Influence Of Intracoronary Stenting To The Short-term Left Ventricular Function After Acute Myocardial

Objective Reperfusion therapy of acute myocardial infarction(AMI) is one of the most important evolvement to cure coronary heart disease. Lots of clinical studies show that early opening of occlusive coronary artery can help resume the forward flow of coronary artery, protect amort cardiac muscle, reduce infarction area, improve heart function and reduce mortality. Ordinary means for reperfusion therapy was limited to thrombolytic therapy and percutaneous coronary intervention (PCI), but the reopening ratio of thrombolytic therapy isn't high, only 50-70%, and after the direct PTCA, short-term acute occlusion and long-term restenosis are high. As an effective means of reperfusion, direct intracoronary stenting inaugurated a new therapy strategy for the treatment of acute myocardial infarction. However, there was few research about its influence to left ventricular function. This article aims to study the effect of intracoronary stenting by check the function of left ventricle with echocardiography and approve its feasibility and curative effect. Method Twenty-six patients with their first AMI were randomly divided into stent group(12 cases) and non-stent group(14 cases) and checked the size of left ventricular and indexes of left ventricular function by color Doppler echocardiography 2 and 4 weeks after myocardial infarction. Diastole function was determined by a new index-flow propagation velocity(FPV). Result After two weeks, exceptthe regional wall motion score index (RWSI) was lower markedly in stent group than the control group(1.25±0.28 versus 1.47±0.20,P=0.024), there were no significant differences with other indexes. After four weeks, Compared with control group, diameters of left ventricular end-diastole and end-systole in stent group reduced markedly (LVDd:50.6±3.37 versus 57.4±6.89mm,P=0.004; LVDs:34.9±5.2 versus 42.7±6.95mm P=0.0009); inner diameter of left atrium was smaller than control group (37.3±7.11对42.8±4.91mm P=0.015); EF was higher than control group markedly(58±8.5% versus 45.8±5.5% P=0.001); RWSI was lower than control group markedly (1.19±0.17 versus 1.52±0.29 P=0.005); FPV was higher than control group markedly(49.4±8.40cm/s versus 39.5±5.6cm/s P=0.009); the weight index of left ventricular was lower than control group markedly(111.6 ±17.5 g/m2 versus 128.4±24.3g/m2 P=0.033). Conclusion 1. Stenting is a safe and effective intervention therapy to reopen coronary artery, increase the coronary flow, maintain normal heart function in the early stage of AMI. 2. Stenting in the early stage of AMI can improve the contracting and diastole function markedly. 3. Stenting in the early stage of AMI can prevent and cure the remolding of left ventricular. 4. Measuring FPV with color M-mode Doppler echocardiography is a new index which can evaluate the diastole function of left ventricular exactly.