Myocardial Perfusion and Left Ventricular Function Early after Successful PTCA in 1-Vessel Coronary Artery Disease

Summary

Myocardial perfusion (²⁰¹TI-ECT) and contractile function (^99mTc-Ventriculography) were studied during exercise and rest 3 to 6 days after PTCA in 20 patients (11 with stable and 9 with unstable angina pectoris). All patients had single vessel disease and no previous myocardial infarction. During exercise after PTCA the ejection fraction increased for 3 to 5% and no regional wall motion abnormalities, ST-segment depression or perfusion defects occurred (with exception in one patient with very early restenosis). Therefore, perfusion and wall motion were completely normalized at rest and during exercise within days after technically successful PTCA even in patients with previously unstable angina pectoris. Pathological stress test results after this time should thus be attributed to other causes e.g. early restenosis, multivessel disease, false positive tests) and are not due to the specific situation early after PTCA.

Zusammenfassung

Myokardperfusion (²⁰¹TI-ECT) und kontraktile Funktion (^99mTc-Ventrikulogra-phie) wurden 3-6 Tage nach PTCA bei 20 Patienten (11 mit stabiler und 9 mit instabiler Angina pectoris) in Ruhe und unter Belastung untersucht. Alle Patienten hatten eine 1-Gefäßerkrankung und keinen Myokardinfarkt in der Vorgeschichte. Unter Belastung nach PTCA stieg die Ejektionsfraktion um 3-5% an, regionale Wandbewegungsstörungen, deutliche ST-Segment-Absenkungen im EKG oder Perfusionsdefekte wurden nicht mehr beobachtet (mit Ausnahme eines Patienten mit sehr früher Restenose). Die Ergebnisse zeigen, daß Myokardperfusion und linksventrikuläre Funktion sogar bei den Patienten mit vormals instabiler Angina pectoris innerhalb weniger Tage nach technisch erfolgreicher PTCA vollständig sowohl in Ruhe als auch während Belastung normalisiert sind. Pathologische Belastungstest-Ergebnisse nach diesem Zeitpunkt sollten daher eher anderen Gründen zugeordnet werden (z.B. frühe Restenose, Mehrgefäßerkrankung, falsch-positive Tests) und sind nicht Ausdruck der spezifischen Situation nach PTCA.

Key words

PTCA - ²⁰¹TI scintigraphy - unstable angina pectoris

Schlüsselwörter

PTCA - TI-201 Szintigraphie - instabile Angina pectoris

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