The value of exercise tests in the follow-up of patients who underwent transluminal coronary angioplasty.

We describe the functional and anatomical follow-up of 25 patients who underwent percutaneous transluminal coronary angioplasty in our hospital. In addition, the relative value of different non-invasive methods in predicting a restenosis in the late follow-up period is described. Before angioplasty all patients had subjective and objective signs of coronary artery disease, mainly due to proximal circumscript one-vessel disease. The anatomical evolution was studied by angiographic investigation before, early and late after angioplasty. At the same time intervals we determined the functional level as based on history, exercise electrocardiography, thallium-201 scintigraphy at rest and maximal exercise and technetium ejection fraction determination at rest and maximal exercise. Our data show that angioplasty is a good method of treatment for a selected group of patients with coronary artery disease. The mean stenosis of the dilated vessel decreased significantly from 83% before to 38% late after angioplasty (P less than 0.001). Furthermore the functional status of the patients improved as reflected by the decrease in anginal complaints (P less than 0.001), the increase in negative exercise electrocardiograms (0.01 less than P less than 0.02), exercise level (0.01 less than P less than 0.02) and ejection fraction difference between rest and maximal exercise (P less than 0.001) and the decrease in thallium ischemic defects (P less than 0.001). Comparison of the different non-invasive methods shows that the evolution of the ejection fraction difference between rest and exercise is the most reliable way to discover a possible restenosis in the late follow-up period.