Assessment The Changes Of Left Ventricular Diastolic Function In Patients After Percutaneous Coronary Intervention Using Real-time Three-dimensional Echocardiography

Backgroud? Coronary artery disease (CAD) is a very common cardiovascular disease. Percutaneous coronary intervention (PCI) is a treatment of CAD. After PCI, the improvement of left ventricular (LV) diastolic function is closed to the treatment effect of the operation. Pulsed-wave Doppler blood flow of mitral valve as common method of the evaluation on LV diastolic function can appear pseudo-normal situation sometimes. To evaluate LV diastolic function using diastolic mitral annular velocity by Doppler tissue imaging (DTI), it is more accurate and saitivity than plused-wave Doppler blood flow of mitral valve. Real-time three-dimensional echocardiography (RT-3DE), as a novel technique, is an ideal tool for the measurement of LV volume because no geometric assumptions about LV shape are needed. Therefore, it can obtain accurate result although LV cavity is deformed or its wall motion is abnormal.Objective To evaluate the effects of PCI on LV diastolic function in patients with CAD via RT-3DE. To explore the clinical value of RT-3DE in assessment of LV diastolic function before and after PCI.Methods 25 patients with CAD who at least had stenosis more than 70 percent at one vessel coronary artery underwent PCI during 2008.5-2009.1 in Shanxi Cardiovascular Hospital. 15 patients was normal control. All patients before and after PCI 7d, 3 months, 6 months, and health subjects, were tested using pulsed-wave Doppler blood flow of mitral valve, DTI and RT-3DE by turns. E, A, E/A, Ea, Aa, Ea/Aa and PFR were measured and analyzed.Results (1) Compared with the normals, all parameters varied significantly before PCI in patients with CAD (P<0.05). (2) Significant change of all parameters were not found during 0 and 7d after PCI (P>0.05). (3) E/A changed significantly in 6 months after PCI (P<0.05). (4) Compared with that of before PCI, Ea, Ea/Aa got significant improvements during 3 months and 6 months after PCI (P<0.05). (5) There were significant statistics differences between before and after PCI during 3 months and 6 months with PFR (P<0.05).Conclusions (1) No significant change of LV diastolic function was found during the short time after PCI. PCI can improve LV diastolic function after a long time of the operation. (2) VTC parameter PFR derived from RT-3DE can assess LV diastolic function.