PTCA後早期treadmil1運動負荷試験の再狭窄予測に対する意義

Prediction of Late Restenosis Using Early Treadmill Exercise Testing after PTCA

　一枝病変患者で初回待機的PTCAに成功し，術後2〜6カ月後に再造影検査を施行し得た30例を対象として，PTCA前（pre-EX），PTCA後平均11日目（early-EX）およびPTCA後平均3.2カ月目（late-EX）にtreadmill運動負荷試験を施行し，FAI,MAI,HRI，平均ST低下（mm），異常ST変化検出率，胸痛誘発率の経時的変化をPTCA後再狭窄群と非再狭窄群とで比較検討した．非再狭窄群におけるFAI,MAI,HRIはpre-EXとearly-EX間，およびpre-EXとlate-EX間で有意な改善傾向を示したが，他の指標ならびに再狭窄群ではなんら有意な変化を示さなかった．さらに，pre-EXおよびearly-EXのFAI,MAIを用いた判別式を求めることにより，非再狭窄群と再狭窄群を判別することが可能であった．以上の結果よりPTCA後早期treadmill運動負荷試験におけるFAI,MAI,HRIの評価は，再狭窄予測に有用であると考えられた．

The purpose of this study was to evaluate the capabil-ity of treadmill exercise testing early after percutaneous transluminal coronary angioplasty (PTCA) for predic-tion of restenosis during the follow-up period. Subjects were comprised of 30 patients with single vessel disease, in whom angiographic success immediately after PTCA was obtained. Follow-up coronary angiography at a mean of 3.5 months after initial PTCA demonstrated restenosis in 15 patients. Treadmill exercise testing was conducted before PTCA (pre-EX), at a mean of 11 days after PTCA (early-EX), and at a mean of 3.2 months after PTCA (late-EX).