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The Effect of Percutaneous Coronary Intervention on Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease Assessed by Strain Rate Imaging

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DOI: 10.4236/wjcd.2014.410063    2,563 Downloads   3,392 Views   Citations

ABSTRACT

Introduction: Coronary artery disease (CAD) is the most common cause for left ventricular dysfunction. Unfortunately, the treatment strategies of regional myocardial diastolic dysfunction in patients with CAD have not been well characterized and benefit of percutaneous coronary intervention (PCI) as a treatment strategy is not clear. So the present study aimed to assess the effects of PCI on regional and global left ventricular diastolic dysfunction in patients with CAD assessed by strain rate (SR) imaging. Methods: Thirty adult symptomatic patients with coronary artery disease that underwent coronary angiography and candidate for PCI on left anterior descending artery were enrolled to our study. Echocardiographic findings and early diastolic SR were measured before and 48 hours after PCI. Results: Mean age of the patients was 59.9 ± 8.3 years. Most of the left ventricular diastolic parameters showed significant difference before and after elective PCI; while mitral E velocity, DT, E/A and pulmonary vein flow before and after PCI did not show significant difference assessed by statically test. Also before PCI, mean (SD) of peak early diastolic SR in ischemic regions (1.89 ± 0.22) was smaller than of non-ischemic regions (2.53 ± 0.26) while after PCI this parameter became similar in ischemic regions (2.55 ± 0.27) and non-ischemic regions (2.55 ± 0.26). Conclusion: Most of the left ventricular diastolic parameters improved after PCI in CAD patients. Also regional myocardial relaxation as measured by peak early diastolic SR (ESR) in the ischemic segments improved significantly compared with that in non-ischemic segments.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Bayat, F. , Farahani, E. and Saadat, H. (2014) The Effect of Percutaneous Coronary Intervention on Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease Assessed by Strain Rate Imaging. World Journal of Cardiovascular Diseases, 4, 522-529. doi: 10.4236/wjcd.2014.410063.

References

[1] Tanaka, H., Kawai, H., Tatsumi, K., et al. (2006) Improved Regional Myocardial Diastolic Function Assessed by Strain Rate Imaging in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention. Journal of the American Society of Echocardiography, 19, 756-762.
http://dx.doi.org/10.1016/j.echo.2006.01.008
[2] Fischer, M., Baessler, A., Hense, H.W., et al. (2003) Prevalence of Left Ventricular Diastolic Dysfunction in the Community. Results from a Doppler Echocardiographic-Based Survey of a Population Sample. European Heart Journal, 24, 320-328.
http://dx.doi.org/10.1016/S0195-668X(02)00428-1
[3] Betocchi, S. and Hess, O. (2000) LV Hypertrophy and Diastolic Heart Failure. Heart Failure Reviews, 5, 333-336.
http://dx.doi.org/10.1023/A:1026559113044
[4] Hunt, S.A., Baker, D.W., Chin, M.H., Cinquegrani, M.P., Feldman, A.M., Francis, G.S., Ganiats, T.G., Goldstein, S., Gregoratos, G., Jessup, M.L., Noble, R.J., Packer, M., Silver, M.A., Stevenson, L.W., Gibbons, R.J., Antman, E.M., Alpert, J.S., Faxon, D.P., Fuster, V., Gregoratos, G., Jacobs, A.K., Hiratzka, L.F., Russell, R.O., Smith Jr., S.C., American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure); International Society for Heart and Lung Transplantation; Heart Failure Society of America (2001) ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary a Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration with the International Society for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America. Circulation, 104, 2996-3007.
http://dx.doi.org/10.1161/hc4901.102568
[5] Taylor, R.S., Brown, A., Ebrahim, S., et al. (2004) Exercise-Based Rehabilitation for Patients with Coronary Heart Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials. American Journal of Medicine, 116, 682-692.
http://dx.doi.org/10.1016/j.amjmed.2004.01.009
[6] Andersen, H.R., Nielsen, T.T., Rasmussen, K., et al. (2003) A Comparison of Coronary Angioplasty with Fibrinolytic Therapy in Acute Myocardial Infarction. The New England Journal of Medicine, 49, 733-742.
http://dx.doi.org/10.1056/NEJMoa025142
[7] Cayly, M., Usal, A., Demir, M., et al. (2007) The Effect of Successful Elective Percutaneous Coronary Intervention on Left Ventricular Functions Assessed with Tissue Doppler Imaging Method. Tanysal ve Giritimsel Radyoloji Dergisi, 11, 146-150.
[8] Tumuklu, M., Kayikcioglu, M., Aliyev, E., et al. (2003) Evaluation of Early Alterations in Transmitral Diastolic Flow and Tissue Doppler Findings of the Basal Segments of Both Ventricles in Early Period after Coronary Angioplasty. Anadolu Kardiyoloji Dergisi, 3, 16-23.
[9] Rashid, H., Abdel-Moniem, A., Email, S. and El-Batran, M. (2012) Evaluation of Myocardial Function in Patients with Chronic Stable Angina and Apparent Normal Ventricular Function (Tissue Doppler Study before and after PCI). Heart Mirror Journal, 6, 141-147.
[10] Hueb, J.C., Hepner, A., Hueb, R.A.S, Okoshi, K., Zanati, S.G. and Matsubara, B.B. (2011) Percutaneous Coronary Intervention Improves Left Ventricular Diastolic Function in Patients with Stable Angina? Revista Brasileira de Ecocardiografia e Imagem Cardiovascular, 24, 29-34.
[11] Hashemi, S.R., Motamedi, M., Khani, M., Hekmat, M., Gachkar, L. and Rezaeefar, A. (2010) Evaluation of the Effect of Elective Percutaneous Coronary Intervention as a Treatment Method on the Left Ventricular Diastolic Dysfunction in Patients with Coronary Artery Disease. Journal of Tehran Heart Center, 5, 194-198.
[12] Ishii, K., Suyama, T., Imai, M., Maenaka, M., Yamanaka, A., Makino, Y., et al. (2009) Abnormal Regional Left Ventricular Systolic and Diastolic Function in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention. Journal of the American College of Cardiology, 54, 1589-1597.
http://dx.doi.org/10.1016/j.jacc.2009.06.030
[13] Marwick, T.H. (2006) Measurement of Strain and Strain Rate by Echocardiography: Ready for Prime Time? Journal of the American College of Cardiology, 47, 1313-1327.
http://dx.doi.org/10.1016/j.jacc.2005.11.063
[14] Djordjevic-Dikic, A. (2011) Echocardiographic Measurements Promising for Predicting Improvement after Elective PCI. Journal of the American Society of Echocardiography, 24, 573-581.
[15] Sampat, U., Prasad, A., Mahmud, E., Ilapakurti, M., Palakodeti, V. and DeMaria, A.N. (2011) Evidence of Ischemic Memory from Strain Rate Analysis of Diastolic Function during/after Percutaneous Coronary Intervention. Circulation, 124, A16710.
[16] Manda, A.K., Chowdhury, A.H.K., Choudhury, A.K., Monwarul Islam, A.K.M. and Guha, B. (2012) Echocardiographic Evaluation of Left Ventricular Diastolic Function after Percutaneous Coronary Intervention in Patients with Coronary Artery Disease. Cardiovascular Journal, 4, 127-131.
[17] Shemirani, H., Karimi, K. and Madad, R. (2012) Evaluation of Early Alterations in Transmitral Diastolic Flow and Tissue Doppler Imaging Findings of the Septal and Lateral Segments of the Left Ventricle in the Early Period after Coronary Angioplasty. ARYA Atherosclerosis Journal, 7, S13-S16.
[18] Sipic, T., Stambuk, K., Trbovic, A., Kapov-Svilicic, K., Szavits-Nossan, J. and Bernat, R. (2013) Echocardiographic Assessment of Revascularization Completeness Impact on Diastolic Dysfunction in Ischemic Heart Disease. Collegium Antropologicum, 37, 1299-1305.
[19] Abhayaratna, W.P., Srikusalanukul, W. and Budge, M.M. (2008) Aortic Stiffness for the Detection of Preclinical Left Ventricular Diastolic Dysfunction: Pulse Wave Velocity versus Pulse Pressure. Journal of Hypertension, 26, 758-764.
http://dx.doi.org/10.1097/HJH.0b013e3282f55038
[20] Redfield, M.M., Jacobsen, S.J., Burnett Jr., J.C., Mahoney, D.W., Bailey, K.R. and Rodeheffer, R.J. (2003) Burden of Systolic and Diastolic Ventricular Dysfunction in the Community: Appreciating the Scope of the Heart Failure Epidemic. JAMA, 289, 194-202.
http://dx.doi.org/10.1001/jama.289.2.194
[21] Voigt, J.U., Lindenmeier, G., Werner, D., Flachskampf, F.A., Nixdorff, U., Hatle, L., Sutherland, G.R. and Daniel, W.G. (2002) Strain Rate Imaging for the Assessment of Pre-load-Dependent Changes in Regional Left Ventricular Diastolic Longitudinal Function. Journal of the American Society of Echocardiography, 15, 13-19.
http://dx.doi.org/10.1067/mje.2002.116536
[22] Stoylen, A., Slordahl, S., Skjelvan, G.K., Heimdal, A. and Skjaerpe, T. (2001) Strain Rate Imaging in Normal and Reduced Diastolic Function: Comparison with Pulsed Doppler Tissue Imaging of the Mitral Annulus. Journal of the American Society of Echocardiography, 14, 264-274.
http://dx.doi.org/10.1067/mje.2001.110375
[23] Hashimoto, I., Li, X., Hejmadi Bhat, A., Jones, M., Zetts, A.D. and Sahn, D.J. (2003) Myocardial Strain Rate Is a Superior Method for Evaluation of Left Ventricular Subendocardial Function Compared with Tissue Doppler Imaging. Journal of the American College of Cardiology, 42, 1574-1583.
http://dx.doi.org/10.1016/j.jacc.2003.05.002
[24] Cosson, S. and Kevorkian, J.P. (2003) Left Ventricular Diastolic Dysfunction: An Early Sign of Diabetic Cardiomyopathy? Diabetes & Metabolism, 29, 455-466.
http://dx.doi.org/10.1016/S1262-3636(07)70059-9
[25] Diller, G.P., Wasan, B.S., Thom, S.A., Foale, R.A., Hughes, A.D., Francis, D.P. and Mayet, J. (2009) Evidence of Improved Regional Myocardial Function in Patients with Chronic Stable Angina and Apparent Normal Ventricular Function—A Tissue Doppler Study before and after Percutaneous Coronary Intervention. Journal of the American Society of Echocardiography, 22, 177-182.
http://dx.doi.org/10.1016/j.echo.2008.10.018
[26] Yamamoto, K., Nishimura, R.A., Chaliki, H.P., Appleton, C.P., Holmes Jr., D.R. and Redfield, M.M. (1997) Dermination of Left Ventricular Filling Pressure by Doppler Echocardiography in Patients with Coronary Artery Disease: Critical Role of Left Ventricular Systolic Function. Journal of the American College of Cardiology, 30, 1819-1826.
http://dx.doi.org/10.1016/S0735-1097(97)00390-2
[27] Ommen, S.R., Nishimura, R.A., Appleton, C.P., Miller, F.A., Oh, J.K., Redfield, M.M., et al. (2000) Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures: A Comparative Simultaneous Doppler-Catheterization Study. Circulation, 102, 1788-1794.
http://dx.doi.org/10.1161/01.CIR.102.15.1788
[28] Kasner, M., Westermann, D., Steendijk, P., Gaub, R., Wilkenshoff, U., Weitmann, K., et al. (2007) Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Diastolic Function in Heart Failure with Normal Ejection Fraction: A Comparative Doppler-Conductance Catheterization Study. Circulation, 116, 637-647.
http://dx.doi.org/10.1161/CIRCULATIONAHA.106.661983
[29] Derumeaux, G., Mouton-Schleifer, D., Redonnet, M., Cribier, A., Soyer, R. and Letac, B. (1998) Blood Flow in the Isovolumetric Relaxation Phase in Heart Transplant Patients. Its Use in the Noninvasive Diagnosis of Acute Rejection. Archives des Maladies du Coeur et des Vaisseaux, 91, 731-738.
[30] Nozari, Y., Oskouei, N.J. and Khazaeipour, Z. (2012) Effect of Elective Percutaneous Coronary Intervention on Left Ventricular Function in Patients with Coronary Artery Disease. Acta Medica Iranica, 50, 26-30.
[31] Ha, S.J., Kim, S.H., Kim, J.B., Kim, S.J., Kim, W. and Kim, W. (2012) Improvement in Regional Myocardial Function Assessed by Strain Rate Imaging in Patients who had Coronary Artery Disease but Normal Wall Motion Undergoing Percutaneous Coronary Intervention. Circulation, 126, A17807.

  
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