DIASTOLIC FUNCTION IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY - INFLUENCE OF DEGREE OF REVASCULARIZATION

To assess the early effects of successful coronary angioplasty on Doppler-derived left ventricular filling patterns and the significance of the extent of revascularization on these variables, 31 patients undergoing coronary angioplasty were examined within 24 h before and after the revascularization procedure. After angioplasty, the peak early to late velocity ratio increased from 0.89 ± 0.2 to 1.05 ± 0.3 (p < 0.0001) and the one-third filling fraction increased from 42 ± 10% to 48 ± 10% (p < 0.0001). The percent atrial contribution to filling decreased from 45 ± 7% to 41 ± 8% (p < 0.01), and the pressure half-time and the isovelumetric relaxation time shortened from 55 ± 15 to 43 ± 13 ms (p < 0.001) and from 100 ± 14 to 82 ± 17 ms (p < 0.0000, respectively. When comparing patients with complete (n = 23) and incomplete (n = 8) revascularization, the same changes in the Doppler variables were observed. However, the mean rate of acceleration of early filling increased significantly after angioplasty only in those patients with complete revascularizalion. These data indicate that the left ventricular diastolic filling pattern is modified significantly as early as 24 h after successful coronary angioplasty. Improvement in impaired relaxation appears to be the most likely explanation for these changes, although increased myocardial stiffness in patients with incomplete revascularization is an alternative hypothesis. © 1990.