Observation And Analysis Of Left Ventricular Systolic And Diastolic Function Before And After Percutaneous Coronary Intervention For Chronic Occlusive Disease Of Single Coronary Artery

Objective: To evaluate the left systolic and diastolic function related indexes before and after percutaneous coronary intervention(PCI)of single-vessel chronic complete occlusion of coronary artery(CTO)by echocardiography,and to observe and analyze the CTO lesions of different branches before and after interventional procedures.Whether there is a difference in the systolic and diastolic functions of the posterior left heart,to explore the application value of PCI in single-vessel CTO lesions.Methods:Collected patients in the Department of Cardiovascular Medicine of the First People’s Hospital of Chenzhou from December 2016 to July 2020.The patients were diagnosed as single-vessel CTO by coronary angiography(CAG),and the diseased blood vessels were successfully opened by PCI,and left A total of 104 patients with main disease were included in this study.They were divided into three groups,15 cases of left circumflex artery CTO,51 cases of right coronary artery CTO,and 38 cases of left anterior descending artery CTO.Collect the basic clinical data of the three groups of patients(including gender,age,history of previous myocardial infarction,history of diabetes,history of hypertension,history of smoking,family history,history of previous stroke,history of medications before and after admission,blood lipid levels,and creatinine levels),Preoperative and 6-12 months postoperative echocardiography results,comparative analysis of left ventricular systolic and diastolic function related parameters;among which echocardiogram(UCG)indicators include: left atrial volume index(LAVI),left ventricular ejection Score(LVEF),left ventricular end-diastolic diameter(LVEDd),left atrial inner diameter(LAd),early and late diastolic peak anterior mitral blood flow(peak E and peak A),E/A value,tricuspid reflex Peak flow velocity(TR),early diastolic velocity of the septal mitral annulus(e’sep),early diastolic velocity of the sidewall side of the mitral annulus(e’lat),and average velocity of early diastolic mitral annulus(e’mean),E/e’mean,to compare and analyze whether there are statistical differences in left ventricular systolic and diastolic function indexes between and within the three groups of patients.Results:(1)General clinical data of the three groups of single-vessel CTO patients(gender,age,previous history of myocardial infarction,history of diabetes,history of hypertension,history of smoking,family history,history of previous stroke,history of medications before and after admission,blood lipid levels,creatinine levels)and Preoperative echocardiographic indicators(LVEF,LVEDd,LAd,LAVI,E peak,A peak,E/A ratio,TR,e’sep,e’lat,e’mean,E/e’mean)were not statistically significant difference.(2)LAD-CTO group: LVEF,e’sep,and e’lat of echocardiogram at 6-12 months after PCI increased compared with preoperative;LVEDd,LAd,LAVI decreased compared with before PCI,the difference was statistically significant(P<0.05).E peak,A peak,E/A ratio,e’mean,E/e’mean,TR were not significantly different from those before PCI.(3)LCX-CTO group: E’sep and e’lat of the echocardiogram of patients 6-12 months after PCI were higher than before PCI,and LAVI was lower than before PCI,P<0.05,the difference was statistically significant;LVEF,LVEDd,There was no significant difference in LAd,E peak,A peak,E/A ratio,TR,e’mean,E/e’mean.(4)RCA-CTO group: LVEF,e’sep,e’lat parameters were higher than that before operation 6-12 months after PCI,while LAVI was lower than before operation,the difference was statistically significant(P<0.05);after PCI The E peak,A peak,LVEDd,LAd,E/A,TR,e’mean,E/e’mean at 6-12 months were not significantly different from those before the operation(P>0.05).(5)Comparison of the three groups of echocardiographic parameters in single-vessel CTO patients 6-12 months after PCI,the increase of E peak,e’sep,and e’lat in the RCA-CTO group was more obvious than that in the LCX-CTO group,and the RCA-CTO group was operated The decrease of LAVI was more obvious than that of LCX-CTO,P<0.05,there was no significant difference among the three groups of LVEF,LVEDd,LAd,peak A,E/A ratio,TR,e’mean,and E/e’mean.Conclusion:(1)The left ventricular systolic and diastolic functions of patients with single LAD-CTO and single RCA-CTO improved after PCI.(2)Left ventricular diastolic function improved after PCI in single-vessel LCX-CTO patients,but systolic function may not be significantly improved.