Parameters of left ventricular diastolic function 48 hours after coronary angioplasty and stent implantation.
BACKGROUND
It has been reported that stent implantation results in an earlier and more pronounced improvement of coronary flow reserve in comparison to conventional balloon angioplasty. Whether this phenomenon translates into hemodynamic changes of left ventricular systolic and diastolic function has not been investigated. This study was designed to determine whether stenting leads to greater changes in measures of diastolic dysfunction than plain angioplasty alone.


METHODS
Parameters of diastolic function were ascertained by Doppler echocardiography in 194 patients with single-vessel disease before and 48 hours after elective coronary angioplasty. A total of 116 patients were initially successfully treated with coronary angioplasty. In 78 patients, stents were used to improve an inadequate result after coronary angioplasty. The parameters of left ventricular diastolic function were evaluated before and 48 hours after coronary intervention by Doppler echocardiography. Ejection fraction was determined and used to characterize systolic left ventricular function.


RESULTS
Both patient groups (116 patients with coronary angioplasty, 78 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after intervention. Surprisingly, there was no significant short-term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.


CONCLUSIONS
Stent implantation results in improved left ventricular diastolic function in comparison to conventional balloon angioplasty. This has to be attributed to a more immediate and increased antiischemic effectiveness due to the scaffolding properties of stents.
Schannwell
Christiana M
CM
Clinic of Cardiology, Pneumology and Angiology, Heinrich-Heine University Duesseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany. schannw@uni-duesseldorf.de
Schneppenheim
Markus
M
Plehn
Gunnar
G
Strauer
Bodo E
BE
D000368:Aged; D000704:Analysis of Variance; D000800:Angioplasty, Balloon / Q000379:methods*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D006328:Cardiac Catheterization; D015331:Cohort Studies; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015607:Stents; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology