scholarly journals Study of left ventricular diastolic function following percutaneous coronary intervention for left anterior descending coronary artery disease in patients with normal left ventricular systolic function

2015 ◽  
Vol 67 ◽  
pp. S66
Author(s):  
Shaikh Zohaib Farooque ◽  
Khedkar Umesh ◽  
Gavade Sachin ◽  
Patil Ganesh ◽  
Ajaykumar Mahajan ◽  
...  
2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Min-Kyung Kang ◽  
Soo Ho Kim ◽  
Jaehuk Choi ◽  
Hee-Sun Mun ◽  
Seonghoon Choi ◽  
...  

Background: Left ventricular (LV) diastolic dysfunction occurs before LV systolic dysfunction and electrocardiographic changes in ischemic cascade. Diastolic wall strain (DWS) has been proposed as a marker of LV diastolic stiffness. Therefore, the objectives of this study were to defined the relationship between DWS and percutaneous coronary intervention (PCI) and see other echocardiographic parameters in patients who undergoing coronary angiography (CAG). Methods: 254 patients (mean age: 61 ± 10, 136 (54%) men) undergoing CAG and normal left ventricular systolic function without regional wall motion abnormalities were enrolled, and among them, 68 (27%) patients performed PCI. All patients performed echocardiography before CAG and DWS defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS =[PWT(systole)-PWTdiastole)]/PWT(systole)). Results: Patients who performed PCI showed significantly lower DWS (0.27 ± 0.09 vs. 0.39 ± 0.08, p < 0.001). Age did not differ between the two groups (61.6 ± 10.6 vs. 60.9 ± 10.4, p = 0.623), and LV ejection fraction was also similar (62.8 ± 4.6 vs. 63.5 ± 5.2%, p = 0.380). Other echocardiographic parameters did not show significance differences but E/E’ ratio was slightly but significantly elevated in patients performed PCI (10.9 ± 4.8 vs 9.2 ± 3.3, p = 0.011). In multiple regression analysis, lower DWS was an independent predictor for PCI (Cut-off value: 0.34, sensitivity: 89%, AUC: 0.870, SE: 0.025, p < 0.001). Conclusion: DWS, a simple parameter that can be calculated from routine 2D echocardiography, is inversely associated with presence of coronary artery disease and PCI.


2015 ◽  
Vol 8 (1) ◽  
pp. 270 ◽  
Author(s):  
Nahid Salehi ◽  
Mohammadreza Saidi ◽  
Alireza Rai ◽  
Farid Najafi ◽  
Seedmokhtar Javeedannejad ◽  
...  

<p><strong>BACKGROUND:<em> </em></strong>There is considerable disagreement over the effects of percutaneous coronary intervention (PCI) on left ventricular diastolic function that has necessitated the investigation of diastolic indices. The present study was conducted to evaluate left ventricular diastolic function and its indices, three months after performing the PCI procedure in patients with coronary artery disease (CAD).</p> <p><strong>METHODS:<em> </em></strong>In a quasi-experimental clinical trial study (before and after), 51 patients with CAD scheduled for elective PCI were investigated provided that their Ejection Fraction (EF) was &gt; 30%. Before and three months after PCI, echocardiography was carried out to evaluate left ventricular diastolic indices including the E/Ea as the most important criteria for diagnosis of diastolic heart failure (DHF).<strong></strong></p> <p><strong>RESULTS:<em> </em></strong>Based on the E/Ea indices and after PCI, the number of patients with DHF decreased significantly: 40 patients (78.4%) before PCI versus 28 patients (54.9%) after PCI (p&lt;0.05). The Mean and Standard error of deceleration time (DT), isovolumic relaxation time (IVRT), early diastolic mitral annulus velocity; Ea (E'), E/Ea and left ventricular ejection function (LVEF) indices underwent significant changes. In addition, MVA dur/PVA dur, PVs/PVd, and E/Ea indices had changed significantly after PCI in both genders. However, no significant difference was reported for the other indices.</p> <p><strong>CONCLUSION:<em> </em></strong>The E/Ea ratio as an important criterion for diagnosis of DHF was improved after PCI. Improvement of several other diastolic indices was observed after the PCI procedure. It can be concluded that PCI can be an effective treatment modality in patients with left ventricular diastolic indices.</p>


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Xinyu Wang ◽  
Haiyi Yu ◽  
Zhaoping Li ◽  
Liuning Li ◽  
Youyi Zhang ◽  
...  

Inflammation plays an important role in plaque development and left ventricular remodeling during acute myocardial infarction (AMI). Clopidogrel may exhibit some anti-inflammatory properties and high loading dose of clopidogrel results in improved clinical outcomes in patients with AMI. 357 patients who received successful primary percutaneous coronary intervention from January 2008 to March 2011 in Peking University Third Hospital were included in this study. Different loading dose of clopidogrel (300 mg, 450 mg, or 600 mg) was given at the discretion of the clinician. Neutrophils reached their peak values on the first day after AMI. Higher levels of peak neutrophil and lower left ventricular ejection fraction (LVEF) were found in patients of low clopidogrel loading dose group (300 mg or 450 mg). After adjusting for the related confounders, a logistic regression model showed that low clopidogrel loading dose remained an independent predictor of low LVEF (LVEF ≤ 50%) [OR: 1.97, 95% CI: 1.03–3.79,P= 0.04]. Low clopidogrel loading dose was associated with higher peak neutrophil count and poor left ventricular systolic function, suggesting an important role of clopidogrel loading dose in the improvement of left ventricular function and high loading dose may exhibit better anti-inflammatory properties.


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