A study of changes in various echocardiographic parameters in patients with chronic stable angina undergoing percutaneous coronary intervention (PCI)

Abstract

Introduction:The basis of pathophysiologic benefit of revascularization is improving the function of viable myocardium 37 . Early coronary re-canalization helps to survive the viable myocardium and improve global LV function and survival 46 . According to the studies in patients with CAD and LV dysfunction, the disease outcome can be improved with surgical revascularization (CABG) or PCI 37 . PCI in patients with preserved LV function and optimal medical therapy doesn't reduce the cardiac death and MI, but it decreases the need for other procedure and the risk of angina. Its effect on LV systolic or diastolic function is not clear 31 . PCI has been used increasingly for revascularization in ischemic heart disease (IHD) patients. In most of the studies, the primary PCI, criterion such as ejection fraction (EF), diastolic function and the wall motion or chamber sizes has been investigated. But result of previous studies in related area, about elective PCI, has shown unequal viewpoints 1,6,13,27,30,32,39,41 . Intervals between MI and PCI, basic left ventricular ejection fraction (LVEF) before PCI and global condition of the patients affect the result of PCI. Angina occurs when there is regional myocardial ischemia caused by inadequate coronary perfusion and is usually but not always induced by A Study of Changes in Various Echocardiographic

Effect of elective percutaneous coronary intervention of left anterior descending coronary artery on regional myocardial function using strain imaging

“…A study done in 2013 by Hossain et al 25 on 40 patients with chronic stable angina, follow up was 48 h and 6 weeks later only, they found that strain and SR significantly increased at both 48 h and 6 weeks after PCI (P < .001) which means significant improvement of systolic function, and they concluded that strain and SR imaging can detect the early changes of improvement of the left ventricular myocardium in patients with chronic stable angina undergoing PCI even as early as 48 h after PCI but this conclusion is not in agreement with our study as we found no significant improvement in strain and SR values early after PCI up to 24 h and only the significant improvement was found in follow up after 3 months.…”

Evaluation of Myocardial Tissue Doppler Echocardiography as a Predictor for Recovery of Left Ventricular Function after Percutaneous Coronary Revascularization for Patients with Coronary Artery Disease

“…This came in agreement with another study El Shafey et al (4) who used tissue doppler imaging to assess LV function before and after PCI to chronic total occlusion. A third study by Hossain et al (22) showed substantial improvement in LVEF with an increase in LVEDD and LVESD following treatments from (54.3±5.8) to (56.2±4.7), p value (<0.001).…”

“…A considerable improvement in LV systolic function is related with effective coronary occlusion closure, by either reducing LV remodeling while maintaining LV function and providing collateral arteries that aid in regaining the contractility of the hibernating myocardium and provide protection against future occurrences, PCI of infarct associated arterial blockage might recover LVEF (22) .…”