| Background:The incidengce of heart failure is high in patients with coronary heart disease,diastolic dysfunction is a sensitive indicator of early involvement.e-arly detection and intervention are of great significance to prevent the occurren-ce and development of heart failure.At present,the research on diastolic function mainly focuses on the functional mechanism,coronary sclerosis results in reduced compliance of the coronary arteries running along the surface of the heart and of the small blood wessels than that run between the heart muscles,it is worth study whether it has a mechanical binding effect on the systolic and diastolic function,thus causing the decline of diastolic function.Percutaneous coronary inte-rvention is an effective means for the treatment of coronary heart disease.Stent implantation further reduces vascular compliance.In particular,whether the impla-ntation of multiple stents or long stents also has similar binding effects on the systolic and diastolic of the heart,resulting in decreased diastolic function has n-ot been studied at present.Objectives:To explore the influence of percutaneous coronary intervention on left ventricular diastolic function in patients with coronary heart disease and an-alysis of related risk factors.Methods:By retrospective analysis,six hundred cases of unstable angina pectoris underwent coronary angiography for the first time.according to the degree of co ronary artery stenosis,the patients were divided into Group A(n=100),Group B(n=100),Group C(n=100)and Group D(n=300).PCI was performed in the Group D,and left ventricular angiography was performed preoperatively and immediately a fter the surgery,and angiography or coronary CT was performed in the hospital 9 months to 1year after surgery.according to the number of stents divided into groupi(n=125),groupii(n=104),groupiii(n=71).According to the length of the stent s,Single stent group were divided into groupⅠ(n=62),groupⅡ(n=38),groupⅢ(n=25),accurate recording of all clinical indicators.indicators of left ventricular diastolic function:E/e’value,LAD,LV-dp/dtmax,T,K,coronary artery pressure and volume we-re measured:C+dp/dtmax,C-dp/dtmax,CEDV,CESV.Compare the cardiac function of each group.Cardiac function was compared before PCI,immediately after and lyear after PCI.Results:1.Compared with the control group,E/e’ value,DT,K and T in groups B,C and D were higher than those in the control group(P<0.05);CEDV,CESV,C+d p/dtmax,C-dp/dtmax and PFR were lower than those in control group(P<0.05).2.Spearman correlation analysis:T was positively correlated with gensini score,K,E/e’ value,diabetes history;Multiple stepwise linear regression analysis:Gensini sc-ore and K is independently related to T;Spearman correlation analysis:Gensini s-core is negatively correlated with C+dp/dtmax、C-dp/dtmax、CEDV、CESV(P<0.05).3.Compared with before stent implantation,T and K immediately after the surgery were significantly higher than Before,and the number of abnormal cases of T was significantly increased(P<0.05).Compared with before stent implan-tation,LVEF,PFR,1/3EF,LV+dp/dtmax were significantly increased in the re-exami-nation of the angiography one year after stent implantation and K,T were signi-ficantly lower than before stent implantation(P<0.05),the number of abnormal cases of T decreased significantly.4.the length and number of stents were indep-endently associated with left ventricular diastolic dysfunction immediately after P CI.ROC curve analysis:The optimal boundary value of stent length to judge T a nomaly is 25mm(sensitivity was 0.608,specificity was 0.776,and AUC was 0.645).the optimal boundary value of the number of stents to judge T anomaly was 3.5(sensitivity was 0.859,specificity was 0.319,and AUC was 0.786).Conclusion:Left ventricular diastolic function in patients with coronary heart dis-ease was not effectively improved immediately after PCI,and multi-stent and lo-ng-stent implantation may be independently related to left ventricular diastolic d ysfunction.Figure[9]table[8]reference[36]... |
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