title: Effect of embolic particles during coronary interventional procedures on regional wall motion in patients with stable angina pectoris.
abstract: Microembolization during percutaneous coronary intervention (PCI) causes minor myocardial injury, and a Doppler guidewire can detect embolic particles as high-intensity transient signals (HITS). The present study investigated the effect of microembolization during PCI on regional wall motion using a Doppler guidewire and myocardial strain analysis. We performed PCI to the left anterior descending coronary artery in 25 patients (18 men and 7 women, 68 ± 8 years old) with stable angina pectoris. Coronary flow spectrums were obtained with a Doppler guidewire to count the total number of HITS throughout the PCI procedures. On the days before and after PCI, we recorded echocardiography and measured the longitudinal peak systolic strain, peak strain rate, and early diastolic strain rate in the left anterior descending territory using a 2-dimensional speckle tracking method. PCI was successfully performed, and 10 ± 6 HITS (range 0 to 22, median 9) were recognized during PCI. The echocardiographic study showed no visible wall motion abnormalities in the left anterior descending territory either after or before PCI. In cases in which the total number of HITS was ≥10, the peak systolic strain, peak strain rate, and early diastolic strain rate worsened on the day after PCI compared with those on the day before PCI (p <0.01). The rates of change in peak systolic strain and early diastolic strain rate, defined as the ratios of those parameters after PCI to those before PCI, had modest to strong inverse correlations with the total number of HITS (R(2) = 0.35 and R(2) = 0.46, respectively). In conclusion, periprocedural microembolization during PCI reduces subclinical cardiac function in patients with stable angina pectoris.
authors.affiliation: Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan. yhiguchi-ja@umin.net
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Higuchi
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Atsunori
authors.initials: A
authors.lastname: Okamura
authors.forename: Motoo
authors.initials: M
authors.lastname: Date
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nagai
authors.forename: Makito
authors.initials: M
authors.lastname: Ozawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity; D003971:Diastole; D004452:Echocardiography; D004617:Embolism / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015607:Stents; D013599:Systole; D020107:Troponin T / Q000097:blood; D018608:Ultrasonography, Doppler; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
chemical_list: D020107:Troponin T