Evaluating The Global And Regional Left Wentricular Function And Effect Of PTCA On It In Patients With CAD By DTI

Objective:The study was designed to evaluate global and regional left ventricular function and the effect of PICA on it in coronary artery disease (CAD) by measuring myocardium velocities in mitral annulus with Doppler tissue imaging (DTI).Material and Method: Part one: 223 patients were divided into 3 group, e.g normal (n=50), angina pectoris(AP) (n=85) and myocardial infarction groups (MI) (n=87) according to history ,physical examination, electrocardiogram, echocardiograms and coronary angiography. Before angiography, peak systolic velocities (Sa), peak early diastolic velocities (Ea) and peak late diastolic velocities(Aa) were recorded at 4 different sites at the mitral annulus corresponding to septum, lateral, anterior and inferior wall of left ventricule. In addition, the ejection ftaction (EF) and conventional Doppler diastolic parameters were measured. Part two: there were 38 patients with coronary artery disease (myocardial infarction in 16 and angina pectoris in 22), the measurements at 4 different sites at the mitral annulus by DTI and the conventional echocardiography parameters of left ventricular function were obtained in pre-PTCA and post-PTCA 1 week, 3post-PTCA 8 week.Rusults:Part one: In all of patients, a relatively correlation was found between ejection fraction ( EF )and mean systolic velocity (M- Sa)from the 4 LV sites except patients with extensive MI. Similar to M-Sa, the mean early diastolic velocity ( M-Ea) correlated well with EF in all patients but for extensive MI. Compared with patients with angina pectoris and normal, the patients with MI had a significantly reduced of Sa, but compared with normal, the patients with AP had not a significantly reduced. Among the normal, AP and MI patients, EalAa and Ea had a significantly regression. Part two: Compared with pre-PTCA measurements, the improvement of Sa at septum and lateral sites were found at 1 week after PTCA; at 8 weeks after PTCA , the improvement of Sa at 4 left ventricular sites Ea and EaIAa at septum, anterior, and inferior sites could been detected, but left ventricular EF and conventional Doppler diastolic parameters were not changed.Conclusion:The results of the study suggested that: first, Quantitative analysis of myocardial velocity by DTI proved a new possibility of assessing LV function along its long axis; second, PTCA might improve left ventricular systolic and diastolic function, the improvements of systolic function were detected in 1 week by DTI, the improvements of diastolic function were observed in 8 weeks by DTI; and third, DTI is superior to conventional echocardiography parameters in detecting left ventricular function.