P033 * Evaluation of myocardial function in patients with chronic stable angina and apparent normal ventricular function (tissue doppler study before and after PCI)

Abstract

Objective: It has been reported that impaired left ventricular longitudinal function may precede circumferential ventricular dysfunction in patients with coronary artery disease. This study is to determine the impact of PCI on myocardial function assessed by tissue Doppler echocardiography in patients with chronic stable angina. Method: Twenty-five consecutive patients with chronic stable angina and preserved systolic LV function (EF%. 50%) underwent PCI were studied by pulsed wave tissue Doppler at different time intervals before and after PCI. All patients were subjected to the following: Full history and physical examination, ECG, Echocardiography before PCI to evaluate baseline systolic & diastolic function as well as 1 day&6 weeks after intervention, and pulsed-wave tissue Doppler Echo was done before PCI, as well as 1 day&6 weeks after intervention to detect mitral and tricuspid inflow velocities, including E and A wave peak velocities (in centimeters per second). Result: We found that systolic myocardial peak velocities improved significantly after PCI in the septal, lateral, anterior, posterior, and inferior walls(P < 0.001 for each) by tissue Doppler imaging while non detected by conventional Echo. There was a significant increase of E'A' ratio at anterior angle of mitral valve annulus and lateral angle of tricuspid valve annulus.(p= 0.02 for both),also The right ventricle showed significant improvement in tissue Doppler measures of systolic function, early, and late diastolic function 1day &6 weeks after PCI compared with baseline values (P< .001),While non detected by conventional Echo. Conclusion: Tissue Doppler Echo. is a noninvasive and widely available diagnostic technique that allows the sensitive detection of right & left myocardial dysfunction.