[Effect of coronary revascularization by percutaneous coronary transluminal angioplasty on the diastolic filling of the left ventricle].

Percutaneous transluminal coronary angioplasty (PTCA) is useful to study the cardiac function in patients with coronary artery disease (CAD). Left ventricular (LV) diastolic filling is often altered in CAD and Doppler-echocardiography can be used in order to assess the behavior of LV diastolic filling. Thus, 68 patients, divided into 2 groups (52 with CAD and 16 normal subjects as controls), underwent Doppler-echocardiography to evaluate the following diastolic filling indexes: peak velocity of early- (E) and late- (A) diastolic filling, the velocity-time integrals of early- (VTI E) and late- (VTI A) diastolic filling, the ratios E/A and VTI E/A. The CAD group was divided into 4 subgroups according to the severity of coronary disease. The overall CAD group showed a significant reduction of E/A and VTI E/A when compared to controls (E/A: 1.10 +/- 0.27 vs 1.67 +/- 0.48; p less than 0.001) (VTI E/A: 1.84 +/- 0.43 vs 2.84 +/- 0.82; p less than 0.001). No differences were found between the 4 subgroups. PTCA was performed in 21 patients: 15 successfully and 6 not. The latters did not show significant changes in diastolic filling parameters (E/A: 0.71 +/- 0.21 vs 0.72 +/- 0.25; NS) (VTI E/A: 1.24 +/- 0.31 vs 1.25 +/- 0.43; NS). The other 15 patients showed significant improvement of E/A ratio (1.07 +/- 0.21 vs 1.37 +/- 0.19; p less than 0.01) and VTI E/A (1.78 +/- 0.30 vs 2.31 +/- 0.29; p less than 0.001). In conclusion, LV diastolic filling indexes are significantly altered in patients with CAD and seem reversible after PTCA.