Doppler Tissue Imaging Assessment Left Ventricular Function And Remodeling In Patients With Coronary Arteriosclerosis Disease After PCI

OBJECTIVE: To investigate left ventricular systolic and diastolic function and left ventricular remodeling by mitral annulus motion velocity with pulsed-wave Doppler Tissue Imaging(PW-DTl) in patients with coronary arteriosclerosis disease(CAD) after percutaneous coronary intervention (PCI), mainly included percutaneous transluminal coronary angioplasty(PTCA) and stent, and evaluate Sa and E/Ea as a sensitive index of CAD patients cardiac function used in clinic. METHODS: we research 52 patients with CAD and 20 health volunteers, who were diagnosed by coronary artery angiography . E/Ea were compared in two groups .All of patients in CAD were divided into two groups, PCI group (n=33) and non-PCI group(n=19), who were treated with normal drug management and performed in examination by PW-DTI and conventional echocardiography in the follow-up period pre-intervention and the 5th day, the 3rd month and 6th month post-intervention in PCI ones, pre-angiography and 6th month post-angiography in non-PCI ones, to research PCI effect on left ventricular function and remodeling in patients with CAD, Then, in PCI group, the patients were divided two subgroups(subgroups: EF>50% and 30% < EF < 50%) as ejection fraction (EF) to analysis the difference of left ventricular function and remodeling pre- and post-intervention in different subgroups. RESULTS: (1) E/Ea inCAD patients significantly elevated compared with health volunteers (P < 0.01).(2) there was a strong correlation between E/Ea and Ea (pre- and post-intervention r=-0.697,-0.720,P < 0.0001).(3) There were significantly elevated in Sa and decreased in E/Ea in patients of PCI group(P < 0.05). (4) The patients of 30% < EF < 50% pre-intervention changed better than that of ones EF>0%. (5) The left ventricular end-systolic volume index (LVESVI) and left ventricular end-diastolic volume index (LVEDVI) in non-PCI group were significantly elevated in the 6th month post-angiography(P < 0.05). (6) E/Ea correlated with Sa (pre- andpost-intervention r=-0.607,-0.705,P < 0.001). CONCLUSIONS: (1) Sa could be a clinic sensitive value to evaluate left ventricular systolic function of CAD patients.(2) E/Ea could be a clinic sensitive value to evaluate left ventricular diastolic function of CAD patients. (3) PCI could be a useful way to promot to cardiac systolic and diastolic function of CAD patients and to delay left ventricular remodeling. (4) The effects of PCI are more distinct on the CAD patients of pre-intervention dysfunction. (5) PW-DTI is a useful and optional tool to follow-up effect of PCI on patients with CAD.