Scintigraphic Analysis of Left Ventricular Diastolic Filling in Patients with Angina Pectoris before and after Percutaneous Transluminal Coronary Angioplasty

Jeon, Eun Seok; Oh, Byung Hee; Chung, June Key; Lee, Myung Chul; Lee, Myoung Mook; Park, Young Bae; Seo, Jung Don; Lee, Young Woo; Koh, Chang Sun

Abstract

Left ventricular(LV) diastolic filling is abnormal at rest in many patients with coronary arery disease, even in the presence of normal resting LV systolic function. To determine the effects of improved myocardial perfusion on impaired LV diastolic filling and to detect the most sensitive parameter to assess LV diastolic function, gated radionuclide ventriculography were performed in 14 patients with coronary artery disease before and after successful percutaneous transluminal coronary angioplasty(PTCA). All patients had no previous myocardial infarction and no abnormal wall motion in gated radionuclide and contrast ventriculography. The following results were obtained; 1) There were no significant differences in the parameters of LV systolic function, such as peak ejection rate(PER, time to peak ejection rate(TPER), ejection fraction(EF) after successful PTCA. 2) Peak filling rate(PFR) and time to peak filling rate(TPFR), indexes of LV diastolic function, had no significant changes after successful PTCA. 3) The percent contribution of late diastolic filling to stroke volume(%LDF/SV) decreased from 26.5+/-6.8% to 19.1+/-6.6%(p<0.005 by paired t-test). These data suggest that in many patients with angina and normal LV systolic function, impaired global diastolic filling is a reversible manifestation of impaired coronary flow, and percent contribution of late diastolic filling to stroke volume(%LDF/SV) can be a sensitive parameter to evaluate impaired LV diastolic filling in coronary artery disease.