Value of exercise electrocardiography and other current instrumental studies in the evaluation of percutaneous coronary interventions and in the detection of restenosis


Cite item

Full Text

Abstract

The current instrumental studies (graded exercise echocardiography (ECG)), exercise tests in combination with myocardial imaging (echocardiography, myocardial perfusion scintigraphy) used to evaluate restenosis after percutaneous coronary interventions (PCI) in patients with coronary heart disease are considered. The sensitivity, specificity, and prognostic value of these studies versus coronarography in the diagnosis of restenosis after PCI are given. The capabilities of other diagnostic techniques (ultrasound study of brachial artery dysfunction, intravascular ultrasound study of coronary arteries, multispiral computed tomography, etc.) are analyzed. It is emphasized that periodic use of exercise ECG tests after PCI has no advantages over their performance only on the basis of the clinical findings of the impact on quality of life, functional status, and clinical signs.

About the authors

Vladimir Pavlovich Lupanov

Email: lupanova@mail.ru

V P Lupanov

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

A. L. Myasnikov Cardiology Research Institute, Russian Cardiology Research-and-Production Complex, Russian Agency for Medical Technologies

References

  1. Focused update of the ACC/AHA/SCAI 2005 Guideline update for percutaneous coronary intervention. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2008; 51: 172-209.
  2. Лупанов В. П. Методы объективной оценки ангиопластики коронарных артерий. Тер. арх. 1998; 70 (4): 74-80.
  3. Аронов Д. М., Лупанов В. П. Нагрузочные пробы после транслюминальной баллонной коронарной ангиопластики. В кн.: Функциональные пробы в кардиологии. 3-е изд. М.: МЕДпресс-информ; 2007. 134-138.
  4. Самко А. Н. Рентгеноэндоваскулярные методы лечения больных хронической ишемической болезнью сердца. В кн.: Чазов Е. И. (ред.). Руководство по атеросклерозу и ишемической болезни сердца. М.: Медиа Медика; 2007. 504-519.
  5. Савченко А. П., Руденко Б. А. Клиническая эффективность эндоваскулярных технологий при лечении ишемической болезни сердца. Кардиол. вестн. 2008; III (XV) [1]: 5-11.
  6. King S. B., Aversano T., Ballard W. L. et al. ACCF/AHA/ SCAI 2007 update of the clinical competence statement on cardiac interventional procedures. Circulation 2007; 116: 98- 124.
  7. Mauri L., Normand S.-L. T. Studies of drug-eluting stents. To each his own? Circulation 2008; 117: 2047-2050.
  8. Диагностика и лечение стабильной стенокардии. Российские рекомендации (второй пересмотр). Разработаны Комитетом экспертов ВНОК. Кардиоваск. тер. и профилакт. 2008; 6, прил. 4: 1-40.
  9. Desmet W., De Scheerder I., Piessens J. Limited value of exercise testing in the detection of silent restenosis after successful coronary angioplasty. Am. Heart J. 1995; 129: 452-459.
  10. Galassi A. R., Tamburino C. Follow-up of patients undergoing percutaneous coronary intervention. Ital. Heart J. 2005; 6 (6): 530-539.
  11. Andersen K., Steinborsdottir S. D., Haraldsdottir S., Gudnasou T. Clinical evaluation and stress test have limited value on the diagnosis of in-stent restenosis. Scand. Cardiovasc. J. 2009; 5: 1-6.
  12. Guidelines on the management of stable angina pectoris - executive summary. The task force on the management of stable angina pectoris of the European Society of Cardiology (Fox K. et al.). Eur. Heart J. 2006; 27: 1341-1381.
  13. Pfisterer M., Rickenbacher P., Kiowski W. et al. Silent ischemia after percutaneous transluminal coronary angioplasty: incidence and prognostic significance. J. Am. Coll. Cardiol. 1993; 22: 1446-1454.
  14. Gibbons R. J., Balady G. J., Bricker J. T. et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology / American Heart Association Task on Practice Guidelines. Circulation 2002; 106: 1883-1892.
  15. Smith S. C., Allen J., Blair S. N. et al. AHA/ACC Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 2006; 113: 2363-2372.
  16. Wenaweser P., Surmely J. F., Windecker S. et al. Prognostic value of early exercise testing after coronary stent implantation. Am. J. Cardiol. 2008; 101: 807-811.
  17. Вурал А., Першуков И. В., Батыралиев Т. А. и др. Прогностическая роль нагрузочных проб в развитии рестеноза у больных после имплантации коронарного стента. Кардиология 2005; 8: 14-16.
  18. Valeur N., Clemmersen P., Grande P. et al. Pre-discharge exercise test for evaluation of patients with complete or incomplete revascularization following primary percutaneous coronary intervention: a DANAMI-2 sub-study. Cardiology 2008; 109: 163-171.
  19. Boden W. E., O'Rourke R. A., Teo K. K. et al. Optimal medical therapy with or without PCI for stable coronary disease. N. Engl. J. Med. 2007; 356: 1503-1516.
  20. Аронов Д. М., Лупанов В. П. Исследование COURAGE: обескураживают или воодушевляют его результаты? (Обзор). Кардиоваск. тер. и профилакт. 2007; 7: 95-104.
  21. Мариолли М. "А король-то голый!". Читая между строк отчет об исследовании COURAGE. Сердце и метаболизм 2008; 22: 11-13.
  22. Eisenberg M. J., Schechter D., Lefkovits J. et al. Use of routine functional testing after percutaneous transluminal coronary angioplasty: results from the ROSETTA Registry. Am. Heart J. 2001; 141: 837-846.
  23. Gidengil C., Garzon P., Eisenberg M. J. Functional testing after percutaneous transluminal coronary angioplasty in Canada and the United States: a survey of practice patterns. Can. J. Cardiol. 2000; 16: 739-746.
  24. Eisenberg M. J., Blankenship J. C., Huynt T. et al. Evaluation of routine functional testing after percutaneous intervention. Am. J. Cardiol. 2004; 93: 744-747.
  25. Sedlis S. P., Eisenberg M. J. Prognostic value of early exercise testing after coronary stent implantation: a strategy of routine stress testing after percutaneous coronary intervention is not of proven benefit. Am. J. Cardiol. 2008; 101: 1681.
  26. Eisenberg M. J., Wilson B., Lauzon C. et al. Routine functional testing after percutaneous coronary intervention; results of the aggressive diagnosis of restenosis in high risk patients (ADORE II) trial. Acta Cardiol. 2007; 62 (2): 143-150.
  27. Алехин М. Н., Божьев А. М., Морозова Ю. А. и др. Возможности стресс-эхокардиографии с тредмилом в оценке безболевой ишемии миокарда у больных ишемической болезнью сердца. Кардиология 2003; 11: 13-36.
  28. Саидова М. А. Стресс-эхокардиография: принципы и методы клинического использования. Атмосфера. Кардиология 2003; 1: 34-36.
  29. Thambyrajah J., Vijayalakshmi K., Graham R. J. et al. Strain rate imaging pre- and post-percutaneous coronary intervention: a potential in role in the objective detection of ischaemia in exercise stress echocardiography. Eur. J. Echocardiogr. 2008; 9 (5): 646-654.
  30. Лупанов В. П. Функциональные нагрузочные пробы в диагностике ишемической болезни сердца. Сердце 2002; 1 (6): 294-305.
  31. Gehi A. K., Ali S., Na B. et al. Inducible ischemia and the risk of recurrent cardiovascular events in outpatients with stable coronary heart disease, The Heart and Soul study. Arch. Intern. Med. 2008; 168: 1423-1428.
  32. Spertus J. A., Winder J. A., Dewhurst T. A. et al. Development an evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J. Am. Coll. Cardiol. 1995; 25: 333-341.
  33. Chin A. S., Goldman L. E., Eisenberg M. J. Stress testing after coronary artery bypass graft surgery: a meta-analysis. Can. J. Cardiol. 2003; 19: 802-808.
  34. Eisenberg M. J., Wou K., Nguyen H. et al. Use of stress testing early after coronary bypass graft surgery. Am. J. Cardiol. 2006; 97: 810-816.
  35. Giedd K. N., Bergmann S. R. Myocardial perfusion imaging following percutaneous coronary intervention: the importance of restenosis, disease progression, and directed reintervention. J. Am. Coll. Cardiol. 2004; 43: 328-336.
  36. Georgoulias P., Tzavara C., Demakopoulos N. et al. Incremental prognostic value of 99m Tc-tetrofosmin myocardial SPECT after percutaneous coronary intervention. Ann. Nucl. Med. 2008; 22 (10): 899-909.
  37. Kitta Y., Nakamura T., Kodama Y. et al. Enothelial vasomotor dysfunction in the brachial artery is associated with late in-stent coronary restenosis. J. Am. Coll. Cardiol. 2005; 46: 648- 655.
  38. Mintz G., Weissman N. Intravascular ultrasound in the drug-eluting stent era. J. Am. Coll. Cardiol. 2006; 48: 421-429.
  39. Takano M., Yamamoto M., Xie Y. et al. Serial long-term evaluation of neointimal stent coverage and thrombus after sirolimus-eluting stent implantation by use of coronary angioscopy. Heart 2007; 93: 1533-1536.
  40. Awata M., Kotani J., Uematsu M. et al. Serial angioscopic evidence of incomplete neointimal coverage after sirolimus-eluting stent implantation. Comparison with bare-metal stents. Circulation 2007; 116: 910-916.
  41. Moses J. W., Dangas G., Mehran R., Mintz G. S. Drug-eluting stents in the real world: how intravascular ultrasound can improve clinical outcome. Am. J. Cardiol. 2008; 102 (9A): 24J- 28J.
  42. Синицын В. Е., Стукалова О. В., Куприянова О. М., Терновой С. К. Безопасность магнитно-резонансной томографии после коронарного стентирования. Кардиология 2007; 6: 94-96.
  43. Manghat N., Van Linden R., Hewson P. et al. Usefulness of 64-detector row computed tomography for evaluation of intracoronary stents in symptomatic patients with suspected in-stent restenosis. Am. J. Cardiol. 2008; 108: 1567-1573.
  44. Bluemke D. A., Achenbach S., Budoff M. et al. Noninvasive coronary artery imaging. Magnetic resonance angiography and multidetector computed tomography angiography. Circulation 2008; 118: 586-606.
  45. Pflederer T., Marwan M., Renz A. et al. Noninvasive assessment of coronary in stent restenosis by dual-source computed tomography. Am. J. Cardiol. 2009; 193: 812-817.
  46. Patti G., Parceri V., Melfi R. et al. Impaired flow-mediated dilation and risk of restenosis in patients undergoing coronary stent implantation. Circulation 2005; 111: 70-75.
  47. Kostis W. J., Schulman S. P., Hopkins J. Documenting ischemia prior to elective percutaneous coronary intervention. J. A. M. A. 2009; 301 (10): 1018-1019.
  48. Лупанов В. П. Алгоритм неинвазивной диагностики ишемической болезни сердца. Сравнительная оценка функциональных проб. Рус. мед. журн. 2004; 12: 718-720.
  49. Lin G., Dudley R. A., Lucas F. L. et al. Frequency of stress testing to document ischemia prior to elective percutaneous coronary intervention. J. A. M. A. 2008; 300 (15): 1765-1773.
  50. Горгадзе Т. Т., Данилов Н. М.,Савченко А. П., Чазова И. Е. Эндоваскулярные методы исследования и лечения в кардиологии: время юбилеев и сомнений. Систем. гипертенз. 2008; 2: 67-70.
  51. Pocock S. J., Lansky A. J., Mehran R. et al. Angiographic surrogate end points in drug-eluting stent trials. J. Am. Coll. Cardiol. 2008; 51: 23-32.
  52. Harrington R. A., Hasselblad V., Califf R. M. et al. Defining and utilizing surrogates in the evaluation of coronary stents. What do we really want and need to know? J. Am. Coll. Cardiol. 2008; 51 (1): 33-36.
  53. Самко А. Н., Бакашвили Н. Г., Лупанов В. П. и др. Покрытые эверолимусом стенты для лечения больных с различными формами ИБС. Кардиол. вестн. 2009; IV (XVI) [1]: 29-32.
  54. Лупанов В. П., Самко А. Н., Бакашвили Г. Н. Реальна ли угроза позднего тромбоза стента с лекарственным покрытием? Сравнение стентов с лекарственным покрытием. Фокус на эверолимус. Кардиоваск. тер. и профилакт. 2009; 8 (5): 80-91.
  55. Bäck M., Wennerblom B., Wittboldt S., Cider A. Effects of high frequency exercise in patients before and after elective percutaneous coronary intervention. Eur. J. Cardiovasc. Nurs. 2008; 7 (4): 307-313.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2010 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies