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

Abstract

Background:The experiments show that pre-ejection velocity analysis is particularly sensitive to blood flow. After reduced regional perfusion, tissue velocities drop, but they rise with reperfusion. Thus, following revascularization, cardiac function recovery may be predicted using tissue doppler imaging (TDI). Objective: The aim of the current work was to determine the effectiveness of tissue Doppler imaging echocardiography in predicting the restoration of myocardial function in patients with coronary artery disease (CAD) following percutaneous coronary revascularization. Patients and Methods: Our study prospectively enrolled 27 patients. Only 24 patients completed the study protocol while, unfortunately, three died during follow up. Included patients were diagnosed with CAD based on previous diagnostic coronary angiography (CA) done before. They have impaired systolic function and regional wall motion abnormality (RWMA) on transthoracic echocardiography (TTE) and were eligible for percutaneous coronary intervention (PCI).Results: From all Tissue Doppler Imaging-Pulsed wave (TDI-PW) derived parameters, only mean IVCPv and mean S wave velocity of dysfunctional segments at baseline correlate significantly with changes in LVEF (global functional recovery) with revascularization. The mean of both IVCPv and the S wave of defective segments varied significantly at baseline among patients who showed significant improvement in LVEF 6 months after revascularization versus those patients who didn't exhibit significant improvement (2.8±0.4 vs. 3.5±0.8 for IVCPv, and 4.5±0.9 vs 5.8±1.1 for S wave, p value <0.05 and <0.01 respectively). There was significant moderate positive correlation between mean IVCPv and mean S wave velocity at baseline and changes in LVEF (global functional recovery) with revascularization (p value<0.05 and <0.01 respectively). Conclusions: It could be concluded that in patients with CAD, the resting IVCPv & S wave by TDI pattern accurately predicts the recovery of global systolic function with high pulse pressure variation (PPV) but not the regional function.