior descending artery 66-69%, left circumflex artery 75-100%, right coronary artery 83-66%, respectively. In conclusion, our findings demonstrating high accuracy of dobutamine myocardial single photon emission tomography for angiographic restenosis suggest its usefulness as a non-invasive tool in the follow-up of percutaneous coronary angioplasty patients. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.