New Doppler echocardiographic applications for the evaluation of early alterations in left ventricular diastolic function after coronary angioplasty.

Abstract

The early effect of percutaneous transluminal coronary angioplasty on left ventricular diastolic dysfunction was investigated with the aid of new Doppler echocardiographic applications. Thirty patients with isolated severe left anterior descending coronary artery stenosis were included. All patients exhibited abnormal diastolic function demonstrated by prolonged isovolumic relaxation and deceleration time and decreased E/A ratio. New Doppler indexes included the flow propagation velocity of E wave, E and A waves' transit time to the left ventricular outflow tract, the ratio of these transit times in addition to the traditional isovolumic relaxation time, mitral deceleration time, and early and late transmitral peak flow velocities. All measurements were performed within 4 h before angioplasty and repeated within 24 h after the procedure. After angioplasty none of these parameters, except the A-wave transit time, were changed significantly. The A-wave transit time increased significantly from 57 +/- 5 ms to 78 +/- 7 ms within 24 h after successful angioplasty. The ratio of E- and A-wave transit time decreased significantly due to this significant increase in A-wave transit time. In this study, early improvement of Doppler index of left ventricular diastolic compliance is demonstrated after successful angioplasty.