Abstract
Background: This study aimed to determine the impact of the percutaneous coronary intervention (PCI) on myocardial function assessed by tissue Doppler echocardiography. Methods: Conventional two-dimensional echocardiography and Myocardial tissue peak velocities were recorded at the lateral, ant.septal, post.septal, posterior, ant. and inferior angles of the mitral annulus as well as at the lateral tricuspid annulus by pulsed-wave tissue Doppler echocardiography before PCI, as well as 1 day and 6 weeks after intervention. Results: Fifty consecutive patients with chronic stable angina and preserved systolic left ventricular function (mean age, 58.3 ± 6.594 years; 32 men) undergoing PCI were studied. Conventional echocardiographic revealed no statistically significant difference between pre- and post-PCI (1 day after PCI and 6 weeks after PCI) as regarding trans-mitral and trans-tricuspid flow velocities except as regarding LVEDD, LVESD and LVEF which showed a significant improvement post-PCI. Compared with pre-interventional values, systolic peak velocity and early diastolic velocities improved at all sites (P ≤ 0.05 for each). The most pronounced improvement occurred in the septal area. Similarly, late diastolic velocities improved at all sites (P ≤ 0.05 for each) except at post Wall A’. Also, there was a significant improvement of E’DT & E’/A’ ratio after PCI (P value is significant 0.05 for each). There were significant reductions in IVRT, IVCT & MPI after PCI (P value is significant Conclusions: Tissue Doppler parameters of diastolic and systolic function improve early after successful PCI, and this effect persists to 6 weeks after the intervention that emphasizes its value in the improvement of regional and global LV functions and myocardial contractility.
Highlights
Percutaneous coronary intervention (PCI) is an established and widely agreed technique for the treatment of coronary artery disease (CAD); with worthy role in symptom relief
The potential of tissue Doppler-derived measurements in identifying ischemia has been established in different experimental and clinical settings so, percutaneous coronary intervention (PCI) for a significant coronary lesion with chronic stable angina has a beneficial effect on left ventricular (LV) functions and improvement in regional and global LV functions and myocardial contractility after revascularization, which can be predicted by conventional echo and more accurate and more details can be obtained by tissue Doppler study (TDI) [6]
The purpose of this study was to investigate the impact of the percutaneous coronary intervention (PCI) on myocardial function in patients with chronic stable angina included a total of 50 patients, assessed by tissue Doppler echocardiography, and its target was to find out if after PCI longitudinal and circumferential myocardial impairment improved or not
Summary
Percutaneous coronary intervention (PCI) is an established and widely agreed technique for the treatment of coronary artery disease (CAD); with worthy role in symptom relief. Evaluation of myocardial contractile function (either global or regional) using TDI echocardiography depends on visual evaluation of the extent of myocardial thickening and endocardial inward motion, along with both M-mode and two-dimensional echocardiographic measurements of left ventricular (LV) ejection fraction (LVEF) [5]. The potential of tissue Doppler-derived measurements in identifying ischemia has been established in different experimental and clinical settings so, PCI for a significant coronary lesion with chronic stable angina has a beneficial effect on LV functions and improvement in regional and global LV functions and myocardial contractility after revascularization, which can be predicted by conventional echo and more accurate and more details can be obtained by tissue Doppler study (TDI) [6]. There was a significant improvement in tissue Doppler measures of early, late diastolic function and E’/A’ at the lateral tricuspid annulus after PCI com-
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