Value and limitations of dobutamine stress echocardiography in the detection of restenosis and development of new disease following percutaneous transluminal coronary angioplasty and coronary artery bypass grafting

Background. Restenosis and development of new disease following PTCA and CABG are not uncommon problems. The value of DSE in this setting is ill defined. Methods. Patients referred for coronary angiography for detection of restenosis or development of new disease (>50% luminal diameter stenosis) post PTCA or CABG underwent DSE. Results. A total of 58 patients were studied post CABG (N = 46) or PTCA (N = 12). Overall, DSE was positive for ischaemia in 47 of 54 patients with significant restenosis or development of new disease (sensitivity = 87%). Of the 4 patients without restenosis or new disease, 1 had a normal study. Positive and negative predictive values were 94% and 13% respectively. Conclusion. A low negative predictive value limits the value of DSE to detect restenosis or new disease.