| Abstract: |
On the clinical and angiographic outcome in patients with LCA stenosis, 40 patients (all were males), their age ranged from 43 to 67 with a mean age of 57 ± 7.05 years and they were classified according to the previously done coronary angiography into:(1)Patient group (group I);This group comprised 30 patients with angiographically proved LCA lesion, and were candidates for PCI, only 20 subjects completed the study.(2)Control group (group II)This group comprised 10 subjects with completely negative stress exercise ECG, normal coronary angiography and normal coronary sinus flow reserve.All patients were subjected to transthoracic echo-Doppler examination. The coronary sinus flow reserve of all patients and normal subjects in the study was measured before PCI, after PCI by 24 hours and after PCI by 6 months and they classified to normal or abnormal on the basis of cut- off point of 2.0 which used in many other studies by other researchers.*All patients were subjected to the following.I- Thorough history taking.II- Clinical examination.III- Twelve –leads surface electrocardiogram to define:-IV-Plain X-ray chestV-Transthoracic Doppler echocardiography to detect CSF at rest and after dipyridamole injection. we measure:VI-Coronary angiography and PCI.VII-Clinical and angiographic follow up after 6 months.The following results were obtained:1-There was non significant difference between patients and controls as regard the age, body weight , HDL, resting heart rate, hyperemic (peak ) heart rate, SBP,smokers and diabetics frequency among studied persons .2- There was statistically significant difference between patients and control as regard total cholesterol level, LDL , triglycerides, angina functional class and ECG abnormalities,3- There was (14) patients with one vessel disease (9 with LAD lesion and 5 with LCX lesion) and 6 with two vessels disease. Also 9 patients with non proximal LCA lesion and 11 patients with proximal lesion.4- Coronary sinus diameter was better at diastole after 6 month of PCI whether resting or at peak of dipyridamole infusion.5-VTI at forward phase was more in patients than in healthy persons and more at 6 months after PCI than before PCI.6-CSF in healthy persons was systolo-diastolic with prevalence of systole, while in LCA patients it was retrograde and antegrade (systole and diastole) with prevalence of diastole.7-0n the basis of CFR it is impossible to differentiate between LCA lesions whether at LAD or LCX.8-CSFR (Peak method) found to be abnormal (<2.0) in 2 of normal persons and in 16 of patients (before PCI) ,while 6 months after PCI It was abnormal in 7 patients (2 of them normal with coronary angiography ).9-CSFR (Volumetric method) was abnormal (<2.0) in only one healthy person, and in 13 of patients before PCI, while 6 months after PCI it was abnormal in 10 patients (5 of them normal with coronary angiography). .10-The absence of significant difference in CSFR between proximal and non-proximal lesion may be due to tightness of lesion (all patients between70%- 90%). And between single and two vessels disease may be due to small number of patients with two vessel disease (6 patients).11-There was good agreement between CSFR peak method and angiographic outcome before and 6 months after PCI, but there was weak agreement between CSFR (Volumetric method) and angiographic outcome before PCI and no agreement 6 months after PCI
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