DETECTION OF RESTENOSIS WITH DOBUTAMINE STRESS TEST AFTER CORONARY ANGIOPLASTY

Dobutamine ECG tests were serially performed before, at 15 days, and at 2 and 6 months after successful coronary angioplasty in 58 patients. The dose of dobutamine was progressively increased from 5 mug/kg/min to a maximum of 40 mug/kg/min every 5 minutes, with ECG and blood pressure control. Coronary angiography was performed at the end of the study. At 15 days after coronary angioplasty, the dobutamine test was of little value for the diagnosis or prediction of restenosis. At the end of the study, both the presence of angina and the results of the dobutamine test were related to coronary angiography, and their accuracy was calculated for the detection of mild (greater-than-or-equal-to 50%) and severe (greater-than-or-equal-to 70%) restenosis or new coronary lesions. The accuracy of angina was 68% for the detection of mild lesions and 70% for that of severe lesions, whereas the accuracy of the dobutamine test was 78% for mild lesions and 80% for severe lesions. It is concluded that the dobutamine stress test is a simple and useful method for the detection of restenosis when it is performed at 2 and 6 months after coronary angioplasty. However, it cannot distinguish between restenosis or new coronary lesions.