Effects of distal protection on left ventricular function in acute anterior myocardial infarction: a Doppler echocardiographic study.
Whether distal protection devices (DPDs) during percutaneous coronary intervention (PCI) can improve myocardial function in patients with acute myocardial infarction (AMI) is still under debate. Using tissue Doppler imaging (TDI), we evaluate the global and regional left ventricular systolic and diastolic functions in patients with anterior AMI using DPDs compared with conventional PCI. Ninety-six patients with anterior AMI were randomly assigned to either PCI with DPDs (DPD, n = 46) or traditional PCI (control, n = 50) groups. At the 3- and 6-month follow-ups, the DPD group had a higher left ventricular ejection fraction than the control group (51.6 +/- 3.6 vs. 49.3 +/- 5.3% and 53.0 +/- 3.7 vs. 50.8 +/- 5.2%, respectively; both P < 0.05). Moreover, peak systolic (S (a)) and early diastolic (E (a)) mitral annular velocities obtained by TDI were significantly higher in the DPD group than in the control group (S (a): 7.57 +/- 0.53 vs. 7.12 +/- 0.62 cm/s and 7.71 +/- 0.63 vs. 7.32 +/- 0.59 cm/s; E (a): 7.23 +/- 0.78 vs. 6.89 +/- 0.86 cm/s and 7.49 +/- 0.69 vs. 7.04 +/- 0.85 cm/s, respectively; all P < 0.05). However, systolic and diastolic regional myocardial velocities significantly improved in the DPD group from the 1-month follow-up compared with those in the control group (all P < 0.05). Patients who received treatment with DPDs experienced enhanced improvement of cardiac function. Thus, anterior AMI patients can benefit from DPDs during PCI.
Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, 710032 Xi'an, China. Dududuan1025@163.com
Yun-Yan
YY
Duan
Hai-Bin
HB
Zhang
Li-Wen
LW
Liu
Xiao-Dong
XD
Zhou
Cheng-Xiang
CX
Li
Jun
J
Li
Ting
T
Zhu
Hai-Li
HL
Su
Yong-Sheng
YS
Zhu
Hong-Ling
HL
Li
Jun
J
Zhang
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D003326:Coronary Circulation; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D018579:Patient Selection; D011237:Predictive Value of Tests; D013318:Stroke Volume; D013599:Systole; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left