Tissue Doppler Study before and after PCI in Patients with Chronic Stable Angina and Apparent Normal Ventricular Function for Evaluation of Myocardial Function (original) (raw)
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Journal of the American Society of Echocardiography, 2009
Background: The aim of this study was to determine the impact of percutaneous coronary intervention (PCI) on myocardial function assessed by tissue Doppler echocardiography. Methods: Myocardial tissue peak velocities were recorded at the lateral, septal, posterior, 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: Twenty-four consecutive patients with chronic stable angina and preserved systolic left ventricular function (20 men; mean age, 64 Ϯ 9 years) undergoing PCI were studied. Compared with preinterventional values, early diastolic velocities improved at all sites (P Ͻ .05 for each). The most pronounced improvement occurred in the septal area. Similarly, systolic peak velocity improved in the septal, lateral, inferior, and right ventricular areas (P Ͻ .04 for each). Conclusions: Tissue Doppler parameters of diastolic and systolic function improve early after successful PCI, and this effect persists to 6 weeks after intervention.
European Heart Journal Supplements, 2012
Background: It has been reported that impaired left ventricular longitudinal function may precede circumferential ventricular dysfunction in patients with coronary artery disease. Objective: To determine the impact of PCI on myocardial function assessed by tissue Doppler echocardiography in patients with chronic stable angina. Patients and methods: Twenty-five consecutive patients with chronic stable angina and preserved systolic LV function (EF %> 50%) underwent PCI were studied by pulsed wave tissue Doppler at different time intervals before and after PCI. All patients were subjected to the following: Full history and physical examination, ECG, echocardiography before PCI to evaluate baseline systolic and diastolic function as well as 1 day and 6 weeks after intervention, and pulsed-wave tissue Doppler echocardiography was done before PCI, as well as 1 day and 6 weeks after intervention to detect mitral and tricuspid inflow velocities, including E and A wave peak velocities
Journal of Cardiovascular Disease Research
Background: Right Ventricular (RV) dysfunction considered as a predictor of mortality in patients with ischemic heart disease (IHD). Aim: This study was aimed to evaluate the impact of elective coronary artery revascularization on RV myocardial function in Egyptian patients with IHD using Colour Tissue Doppler Imaging (CTDI). Methods: The present study is prospective observational self-control study. Fifty consecutive patients with IHD were included in this study. All participants were subjected to physical examination, Electrocardiograph (ECG), Laboratory test, Transthoracic Echocardiography and color tissue Doppler Imaging. The RV myocardial performance index (MPI) and S'/RMPI index were calculated in TDI modalities parameters. Results: No significant differences were detected between the demographic characteristics of the investigated patients. Tricuspid annular plane systolic excursion (TAPSE) by echocardiographic RV function parameters was improved significantly after PCI (P=0.001). Most of RV myocardial function showed significant improvement after PCI by using PW-DTI: Early and late diastolic function: The E` and A` diastolic wave velocities were improved significantly after PCI (P= 0.003, P= 0.008 respectively), RMPI (P= 0.008) Sˋ/RIMP ratio (P=0.04). The myocardial functions showed significant improvement after PCI by using color-coded tissue Doppler; E` wave (P= 0.02), RMPI was improved significantly after PCI (P= 0.01). Conclusion: The TAPSE and Doppler tissue indices added important information to the RV functions after successful percutaneous revisualization of coronary arteries. The measurements performed by color-coded TDI derived myocardial velocities at basal, mid and apical might have added additional data describing RV function and its recovery after RV ischemia.
2019
Objectives: this study aimed to assess the effects of percutaneous coronary intervention (PCI) on regional and global left ventricular (LV) functions (systolic and diastolic) in patients with coronary artery disease (CAD) using tissue Doppler strain rate (SR) imaging. Patients and Methods: in this study, we randomly assigned 100 Egyptian adult symptomatic patients with CAD that underwent coronary angiography and candidate for PCI on the left anterior descending artery. LV early diastolic and systolic SR were measured 24 h before and 48 h after PCI. Results: Most of the LV diastolic and systolic parameters (A, E', E/A, E/E', and isovolumic relaxation time [IVRT]) showed significant difference before and after elective PCI, while mitral E velocity, DT, and pulmonary vein flow before and after PCI did not show significant difference. SR imaging findings showed high significant difference mean peak systolic and mean early diastolic SR of ischemic regions after PCI; mean early di...
Reviews in Clinical Medicine, 2014
Coronary artery diseases affect both systolic and diastolic functions and can be assessed both globally and regionally. Tissue doppler imaging is a novel technique with additional advantages to the currently used two-dimensional echocardiography. This paper is a review of the published articles on documented Coronary artery diseases patients confirmed by angiography, without any previous myocardial infarction and with normal left ventricular ejection fraction. Accordingly, a significant relationship was achieved between systolic rather than diastolic parameters with Coronary artery diseases. Furthermore, major heterogeneity was noticed among the available studies in this respect.The incremental values of tissue doppler imaging in patients with stable angina in addition to other non invasive tests has led to its recommendation by ACC/AHA.
2020
Background: The experiments show that pre-ejection velocity analysis is particularly sensitive to blood flow. After reduced regional perfusion, tissue velocities drop, but they rise with reperfusion. Thus, following revascularization, cardiac function recovery may be predicted using tissue doppler imaging (TDI). Objective: The aim of the current work was to determine the effectiveness of tissue Doppler imaging echocardiography in predicting the restoration of myocardial function in patients with coronary artery disease (CAD) following percutaneous coronary revascularization. Patients and Methods: Our study prospectively enrolled 27 patients. Only 24 patients completed the study protocol while, unfortunately, three died during follow up. Included patients were diagnosed with CAD based on previous diagnostic coronary angiography (CA) done before. They have impaired systolic function and regional wall motion abnormality (RWMA) on transthoracic echocardiography (TTE) and were eligible for percutaneous coronary intervention (PCI). Results: From all Tissue Doppler Imaging-Pulsed wave (TDI-PW) derived parameters, only mean IVCPv and mean S wave velocity of dysfunctional segments at baseline correlate significantly with changes in LVEF (global functional recovery) with revascularization. The mean of both IVCPv and the S wave of defective segments varied significantly at baseline among patients who showed significant improvement in LVEF 6 months after revascularization versus those patients who didn't exhibit significant improvement (2.8±0.4 vs. 3.5±0.8 for IVCPv, and 4.5±0.9 vs 5.8±1.1 for S wave, p value <0.05 and <0.01 respectively). There was significant moderate positive correlation between mean IVCPv and mean S wave velocity at baseline and changes in LVEF (global functional recovery) with revascularization (p value<0.05 and <0.01 respectively). Conclusions: It could be concluded that in patients with CAD, the resting IVCPv & S wave by TDI pattern accurately predicts the recovery of global systolic function with high pulse pressure variation (PPV) but not the regional function.
University Heart Journal, 2015
The basis of pathophysiologic benefit of revascularization is improving the function of viable myocardium 37. Early coronary re-canalization helps to survive the viable myocardium and improve global LV function and survival 46. According to the studies in patients with CAD and LV dysfunction, the disease outcome can be improved with surgical revascularization (CABG) or PCI 37. PCI in patients with preserved LV function and optimal medical therapy doesn't reduce the cardiac death and MI, but it decreases the need for other procedure and the risk of angina. Its effect on LV systolic or diastolic function is not clear 31. PCI has been used increasingly for revascularization in ischemic heart disease (IHD) patients. In most of the studies, the primary PCI, criterion such as ejection fraction (EF), diastolic function and the wall motion or chamber sizes has been investigated. But result of previous studies in related area, about elective PCI, has shown unequal viewpoints 1,6,13,27,30,32,39,41. Intervals between MI and PCI, basic left ventricular ejection fraction (LVEF) before PCI and global condition of the patients affect the result of PCI. Angina occurs when there is regional myocardial ischemia caused by inadequate coronary perfusion and is usually but not always induced by
European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 2010
Aim To determine how the left ventricular wall motion assessed by echocardiographic Tissue Doppler Imaging (TDI) is affected by increasing severity of coronary artery disease (CAD) among patients with stable angina pectoris and preserved ejection fraction. This study comprises 82 patients with suspected angina pectoris, no previous cardiac history, and a normal ejection fraction, who were all examined with colour TDI prior to coronary angiography. Patients without significant stenoses (n = 35) constituted the control group and patients with significant stenoses (n = 47) were divided into three groups according to significant one-, two-, or three-vessel disease (n = 18, n = 14, and n = 15, respectively). Regional longitudinal peak systolic (s'), early (e'), and late diastolic (a') myocardial velocities were measured at six mitral annular sites and averaged to provide global estimates. Each patient with significant coronary disease was matched with a control of the same ag...
International journal of cardiac imaging, 1997
The increasing demand for insight into the relationship between coronary perfusion and myocardial function stimulated the development of tissue Doppler echocardiography. This new technique was applied simultaneously with PTCA of a subtotal LAD lesion (single vessel disease, no collaterals) in a 68-year-old patient suffering from unstable angina pectoris. Prior to the conventional signs of ischaemia a decrease in myocardial tissue velocities and a loss of color-coded heart cycle intervals was observed. A myocardial velocity gradient calculated from the higher subendocardial and lower subepicardial velocity decreased from 3.3 to 1.3. This decrease was prevented by an active autohaemoperfusion device which supplied blood distally to an insufflated balloon (60 ml/min). Thus, contractility and viability might be maintained by preserving myocardial velocity gradients.
World Journal of Cardiovascular Diseases, 2014
Introduction: Coronary artery disease (CAD) is the most common cause for left ventricular dysfunction. Unfortunately, the treatment strategies of regional myocardial diastolic dysfunction in patients with CAD have not been well characterized and benefit of percutaneous coronary intervention (PCI) as a treatment strategy is not clear. So the present study aimed to assess the effects of PCI on regional and global left ventricular diastolic dysfunction in patients with CAD assessed by strain rate (SR) imaging. Methods: Thirty adult symptomatic patients with coronary artery disease that underwent coronary angiography and candidate for PCI on left anterior descending artery were enrolled to our study. Echocardiographic findings and early diastolic SR were measured before and 48 hours after PCI. Results: Mean age of the patients was 59.9 ± 8.3 years. Most of the left ventricular diastolic parameters showed significant difference before and after elective PCI; while mitral E velocity, DT, E/A and pulmonary vein flow before and after PCI did not show significant difference assessed by statically test. Also before PCI, mean (SD) of peak early diastolic SR in ischemic regions (1.89 ± 0.22) was smaller than of non-ischemic regions (2.53 ± 0.26) while after PCI this parameter became similar in ischemic regions (2.55 ± 0.27) and non-ischemic regions (2.55 ± 0.26). Conclusion: Most of the left ventricular diastolic parameters improved after PCI in CAD patients. Also regional myocardial relaxation as measured by peak early diastolic SR (ESR) in the ischemic segments improved significantly compared with that in non-ischemic segments.