Quantitative Evaluation For Myocardial Perfusion Of Patients Received PCI With Coronary Artery Disease Using Doppler Tissue Imaging

Objective: To quantitatively evaluate the myocardial perfusion situation of the patients with coronary artery disease after per- cutaneous coronary intervention (PCI) by Doppler tissue imag- ing (DTI), and compare cardiac function indexes of patients with normal controls group's.Methods: Forty-five patients with CAD and 20 healthy volunteers were divided into the CAD group and controls group, respectively. All patients in CAD group were divided into two groups according to their disease histories and electrocardiograms: non-myocardial infarction group (20 cases) and myocardial infarction group (25 cases). Firstly, the final internal diameter when the left ventricle relaxing or contracting, blood current of mitral valvula E and A, and the value of E/A were measured for all subjects. At the same time, LVEF were determined by the simpson's method. Then, PW-DTI was used to detect the motion of the interested myocardial segments and mitral valve annulus. The peak velocity of systolic wave (Vs), peak velocity of early diastolic wave (Ve), peak velocity of atrial contractive wave (Va) and peak velocity of early diastolic wave/peak velocity of atrial contractive wave (Ve/Va) were measured, too. All index changes of the two groups were observed on the 1 day before PCI and on the 7 days and 1 month after PCI.Results:1.Before PCI: (1) Vs,Ve,Ve/Va of mitral valve annulus in CAD group were significantly lower than that of the control group, whereas there was no significant difference in Va between them. (2) Vs had a correlation with left ventricular ejection fraction (LVEF) (r=0.701, P<0.05).2. Comparison between Post-PCI with Pre-PCI: (1) Global cardiac systolic and diastolic function: Vs,Ve,Ve/Va of mitral valve annulus were increased in non-myocardial infarction group and myocardial infarction group, and Ve/Va of mitral valve annulus was significantly increased from the post-PCI 7th day. (2) Regional cardiac systolic and diastolic function: Vs,Ve and Ve/Va were increased in corresponding myocardial segments in both of the myocardial infarction group and non- myocardial infarction group on the 7 day and 1 month after PCI, respectivelyConclusion:1.Diastolic and systolic velocities parameters of Mitral annulus and corresponding myocardial segments measured by DTI can be used to evaluate quantitatively the left ventricular function in CAD: (1) Ve,Ve/ Va are clinic values to evaluate left ventricular diastolic function of CAD patients sensitively. (2) Vs is a clinic sensitive value to evaluate left ventricular systolic function of CAD patients, and there is a strong correlation between Vs and LVEF. 2. Ve/Va of mitral valve annulus is an early index to reflect cardiac global perfusion condition after PCI, and Vs of mitral valve annulus is a useful index to evaluate cardiac global systolic function. The global myocardial perfusion recovery time had its own different characteristics in non-myocardial infarction and myocardial infarction patients after PCI.