Changes of Segmental Left Ventricular Wall Motion after PTCA in Ischemic Heart Diease

Jeong, Jin Won; Kim, Min Seok; Hyoung, Keun Young; Seo, Gum Suk; Kim, Seok Whan; Park, Yang Kyu; Park, Ock Kyu

Abstract

OBJECTIVES
To assess the long-term changes of left ventricular(LV) asynergy after percutaneous transluminal coronary angioplasty(PTCA) in 25 patients with ischemic heart disease(15 unstable angina pectoris(UAP), 10 acute myocardial infarction(MI) ; mean age 58 years).
METHODS
Two-dimensional(2-DE) and Doppler echocardiography was performed before, after PTCA(mean 313 days) and LV segmental wall motion was analyed in 4 apical rotational views(divided by 2 proximal and 2 distal segments each) by visual scoring method. The score was assigned to each segment(1, normal or hyperdynamic ; 2, hypokinetic ; 3, akinetic ; 4, dyskinetic ; 5, aneurysmal), and regional wall motion score index(RWMI) was derived as sum of score divided by 16 segments.
RESULTS
After PTCA, 13 of 15 patients with UAP and all patients with MI demonstrated improvement in segmental wall motion at least one grade of score. 2) The RWMI improved significantly in both groups(1.29±0.20 to 1.11±0.15 in UAP(p < 0.11 1.24±0.14 to 1.06±0.11 in MI(p < 0.05), but other 2-DE and Doppler parameters showed no significant changes after PTCA from baseline. 3) Fifty(83%) of 60 hypokinetic segments improved to normal(29/34 in UAP, 21/26 in MI) and 10 of 20 akinetic segments improved to hypokinetic(2/10 in UAP, 3/10 in MI) after successful PTCA. 4) Thus, 36(80%) of 45 in UAP and 27(75%) of 36 abnormal segments in MI improved after PTCA.
CONCLUSION
Resting regional wall motion abnormality assessed by 2-DE and Doppler echocardiography in the patients with UAP of MI can be improved after PTCA.