Exercise Electrocardiography and Myocardial Scintigraphy in the Serial Evaluation of the Results of Percutaneous Transluminal Coronary

SUMMARY The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scinti-graphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. Thirty-three of these 36 were asymptomatic 1 month after PTCA; the number of patients with an abnormal exercise ECG decreased from 20 to seven (p < 0.01) and with an abnormal thallium-201 scintigram from 21 to six (p < 0.001); the number of patients who had at least one of the two tests positive decreased from 26 to 10. The average treadmill time increased from 448 + 183 to 618 119 seconds (i < 0.001), and the average rate-pressure product increased from 19.81 ± 6.4 to 31.35 4.6 units x 10 (p < 0.001). Of the 10 patients with a positive test, two had a partial restenosis 50 % but < 70 % on the 6-month control angiogram; two had a residual stenosis ¢ 50 % in a vessel that was not dilated and three had an abnormal scintigram before and 1 month after PTCA that subsequently became negative at 6 months. Six months after PTCA, a control angiogram was performed in 20 asymptomatic patients; 18 had an excellent PTCA result and two had a partial restenosis ¢ 50 % but < 70%. The stress test results were normal in patients with a successful 6-month PTCA and abnormal in the two patients with a partial restenosis