The Effects Of The Length Of Home-made Sirolimus Drug-Eluting Stents On The Left Ventricular Function

Background:According to ACC/AHA standard, the lenth of diffuse lesion >20mm belongs to C type lesion. Treatment of diffuse long coronary artery stenosis with a long segment of bare metal stent is associated with high restenosis rates(50%) and poorer clinical outcome. Therefore, in contrast to shorter lesions, stent placement for diffusely diseased coronary segments is frequently avoided. The efficency of the drug eluting stent(DES) implantation has been evaluated in the context of a few large randomized trials.The significance of reduction restenosis has been showed in DES.Therefore DES is used more and more generally in clinic and the indications of percutaneous coronary interventions has been used to diffuse lesions , then whether the long or multiple overlapping drug-eluting Stents after PCI have the same improvements with the short drug-eluting Stent is still unknow abroad and domestic.Objective: The aim of this study was to determine the impact of the effects of length of domestic-made Sirolimus Drug-Eluting Stents on myocardial function after percutaneous coronary intervention (PCI) on assessed by tissue Doppler echocardiography.Methods: The patient population consisted of consecutive series of 147 patients at ChangHai hospital Cardiovascular Medicine who had been treated with single short or long stents or overlapping stents from Feb 2007 to Feb 2008. Patients with culprit left anterior descending (LAD) lesions and subjects with normal coronary angiography were evaluated divided in four groups(≥20,20-28,28-36,>36mm)。Before and 6 months After PCI, the pulsed-wave tissue Doppler imaging (pw-TDI) parameters were taken and compared among the patients.Results:1.The procedural success rate was 97.4%. 2. The overall complication in hospital is 8.4%. 3 .Before PCI, there was no significant difference between the four groups in the volume of the cardic and both the contractive or diastole function. 4.Six months after PCI,LA,RA,LV,RV in overlapping stent group (> 36 mm) were increased more than any other three groups,besides,the myocardial function was decrese more than the others.5.The there vessels revascularization group was increased more in the volumes of LA,RA,LV,RV than single and double vessels revascularization groups.6.In the patients who survise hypertention,the RA is bigger than the ones without hypertention.(P=0.02) The ones survise diabetes mellitus were increased more in the volumes of LA,RA,LV,RV and have a poor myocardaial function.Conclusions:Home-made Sirolimus Drug-Eluting Stents is safe and effective in the using of long coronary diffuse lesions, although the acute complications are higher.After implantationed SES stens> 36 mm, the LA,RA,LV,RV volumes turns to be bigger and EF,FS turns to be improve smaller,but there is no significant influence in the cadivescular function.