The Effect of Percutaneous Coronary Intervention on Isolated Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease Assessed by Using Strain Rate Imaging (original) (raw)
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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.
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...
The Egyptian Journal of Hospital Medicine, 2022
Background: It is well established fact that acute coronary occlusion leads to diastolic dysfunction, followed by systolic dysfunction when myonecrosis occurs. It is also proven that primary percutaneous coronary intervention (PPCI) is an excellent therapy for ST elevation myocardial infarction (STEMI) to improve outcomes. However there is a paucity of information on efficacy of PPCI in improving diastolic function. Evaluation of the role of PPCI in improving diastolic dysfunction is required. Objective: To evaluate diastolic dysfunction recovery following successful PCI in STEMI patients according to the occluded artery including Left Anterior Descending (LAD) group and Non-LAD group including Left Circumflex Artery (LCX) and Right Coronary Artery (RCA). Patients and methods: The study included sixty one patients who were presented to emergency room with STEMI and underwent primary PCI. Echocardiographic evaluation was performed within 24 h of PPCI and then on 3 months after PPCI. We evaluated the prevalence of diastolic dysfunction after PPCI and its recovery during 3 months. Results: There was a significant difference between grading of degree of diastolic dysfunction before PCI and after 3months follow up with significant improvement after PCI. Conclusion: We concluded that primary PCI improves diastolic dysfunction in patients with anterior wall STEMI over a period of 3 months.
International Journal of Cardiovascular Practice, 2019
Introduction: Strain (S) and Strain Rate (SR) as echocardiography parameters are important in assessing changes in myocardial tissue and global and regional evaluation of systolic and diastolic functions and in detection of myocardial disorders as they change in early stages of myocardial ischemia. Therefore, the aim of this study was to compare changes of S and SR indices in systolic phase in patients with a significant stenosis of left anterior descending (LAD) before and after percutaneous coronary intervention (PCI). Methods: 48 patients candidate for PCI with significant lesion in LAD were enrolled in this study. Echocardiographic images taken one day before and a week after PCI. Echocardiographic scope of the LAD was defined as mid, basal, anteroseptal and midseptal and apical segments then, S and SR parameters in all segments measured separately during systolic phase before and after PCI and compared together. Results: there was a significant increase after PCI only in two segments and SR values showed significant increase after PCI in four segments. In the analysis of sum of mean parameters, a significant increase was observed in SR values (10.12 to 11.30; P = 0.001), but not in S values (149.54 to 143.36; P = 0.1) Conclusions: The remedial effect of PCI on deformation values was observed in the first week. In early reperfusion period, S/SR indices have potential to be used as determinants of favorable response to revascularization therapy.
2012
Coronary artery disease is one of the most common causes of mortality and morbidity across the world. Its treatment includes medical treatment, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). The purpose of this study was to investigate the effect of PCI on echocardiographic findings of left ventricular (LV) systolic and diastolic function. 115 patients with coronary artery disease candidate for PCI were enrolled to our study. Echocardiography was done before PCI, the day after and 3-6 months later. LV systolic and diastolic function were measured and recorded. Echocardiographic finding compared with repeated measurement analysis. Mean age of the patients was 57.8±8.38 years. The mean Ejection Fraction (EF) was (%40.52±6.36) before, (%41.83±7.14) the day after, and (%44.0±7.89) 3-6 months after PCI. Diastolic dysfunction were mild to moderate before PCI, which in %74 (86 patients) were improved to mild dysfunction the day after PCI but not changed 3...
Acta medica Iranica, 2012
Coronary artery disease is one of the most common causes of mortality and morbidity across the world. Its treatment includes medical treatment, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). The purpose of this study was to investigate the effect of PCI on echocardiographic findings of left ventricular (LV) systolic and diastolic function. 115 patients with coronary artery disease candidate for PCI were enrolled to our study. Echocardiography was done before PCI, the day after and 3-6 months later. LV systolic and diastolic function were measured and recorded. Echocardiographic finding compared with repeated measurement analysis. Mean age of the patients was 57.8 ± 8.38 years. The mean ejection fraction (EF) was (%40.52 ± 6.36) before, (%41.83 ± 7.14) the day after, and (%44.0 ± 7.89) 3-6 months after PCI. Diastolic dysfunction were mild to moderate before PCI, which in %74 (86 patients) were improved to mild dysfunction the day after PCI but not c...
Journal of medical science and clinical research, 2017
In patients with coronary heart disease, evaluation of the left ventricular end diastolic pressure (LVEDP) provides assessment of the hemodynamic severity and aids in assessing the prognosis, and in deciding the proper management and therapeutic interventions. It also helps to distinguish this syndrome from other diseases such as pulmonary disease that can result in dyspnoea. The early diastolic doppler indexes derived from transmitral flow velocity curves correlated significantly with LV filling pressures in patients with systolic dysfunction, but the correlation was weak in patients with preserved systolic function. The difference between the pulmonary venous and mitral A durations correlated well with LVEDP in patients with CAD, irrespective of the systolic function. In this study we found echocardiographic doppler derived transmitral and pulmonary venous flow indices can be used as a safe and noninvasive means of predicting the LV filling pressures in patients with coronary artery disease, especially in patients with LV systolic dysfunction, as an alternative to the invasive measurements obtained during cardiac catheterization.
Biomedical Research-tokyo, 2017
Background: Recovering blood flow to a coronary stenosis may improve left ventricular (LV) function in patients with coronary artery disease (CAD). However, the reported data about evaluation of LV function post-percutaneous coronary intervention (PCI) in CAD was limited. Purpose of this study was to compare the LV function measured by ejection fraction (EF) and global longitudinal strain in patients with CAD underwent PCI, and to identify factors affecting the change of LV function. Methods: Patients with CAD who underwent elective PCI were enrolled. Echocardiographic measurements of LV function by EF as well as by 2D speckle tracking to assess global longitudinal strain were performed in all patients within 24 hours pre- and post-PCI procedure. The LV global longitudinal peak strain average (GLPS-Avg) was calculated from 18 segments measurement. Results: A total of 40 patients (55.9 ± 7.5 y.o.) were enrolled. Means of GLPS-Avg pre- and post-PCI were -12.41 ± 4.82% and -13.41 ± 4.9...
Cardiology and Cardiovascular Research, 2020
This prospective cohort study was conducted on fifty patients presented with STEMI and underwent primary PCI to Assess the impact of primary percutaneous coronary intervention (Primary PCI) on the left ventricular (LV) systolic function in patients with Acute STEMI using speckle tracking Echocardiography within the first 24 hrs and within 1 month after performing PCI. All patients were evaluated by history taking, clinical examination, laboratory investigations and coronary angiography assessment with revascularization of the infarct-related artery (IRA). All patients had CCU admission for 3 days. Conventional 2D echocardiography was performed within 24 h of Primary PCI to assess LV Global longitudinal peak systolic strain (GLPSS). All patients had been discharged to home with the guidelines-based medical treatment including (DAPT, Atorvastatin, ACEIs, Beta blockers). GLPSS was reassessed after 1 month. The patients were divided into two groups: improved and non-improved, according to the improvement of LV systolic function measured by GLPSS. Improvement is defined by increase of GLPSS ≥ 10%. Our study demonstrated Improvement of LV function was based on GLPSS and was observed in 54% of the patients. Peak cardiac troponin T level, Peak creatine phosphokinase levels (CPK), LV diastolic function, and baseline GLPSS were identified as independent predictors of recovery of LV function. The patients who showed improvement of GLPSS were associated with improvement of EF (using simpson method).
International cardiovascular research journal, 2014
Right Ventricular (RV) dysfunction has been introduced as a predictor of mortality in acute myocardial infarction. This study aimed to investigate the effect of right coronary revascularization on systolic and diastolic RV dysfunction. This study was conducted on unstable angina patients who were candidate for elective Percutaneous Revascularization Intervention (PCI) on the right coronary artery. The participants were initially evaluated by transthoracic echocardiography and tissue Doppler imaging prior to PCI and the RV function parameters were assessed. Echocardiography was repeated two months after PCI and the results were compared with baseline. Paired t-test was used to compare the pre- and post-procedural measurements. Besides, Pearson's correlation was used to find out the linear association between the RV function parameters and Left Ventricular Ejection Fraction (LVEF). P value < 0.05 was considered as statistically significant. This study was conducted on 30 patien...