The effect of successful percutaneous transluminal coronary angioplasty on left ventricular functions assessed with tissue doppler imaging method

ABSTRACT THE EFFECT OF SUCCESSFUL PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY ON LEFT VENTRICULAR FUNCTIONS ASSESSED WITH TISSUE DOPPLER IMAGING METOD Reperfusion after percutaneous transluminal coronary angioplasty (PTCA) has been shown to improve the global and regional systolic and diastolic functions of left ventricle. Tissue Doppler Imaging (TDI) is a new non-invasive technique that allows assessing quantitatively the global and regional ventricular systolic and diastolic function. The aim of the present study was to evaluate the effects of ischemia on left ventricular functions in patients who underwent elective PTCA and also to determine the effects of successful PTCA on left ventricular functions by using TDI method. Forty-one patients (29 men, 12 women, mean age: 56.0±7.3) who underwent elective PTCA of major and one coronary artery were studied. Patients were divided into three groups according to coronary artery PTCA performed; left anterior descending artery (LAD) (Group 1), circumflex artery (Group 2) and right coronary artery (Group 3). Routine echocardiographic examination (2D, M-Mode, color Doppler, PW Doppler and CW Doppler) and TDI were performed in all patients. All examinations were done before PTCA and 24 hours after PTCA and 3 months after PTCA. There were 13 patients in Group 1, 14 patients in Group 2 and 14 patients in Group 3. There was no significant difference in global systolic and diastolic function of left ventricle at 24 hours after PTCA and 3 months after PTCA in all patients. Regional S wave increased at 24 hours after PTCA only in Group 1 patients (p=0.004). Although S wave tended to increase at 3 month after PTCA in all groups, there was no significant S wave change when compared with before PTCA (p>0.05). In Group 1 patients, there was no significant change in E and A wave at 24 hours after PTCA (p>0.05), but significant reduction in A wave at 3 months after PTCA was observed (p=0.02). In Group 2 patients, there was no significant change in E and A wave at 24 hours after PTCA (p>0.05), but significant increase in E wave (p=0.03) and significant reduction in A wave (p=0.02) at 3 months after PTCA was established. In Group 3 patients, we couldn't determine any change in E and A waves at both 24 hours and 3 months after PTCA (p>0.05). In conclusion improvement of regional systolic function was observed only in Group 1 patients and only at 24 hours after successful PTCA. Although no significant change was present at 24 hours, improvement of regional diastolic function occurred at 3 months after PTCA. Key Words: Percutaneous transluminal coronary angioplasty, tissue Doppler imaging VI