Early changes in wall motion and wall thickness during percutaneous transluminal coronary angioplasty in man.
Epicardial wall motion, myocardial wall thickness and segmental wall motion during percutaneous transluminal coronary angioplasty, a situation which resembles the experimental abrupt occlusion of a major coronary artery in the animal laboratory, have been studied in patients undergoing the procedure. Epicardial wall motion was analyzed using biplane cineradiography with frame to frame measurements of distances between pairs of radiopaque epicardial markers, placed at the time of previous cardiac surgery in a patient with a stenosis of a coronary artery bypass graft. Bypass graft occlusion led to early onset of biphasic epicardial late systolic lengthening and early diastolic shortening similar to the regional wall motion abnormality preceding the procedure. Continuous M-mode echocardiogram throughout coronary luminal occlusion, showed a decreased systolic thickening in the septum with a concomitant, prominent notch in early diastole occurring after the seventh beat following occlusion. At the 28th beat, septal systolic motion was absent while only an early diastolic septal motion was observed. Contemporaneously the end-diastolic septal thickness results decreased. Segmental wall motion analysis during ischemia was carried out performing a left ventricular angiogram before, 20 and 50 seconds after the onset of balloon inflation, 5 minutes after completion of the procedure. During the early phase of ischemia, in the ischemic segments, a late systolic lengthening with an early diastolic shortening was observed. We refer to this biphasic motion as the "W" phenomenon which appears to be the early and characteristic change in wall motion and thickness during coronary angioplasty in man.
D000800:Angioplasty, Balloon; D002306:Cardiac Volume; D002932:Cineangiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003971:Diastole; D004452:Echocardiography; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D009200:Myocardial Contraction; D011312:Pressure; D013599:Systole