Evaluation of Subendocardial and Subepicardial Left Ventricular Functions Using Tissue Doppler Imaging after Complete Revascularization

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 26; no. 2; pp. 203 - 210
• Main Authors: Sürücü, Hüseyin, Tatlı, Ersan, Okudan, Selnur, Aktoz, Meryem
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-02-2009
• Subjects: Angioplasty, Balloon, Coronary; Aortic Valve - diagnostic imaging; Coronary Artery Disease - surgery; Echocardiography, Doppler, Pulsed - methods; Female; Heart Atria - diagnostic imaging; Heart Ventricles - diagnostic imaging; Humans; Male; percutaneous coronary intervention; Postoperative Complications - diagnosis; Postoperative Complications - diagnostic imaging; tissue Doppler imaging; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Function, Left
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/j.1540-8175.2008.00765.x

Objective: We aim to evaluate subepicardial and subendocardial left ventricular (LV) functions in patient single coronary artery lesion at early stage after percutaneous coronary intervention (PCI). Additionally, a comparison of LV functions between patients and control cases was aimed. Method: Patients with culprit left anterior descending (LAD) lesion (n = 25) and subjects with normal coronary angiography (n = 25) were evaluated. Patients underwent PCI and at least one coronary stent was placed. After PCI, the pulsed‐wave tissue Doppler imaging (pw‐TDI) parameters taken from subepicardial and subepicardial layers were compared among the patients. Results: Left atrium (P = 0.050), LV end‐diastolic (P = 0.049), and end‐systolic (P = 0.006) diameters were larger compared to the control group. LV inflow velocities were not different between the patient and the control group. But, the myocardial performance index was different (P = 0.049). The systolic and diastolic pw‐TDI parameters were apparently different between the patient and the control group. While the systolic pw‐TDI parameters did not change, the diastolic pw‐TDI parameters taken from both subepicardial (circumferential contraction) and subendocardial layers (longitudinal contraction) improved after PCI. After PCI, it was shown that while Ea velocity (P = 0.012) taken from the subendocardial layer increased, IVRa velocity (P < 0.001) taken from the subepicardial layer decreased. Conclusion: In our study, it could be said that LV, left atrium, and aortic valve diameter increase in patients with coronary artery disease. The systolic and diastolic functions were impaired at subendocardial and subepicardial layers. These dysfunctions can be easily presented with pw‐TDI. Although systolic dysfunction persists, diastolic dysfunction improves at early stage after PCI.