[Serial changes in left ventricular global and regional function during exercise after percutaneous transluminal coronary angioplasty; effect of complete coronary revascularization].
In order to evaluate the effect of complete coronary revascularization (CR) with PTCA on global LV function at rest and during exercise, EF, LV volumes and systolic blood pressure/end-systolic volume index (SP/ESVI) were assessed in 23 patients with CR before, 14 days after (early FU) and 4 to 12 months after PTCA (late FU) by first-pass radionuclide angiography (FRNA). The subjects were divided into 3 groups in this study, G-I which consisted of 14 patients with continued CR, G-II, 9 patients with discontinued CR due to restenosis and G-C, 7 normal subjects. To further assess anterior (Ant) and apical (Ap) regional EFs, 15 patients with dilatation of left anterior descending artery were subdivided into 9 patients with continued success (G-I LAD) and 6 patients with restenosis (G-II LAD). Exercise-induced global LV dysfunction improved significantly both at early FU and late FU in G-I, however improved insignificantly at early FU and did not change at late FU in G-II. Even response to exercise (delta EF, % delta SP/ESVI) at late FU in G-I was significantly (p less than 0.05) less than those in G-C. Regional dysfunction during exercise already improved significantly (Ant: p less than 0.05, Ap: p less than 0.01) at early FU in G-I LAD, but did not improve sufficiently in G-II LAD. In conclusion, FRNA may be useful for the assessment of completeness of coronary revascularization by PTCA and may give guidelines for repeat angiography.
Yoshino
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D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D004562:Electrocardiography; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011875:Radionuclide Angiography; D013318:Stroke Volume