This article is more than 5 years old. Information may no longer be current.
Echocardiographic measurements promising for predicting improvement after elective PCI
Djordjevic-Dikic A. J Am Soc Echocardiogr. 2011;24:573-581.
Click Here to Manage Email Alerts
Among patients with previous MI, evaluation of basal coronary blood flow pattern and diastolic deceleration time measurements were shown to predict myocardium improvement after elective percutaneous coronary intervention.
The study featured 50 patients (mean age, 53 years; 82% men) with previous MI who underwent elective PCI. Researchers measured their coronary flow using transthoracic Doppler echocardiography before PCI, as well as both 24 hours and 3 months after. Recovery from PCI was determined by an improvement in resting wall motion score index of more than 0.20.
Researchers reported that patients with recovered left ventricular function (n=32) had a longer diastolic deceleration time (DDT) before the procedure compared with patients without improvement in LV function (n=18; 841 ± 286 ms vs. 435 ± 80 ms; P<.001). Furthermore, coronary flow reserve 24 hours after PCI was higher in the recovered group (2.60 ± 0.70 vs. 2.16 ± 0.34, P=.034). Among the univariate predictors of LV functional recovery were end-diastolic and end-systolic volumes, global and regional wall motion scores, as well as DDT before PCI and coronary flow reserve 24 hours after PCI.
Additionally, multivariate analysis also indicated that DDT (P=.003) and regional wall motion score (P=.007) were independent predictors of LV recovery during follow-up.
Commenting on the clinical implications of the study, the researchers wrote that although transthoracic Doppler echocardiography could not be considered as a substitute for other techniques that can directly assess transmurality of myocardial viability, such as MRI or myocardial contrast imaging, it could be useful in providing additional information about coronary pathophysiology and prognosis, considering the broad availability and low cost of the method.
|
|
The results look surprisingly promising. The key question is whether the frequency of success in evaluating coronary reserve with Doppler can be replicated in a general population.
– Nathaniel Reichek, MD
Cardiology
Today Editorial Board member
Disclosure: Dr. Reichek reports no relevant financial disclosures.
 |
Follow CardiologyToday.com on Twitter. |