Nuclear cardiology after angioplasty and stent placement: beyond sensitivity and specificity.

Despite excellent immediate clinical results and anatomic improvement of critical coronary artery stenosis, functional abnormalities have been noted to persist for several days or weeks after successful percutaneous transluminal coronary artery balloon angioplasty (PTCA) (1–13). Even without eventual angiographic restenosis, persistent abnormalities of wall motion (1,2), myocardial perfusion (3–8) and coronary blood flow dynamics (9–13) have been reported early after successful PTCA. The clinical and pathophysiologic significance of these persistent functional abnormalities have remained elusive since they were first described more than 15 years ago. Is there light at the end of the tunnel? We will briefly summarize the extensive nuclear cardiology data as it relates to the functional abnormalities present early after PTCA and stent placement, including the study of Kosa et al. (14) published in this issue of the Journal of the American College of Cardiology.