Evaluation of diastolic functions by transthoracic echocardiography after stenting in patients with carotid artery stenosis

摘要

Background: Although carotid stenting is an effective treatment for severe carotid stenosis, it has been associated with alterations in autonomic functions (which may influence diastolic parameters) during or shortly after the procedure. Aim: To determine whether there is any relation between the alteration in autonomic functions and diastolic functions by transthoracic echocardiography (TTE). Material and methods: Patients (15 male, 7 female) who were suitable for carotid artery stenting, without a history of hypertension, diabetes mellitus, or severe coronary artery or valvular heart disease, were enrolled in our study. Transthoracic echocardiography recordings were obtained before, and the day after the procedure. E wave velocity, A wave velocity, E/A ratio, mitral E wave deceleration time (DT), isovolumic relaxation time (IVRT), and by using tissue Doppler echocardiography Ea, Aa, Ea/Aa and E/Ea ratios were measured. Results were statistically analysed using Friedman and Wilcoxon tests. Results : While E wave velocity, and E/A ratio increased non-significantly (78 ±20, 0.88 ±0.17/82 ±20, 0.96 ±0.22), A wave and Aa velocities did not change after the procedure (87 ±18, 8.5 ±1.6/88 ±21, 8.6 ±1.5). The value of Ea increased significantly (9 ±1.7/9.9 ±2) and the E/Ea ratio decreased non-significantly after the procedure (8.6 ±1.1/7.8 ±1.9). Values of IVRT and DT decreased significantly after the procedure (91 ±16, 220 ±44/86 ±18, 200 ±23). Conclusions : Sympathetic overactivity may impair diastolic functions. By carotid artery stenting, which is associated with an increase in parasympathetic activity by a vagally mediated stimulus, diastolic functions may improve. In our study, echocardiographic parameters showed improvement in diastolic functions.