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Parameters of left ventricular diastolic function 48 hours after coronary angioplasty and stent implantation
Christiana M Schannwell1, Markus Schneppenheim, Gunnar Plehn
1Clinic of Cardiology, Pneumology and Angiology, Heinrich-Heine University Duesseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany. schannw@uni-duesseldorf.de
Insights
Coronary stenting significantly improves left ventricular diastolic function within 48 hours compared to balloon angioplasty alone. This enhanced anti-ischemic effect is attributed to the scaffolding properties of stents, offering a more immediate benefit.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Physiology
Background:
- Coronary stent implantation shows earlier improvement in coronary flow reserve than balloon angioplasty.
- The impact of stenting on left ventricular systolic and diastolic function remains under-investigated.
- This study aimed to compare diastolic dysfunction changes between stenting and conventional angioplasty.
Purpose of the Study:
- To determine if stent implantation leads to greater improvements in left ventricular diastolic function compared to balloon angioplasty alone.
- To evaluate the short-term hemodynamic changes in left ventricular function post-intervention.
Main Methods:
- Doppler echocardiography assessed diastolic function in 194 patients with single-vessel disease.
- Patients underwent either elective coronary angioplasty (116) or angioplasty with stenting (78).
- Left ventricular diastolic function and ejection fraction were measured before and 48 hours after intervention.
Main Results:
- No significant differences in baseline characteristics were observed between the angioplasty and stenting groups.
- Patients receiving stents showed early improvement in left ventricular diastolic function 48 hours post-intervention.
- Patients treated with angioplasty alone did not exhibit significant short-term improvement in diastolic function.
Conclusions:
- Stent implantation significantly improves left ventricular diastolic function compared to conventional balloon angioplasty.
- The enhanced anti-ischemic effectiveness, due to stent scaffolding, likely accounts for the immediate functional improvement.
- Stenting offers a more immediate benefit for diastolic dysfunction than angioplasty alone.
Introduction:
It has been reported that stent implantation results in an earlier and more pronounced improvement of coronary flow reserve in comparison to conventional balloon angioplasty. Whether this phenomenon translates into hemodynamic changes of left ventricular systolic and diastolic function has not been investigated. This study was designed to determine whether stenting leads to greater changes in measures of diastolic dysfunction than plain angioplasty alone.
Methods:
Parameters of diastolic function were ascertained by Doppler echocardiography in 194 patients with single-vessel disease before and 48 hours after elective coronary angioplasty. A total of 116 patients were initially successfully treated with coronary angioplasty. In 78 patients, stents were used to improve an inadequate result after coronary angioplasty. The parameters of left ventricular diastolic function were evaluated before and 48 hours after coronary intervention by Doppler echocardiography. Ejection fraction was determined and used to characterize systolic left ventricular function.
Results:
Both patient groups (116 patients with coronary angioplasty, 78 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after intervention. Surprisingly, there was no significant short-term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.
Conclusion:
Stent implantation results in improved left ventricular diastolic function in comparison to conventional balloon angioplasty. This has to be attributed to a more immediate and increased antiischemic effectiveness due to the scaffolding properties of stents.