Left ventricular diastolic function parameter after PTCA and stent implantation

This study was designed to determine the effect of successful coronary reva scularisation on left ventricular diastolic function. Methods We consecutiv ely studied the time course of diastolic function by Doppler echocardiograp hy in 100 patients with one-vessel disease before and 48 hours after electi ve coronary angioplasty. Three abrupt vessel closures occurred within 24 ho urs after intervention. These three patients were excluded from the study. 58 patients were initially successful treated with coronary angioplasty (re sidual stenosis < 40%). In 39 patients stents were used to improve an inade quate result after coronary angioplasty. The following parameters of left v entricular diastolic function were evaluated before and 48 hours after coro nary intervention: peak early (V-E, m/s) and peak late diastolic (V-A, m/s) flow velocity, E/A ratio, acceleration time (AT, ms), deceleration time (D T, ms) and isovolumetric relaxation time (IVRT, ms). Ejection fraction (EF; %) was determined and used to characterise systolic left ventricular funct ion. Results Both patient groups (58 patients with coronary angioplasty and 39 patients with combined coronary angioplasty and stent implantation) sho wed no relevant differences concerning sex, age, atherosclerotic risk facto rs, exercise capacity and results of exercise electrocardiography. All pati ents who underwent stent implantation showed an early improvement of left v entricular diastolic function 48 hours after revascularisation. Surprisingl y there was no significant short-term improvement (48 hours) of diastolic f unction in patients with initially successful angioplasty. Conclusion We su ppose that stent implantation faster normalises coronary blood flow than co ronary angioplasty.