Study of left ventricular diastolic function following percutaneous coronary intervention for left anterior descending coronary artery disease in patients with normal left ventricular systolic function

摘要

Introduction: Regional wall motion abnormalities are frequentlyseen in coronary artery disease (CAD) and diastolic function isimpaired before systolic dysfunction in these patients. Reperfusionwith percutaneous coronary intervention (PCI) has beenshown to improve the left ventricular systolic and diastolic functions.Scores of studies have focused on the effects of revascularizationwith respect to regional and global systolic functions,there is paucity of information concerning possible effectsof angioplastywith stenting on left ventricular diastolic function;particularly in presence of normal left ventricular systolic function.Given the high prevalence of left ventricular diastolic dysfunctionin CAD patients and the probable progression of diastolicdysfunction to heart failure, an evaluation of PCI effectiveness inimproving left ventricular diastolic function in symptomaticpatients seems necessary. The present study addresses thisissue.Methodology: In the present study, we evaluated 30 symptomaticcoronary artery disease patients withnormalleftventricular systolicfunction and single vessel disease involving the left anterior descendingcoronary artery with routine echocardiography and tissueDoppler imaging pre and 48 h after elective successful percutaneoustransluminal coronary angioplasty with drug eluting stent implantation.Patients with the presence of structural heart disease (hypertrophic,restrictiveanddilatedcardiomyopathy, valvular,congenitalheart disease), pericardial effusion, myocarditis, atrial fibrillationand unsuccessful angioplasty were excluded.Results: Mean age of the patients was 56.9 7.8 years. There wasstatistically significant improvement in mitral A velocity (cm/s)(72.6 11.3 vs 68.6 10.9, p = 0.03) E' (cm/s)(6.7 1.1 vs 8.6 1.1,p = 0.02) E/E' (8.1 1 vs 6.8 1.2, p = 0.04), IVRT (ms) (119.4 27.899 17.7, p = 0.03) before and after elective PCI, while mitral Evelocity, DT, E/A and before and after PCI did not have any statisticallysignificant difference.Conclusion: There occurs improvement in Left ventricular diastolicfunction parameters after successful elective PCI in patients withleft anterior descending coronary artery disease with normal leftventricular systolic function.