COLOR DOPPLER STUDY OF MITRAL REGURGITATION DURING PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Mitral regurgitation (MR) was evaluated by color Doppler echocardiogra phy during percutaneous transluminal coronary angioplasty (PTCA) in 28 patients with one-vessel coronary artery disease (left anterior desce nding artery in 11, right coronary artery in 8, and circumflex artery in 9) and normal left ventricular function. In all three groups, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI ) decreased significantly during artery occlusion in comparison with b aseline values (no differences among various groups). Anterior and inf erior akinesia/dyskinesia was observed in all patients during left ant erior descending and right coronary artery occlusion, respectively. La teral akinesia/dyskinesia was induced by occlusion of the circumflex a rtery in six patients (all with proximal lesions [p < 0.05 vs the othe r two groups]) and the right coronary artery in one. Only the six pati ents with circumflex artery occlusion showed PTCA-related MR (> 2+ in two). LVEF and WMSI were similar during artery occlusion in patients w ith and without MR. Neither mitral leaflet prolapse nor anulus dilatio n occurred during PTCA in any of the patients. Our data show that duri ng brief occlusion of the proximal circumflex artery, functional MR (u sually mild) frequently occurs in relation to specific lateral akinesi a/dyskinesia.