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Abstract

Background: Although
percutaneous coronary intervention (PCI) is an excellent therapy for coronary

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artery disease,
there is a paucity of information on the efficacy of PCI in improving diastolic

function,
especially in Bangladesh. Because of the high prevalence of left ventricular
diastolic

dysfunction in
coronary artery disease patients and its probable progression to heart failure,
an

evaluation of the
role of PCI in improving diastolic function is required. Objective of the study
was

to evaluate the
impact of percutaneous coronary intervention on left ventricular diastolic
dysfunction

by Doppler
echocardiography in patients with coronary artery disease.

Methods: One hundred
patients scheduled for elective PCI were enrolled in this study whose left

ventricular
systolic ejection fraction was normal or only mildly abnormal. Before PCI and
48 hours

after PCI,
echocardiography was done to evaluate the indices of LV diastolic function in
these

patients.

Results: The mean age of
the patients was 52 ± 8.6 years, and 90 patients were male. All had mild to

moderate degree of
left ventricular diastolic dysfunction. Mitral E wave velocity (58.8 cm/s ±
11.8

before treatment
versus 78.1 cm/s ± 13.9, 48 hours after treatment), the peak velocity of late
filling

due to atrial
contraction (mitral A wave velocity) (76.6 cm/s± 13.5 before treatment vs.
67.7cm/s ±

15.2 , 48 hours
after treatment) , E/A ratio (0.81± 0.25 before treatment vs. 1.2 ± 0.31 , 48
hours after

treatment) showed
improvement after PCI. After PCI deceleration time (DT) decreased (245.6msec

±41.6 before
treatment versus 175.5msec ± 31.9, 48 hours after treatment), and the
difference was

statistically
significant (p 50% 49 49.0

Mean±SD 52.89±7.8

Range 36%-73%

Table III showed that left ventricular
ejection

fraction (LVEF%) 30%-50% was found in
51

patients and left ventricular ejection
fraction

(LVEF%) >50% was found in 49
patients. Mean

percent of ejection fraction was
52.89±7.8 with

range from 36% to 73%.

Table IV

Distribution of
study populations by number of

coronary artery
involvement (n=100).

Vessel involved Study subjects

Number %

Single vessel disease (SVD) 39 39.0

Multi vessel disease 45 45.0

Double vessel disease (DVD)

Triple vessel disease (TVD) 16 16.0

Total 100 100.0

Table IV showed that double vessel
disease (DVD)

was found in 45% patients followed by
single vessel

disease (SVD) 39% patients, and triple
vessel

disease (TVD) 16% patients.

Fig.-1: Distribution of
the study populations by sex

(n=100).

Echocardiographic Evaluation of Left
Ventricular Diastolic Function

 

Table-V

Hemodynamic
Findings before and

after PCI
((n=100).

Haemodynamic Before PCI After PCI P value *

Parameters Mean ± SD Mean ± SD

Heart rate 69±9 72±12 0.57

Systolic BP 125±16 119±14 0.03

Diastolic BP 80.4±7.4 79.6±6.6 0.69

* Paired t test was done to
measure the level of significance.

Table V showed that there were no
significant

changes before and after PCI in heart
rate and

diastolic blood pressure. Systolic
blood pressure

decreased slightly after PCI from
125±16 to 119±14

(p

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