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[Noninvasive determination of left ventricular diastolic filling parameters using Doppler echocardiography before and
M Jeserich1, K Ruffmann, W Kübler
1Abteilung Innere Medizin III (Kardiologie, Angiologie), Pulmonologie, Medizinische Universitätsklinik Heidelberg.
Insights
Successful percutaneous coronary angioplasty (PTCA) significantly improves left ventricular diastolic filling in patients with coronary heart disease. These improvements are more pronounced 24 hours after PTCA compared to 3 hours post-procedure.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Context:
- Diastolic dysfunction is a key indicator of myocardial ischemia.
- Percutaneous coronary angioplasty (PTCA) is a common intervention for coronary heart disease (CHD).
Purpose:
- To investigate the impact of successful PTCA on left ventricular diastolic filling in patients with CHD.
- To assess changes in diastolic filling parameters before and after PTCA using 2D Doppler echocardiography.
Summary:
- 40 CHD patients underwent 2D Doppler echocardiography before and after PTCA.
- Successful PTCA (n=34) led to significant improvements in diastolic filling parameters, including peak early diastolic velocity (E) and E/A ratio.
- Improvements were more pronounced in patients with pre-existing diastolic impairment and became more evident 24 hours post-procedure.
Impact:
- PTCA effectively enhances left ventricular diastolic function in CHD patients.
- The positive effects on diastolic filling are sustained and amplified up to 24 hours post-intervention.
- This study highlights the therapeutic benefits of PTCA for diastolic dysfunction in coronary artery disease.
Abstract:
Impaired ventricular diastolic filling may be an early sign of myocardial ischemia. To study the influence of coronary angioplasty (PTCA) on diastolic filling, 40 patients with coronary heart disease (CHD) were studied by pulsed two-dimensional Doppler echocardiography (2DDE) before and after PTCA. In six patients PTCA was not successful and 2DDE indices of ventricular filling did not change significantly. In 34 patients with successful PTCA, peak early diastolic velocity (E) increased by 8.5% (p less than 0.03), the ratio (E/A) of peak early vs peak late diastolic velocity by 11.2% (p less than 0.005) and the diastolic filling time per minute (diast.-t/min) by 4.6% (p less than 0.01). In patients with impaired diastolic filling before PTCA (group I, n = 28) the changes in diastolic filling were even more pronounced. Patients with unimpaired diastolic filling properties before PTCA did not show significant alterations (group II, n = 6). Seventeen patients were examined 3 h and 24 h after PTCA. The changes in diastolic filling parameters apparent already 3 h after PTCA were even more pronounced after 24 h. According to these data, PTCA improves left ventricular diastolic filling. These changes are more pronounced 24 h compared to 3 h after PTCA.