| PrefaceTwo main prognostic factors of myocardial infarction are the extent of coronary artery lesion and the ventricular remodeling. It is well know that interventional angioplasty relieves the vascular obstruction, improves perfusion. But it still remains uncertain as to whether interventional angioplasty prevents ventricular remodeling and improves cardiac function. The objective of our research is to find if percutaneous transluminal coronary angioplasty (PTCA) can attenuate the process of ventricular remodeling and improves cardiac function for patients suffering a first recent Q - wave infarction in long - term.MaterialsPatients; 51 consecutive patients from Apr. 2000 to Dec. 2000 suffering a first recent Q - wave myocardial infarction were enrolled. Inclusion criteria were: 1) at least one artery lesion >70% reduction of lumen diameter showing in angiography; 2) no congenital, hypertensive or valvular heart disease. 25 of them underwent PTCA, consisting the PTCA group. The other 26 did not receive angioplasty because of any other consideration and consisted the control group.Apparatus: 1) ultrasound system ( SONOS5500, Hewlett Pack-ard) incorporated with color kinesis software and 2. 0 -4. 0 MHz detector. 2) digital cardiac imaging system (Siemens HICORT. 0. P, Siemens Medical Instrumentation. Inc. ) 3 ) 24 - channel recorder (HELLIGE 66E95).Statistical analysis: All values were expressed as mean value ?1SD. All data acquired were analyzed using EXCELL and SPSS. The null hypothesis was rejected at the 95% confidence level, considering a p value P <0.05 as significant.Methods1. Catheterization procedure-, all patients received Aspirin (0.3 Qd p. o. ) Diclid (0. 25 Bid p. o. ) and Hebessor (3mg tid p. o. ) for consecutive 3 days until the day of PTCA. B - receptor blockers were stopped on the day of PTCA. When PTCA, a 7F sheath was positioned in the right femoral artery. Then we introduced a 0. 014 inch diameter guiding wire through guiding catheter. The optimal balloon size we selected was around coronary artery diameter proximal to the lesion. Catheter was advanced across the stenosis. For each lesion, inflations were performed 3-4 times, with an inflation pressure of 4 -16 bars. An interval of 60 seconds was allowed between each balloon inflation.2. Echocardiography operation: patients in PTCA group went through echocardiographic examination before and 3 months after PTCA. Patients in control group went through the same examination before and 3 months after coronary angiography procedure.Results1. Comparison of the data derived before and 3 months after PT-CA in PICA group. WMAS decreased by 41. 0% 3 months after PICA , from 12.2±3.2to7.2±3.6(P<0.05).Ai decreased by 26.6% , from 5. 5 ± 1. 9cm to 4. 0 ± 1. 4cm (P < 0. 05). Ei/Ai increased by 35. 6% , froml.4±1.6 to 1.9±0.2 (P<0.05). ESV decreased by 2 6. 5% ,from87.6 ±20. 4mlto64. 4 ±10.8ml(P <0. 01). EDV decreased by 5.6%, from 148. 6 ± 30. 5ml to 125.4 ± 24.4ml (P < 0.01). LVEF increased by 17. 8% , from 41.1 ± 6.5 to 48.4±8.6 (P<0.01).2. Comparison of the data derived before and 3 months after angi-ography in control group . EDV increased by 9 . 6 % , from 146. 2 ± 27.4ml to 160. 2 ± 33.4ml (P < 0. 01). ESV increased by 10. 8% , from 90.4 ± 20.2m to 100. 2 ± 22. 8ml ( P < 0. 01). LVEF decreased by 10.0%, from 40.2 ±5.8 to 36.2 ±6.4 (P<0.01).3. Comparison between data derived from PTCA group and control group. There is no significantly difference in the indices of left ventricular systolic or diastolic function between these two groups before angiography or PTCA. 3 months later, patients in PTCA group had a higher Ai value of 4 . 0 ± 1 . 4 cm than that in control group of 5 . 3 ±1. 8cm (P <0. 01) ; a higher Ei/Ai value of 1. 9 ±0. 2 than that in control group of 1.5 ± 0.2 (P < 0.01) ; a higher LVEF value of 48.4±8.6 than that in control group of 36.2 ±6.4 (P <0.01) ; a higher WMAS value of 7 . 2 ±3.6 than that in control group of 14 . 1 ±3.9 (P <0.01); a...
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