Journal of Tehran University Heart Center (Nov 2010)
Evaluation of the Effect of Elective Percutaneous Coronary Intervention as a Treatment Method on the Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease
Abstract
Background: Although percutaneous coronary intervention (PCI) is an excellent therapy for coronary artery disease, there is a paucity of information on the efficacy of PCI in improving diastolic function, especially in Iran. Because of the high prevalence of left diastolic dysfunction in coronary artery disease patients and its probable progression to heart failure, an evaluation of the role of PCI in improving diastolic function is required.Methods: Thirty patients scheduled for elective PCI were enrolled in this study providing that their systolic ejection fraction was > 40%. Before PCI and 48 hours and 3 months after PCI, echocardiography was done to evaluate some diastolic values in these patients.Results: The mean age of all the patients was 54 ± 10 year, and 20 patients were male. All the patients had a low degree of left ventricular diastolic dysfunction. Isovolumic relaxation time (115 ± 10 before treatment versus 120 ± 1 and 119 ± 3 respectively 48 hours and 3 months after treatment), mitral E wave velocity in septal (0.70 ± 0.05 before treatment vs. 0.71 ± 0.15 and 0.72 ± 0.12 respectively 48 hours and 3 months after treatment), and the peak velocity of late filling due to atrial contraction (mitral A wave velocity) in septal (0.74 ± 0.02 before treatment vs. 0.73 ± 0.01 and 0.68 ± 0.16 respectively 48 hours and 3 months after treatment) showed improvement after PCI. It is notable that early diastolic mitral annulus velocity (E′) wave velocity in the septal part of the mitral annulus improved significantly 48 hours and 3 months after PCI (p value < 0.05). The early-to-late diastolic tissue velocity ratio of the mitral annulus (E/A) ratio of the mitral inflow improved 48 hours after PCI; it was statistically significant (p value = 0.05). Also, mitral A wave velocity in septal and the E/A ratio of the mitral inflow improved significantly 3 months after PCI (p value < 0.05).Conclusion: Improvement in some of values related to left ventricular diastolic function followed by PCI shows that this method can be used to improve cardiac diastolic function in patients with symptomatic coronary artery disease.
