Changes in lvef during ptca monitored continuously with a miniature nuclear detector

T. B. Lindhardt*, H. Kelbæk, K. Saunamäki, J. K. Madsen, P. Clemmensen, B. Hesse, N. Gadsbøll

*Corresponding author af dette arbejde

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    Abstrakt

    Purpose: To study the acute impact of PTCA on LV-function and the effect of multiple balloon dilatations on global LVEF and ECG changes. Methods: LV-function was monitored in 40 patients using the Cardioscint system. Red blood cells were labeled with 800 Mbq Tc. Mean duration of balloon inflation: 113 ± 45 sec. Results: Pre-PTCA PTCA Post-PTCA LVEF: 63 ±.10 .51 ±.14* .65 ± .10* *P<0.05 LVEDC: 78 ± 19 79 ± 19 78 ± 19 LVESC: 29 ± 12 39 ± 16* 29 ± 12 LVEDC,LVESC: LV enddiastolic and endsystolic counts. 65%, 33% and 25% of the patients with LAD, CX and RCA disease, respectively had a decrease in LVEF > 10 EF units during PTCA. The decrease in LVEF and the return to post-PTCA levels occured within seconds after balloon inflation and deflation. 10 patients recived two consecutive and identical balloon dilatations: 1. PTCA 2.PTCA LVEF .41 ± .14 .44 ± .15* * P<0.05 STmax 294 ± 170 224 ± 150* STsum 102 ± 50 71 ± 46* STmax: The maximal ECG ST-segment deviation in a single lead. STsum: The mean of the ECG ST-segment deviations in 12 leads. Conclusion: There is a significant and abrupt decrease in LVEF during PTCA, explained by an increase in ESV with no change in EDV indicating a reduced contractility. The effect of dilatation on LVEF was more pronounced for LAD than CX and RCA. No patient showed any sign of post-PTCA stunning. In the 10 patients who recived two balloon dilatations the findings suggest that preconditioning can be induced in humans during PTCA.

    OriginalsprogEngelsk
    Antal sider1
    TidsskriftScandinavian Cardiovascular Journal, Supplement
    Vol/bind31
    Udgave nummer45
    StatusUdgivet - 1 dec. 1997

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