| Abstract: |
SummaryThis study was carried out in cardiology department, Zagazig University from September 2003 to December 2004.This study included 50 patients with ischaemic heart disease underwent elective first PTCA. These patients included 36 male (72%) and 14 female (28%), their ages ranged from 36 to 65 years with mean age of 50.2±8.3 years.Patients included in our study were known to be ischaemic heart disease by coronary angiography and electrocardiographic changes of myocardial infarction and ischemia.The patients were classified according to the previous coronary angiographic results into two groups:1) Single vessel disease group: This group includes 34 patients2) Two vessel disease group: This group includes 16 patientsPatients were excluded if they had: abnormal myocardial repolarization, ventricular pacing, prosthetic valve, myocarditis, poorly echogenic window, valvular heart disease, cardiomyopathy, pericardial heart disease, congential heart disease, arrhythmias, previous or failed revascularization (PTCA & stenting or CABG).All patients were subjected to all of the following:Complete history taking, thorough physical examination, laboratory tests, 12- lead surface ECG, plain X- ray chest and heart, echocardiographic evaluation of LV function before and within one week after PTCA, coronary angiography, coronary angioplasty, tissue Doppler evaluation of LV function before and within one week after PTCA, color kinesis evaluation of LV function before and within one week after PTCA.The present study specifically sought to identify improvement in LV function after successful coronary angioplasty on basis of systolic and diastolic parameters using TDE and CK.The study showing the following:As regard ECG finding :The difference between single vessel and two vessel groups was statistically significant.As regard TIMI grade flow:In the single vessel disease group TIMI grade flow was improved from 0.88±0.02 Before PTCA to 2.76 ±0.1 after PTCAIn the two-vessel disease group TIMI grade flow was improved from 0.87 ±0.05 Before PTCA to 2.75 ±0.01 after PTCAAs regard Echocardiographic finding :Systolic function: The difference between before and after PTCA was statistically non- Significant in all Patients.Diastolic function: The difference between before and after PTCA was statistically highly Significant in (IVRT) parameters only .The other parameters was statistically non- significant.Comparison between single and two vessel disease groups:There was non-significant difference between diastolic function parameters by echocardiography before and after PTCA in two groups.As regard Pulsed –wave Tissue Doppler echocardiographic finding:Peak systolic velocities that reflect the LV systolic functions of septal and lateral mitral annulus sites significantly improved early after PTCA.Comparison between single and two vessel disease groups: There was non-significant difference between peak systolic velocities that reflect the LV systolic functions of septal and lateral mitral annulus sites before and after PTCA in two groups.Diastolic parameters of PWTD that reflect the LV Diastolic functions of septal and lateral mitral annulus sites significantly improved early after PTCA.Comparison between single and two vessel disease groups: There was non-significant difference between diastolic parameters of PWTD that reflect the LV diastolic functions of lateral mitral annulus sites after PTCA in two groups. Only Septal Em maximum velocity ( cm/sec) and Isovolumic relaxation time ( IVRT) msec showed significant difference between two groups after PTCA. Other diastolic parameters of PWTD that reflect the LV Diastolic functions of septal mitral annulus sites showed non-significant difference between two groups after PTCA.As regard Color Kinesis: The mean values of the velocity of endocardial motion in systole before and after PTCA & Stenting. Basal anteroseptal, basal inferior and basal septal segments showed no statistical significant difference regarding before and after PTCA. The mid inferior and basal anterior segments showed statistical significant difference regarding before and after PTCA .The rest of segments showed highly statistical significant difference regarding before and after PTCA.
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