ABSTRACT
The purpose of this study was to determine whether global and segmental left ventricle (LV) systolic function, assessed by exercise echocardiography (EE), improves after PTCA in patients without previous myocardial infarction (MI) and after infarction and angioplasty of infarct related coronary artery. 32 patients without MI and 35 patients with previous (4 +/- 3 months) MI were examined before PTCA (percutaneous transluminal coronary angioplasty), 3-5 days after successful elective PTCA and 6 months later with EE (modified Bruce protocol). LV ejection fraction (EF) and wall motion score index (WMSI) at the baseline and immediately after exercise were assessed. Following angioplasty (after 3-5 days and 6 months later), exercise duration was significantly (p < 0.001) increased in both groups of patients. Resting EF and WMSI did not change after angioplasty of infarct-related artery, but in patients without prior MI resting EF increased (p < 0.001) after PTCA in comparison with pre-PTCA values. Significant improvement of exercise EF and WMSI were observed in both groups of patients. In 25 of 35 patients with old MI wall motion improvement in the infarcted region after PTCA was observed. Twenty of these 25 patients developed exercise-induced akinesia in this area during pre-PTCA EE. Among 10 patients without improvement of the regional contractility were 9 after type Q-wave infarction and only 2 developed angina during EE. These data demonstrate improvement in global and regional systolic LV function and better exercise tolerance following successful PTCA both in patients without prior MI and with old MI after angioplasty of a stenosis in an infarct-related coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)
