Evidence for left ventricular remodeling after percutaneous coronary intervention. Effect of percutaneous coronary intervention on left ventricular ejection fraction and volumes

• Published in: International journal of cardiology 2004-08, Vol.96 (2), p.197-201
• Main Authors: ZELLWEGER, Michael J, TABACEK, Georg, ZUTTER, Andreas W, WEINBACHER, Markus, CRON, Thomas A, MÜLLER-BRAND, Jan, PFISTERER, Matthias E
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary - methods; Biological and medical sciences; Cardiology. Vascular system; Cohort Studies; Coronary heart disease; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - physiopathology; Exercise Test; Female; Follow-Up Studies; Gated Blood-Pool Imaging; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - therapy; Probability; Radionuclide Angiography; Risk Assessment; Sampling Studies; Sensitivity and Specificity; Stroke Volume - physiology; Tomography, Emission-Computed, Single-Photon; Ventricular Function, Left - physiology; Ventricular Remodeling - physiology
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2003.06.016

Post-stress ejection fraction (EF), end-diastolic (EDV) and end-systolic (ESV) volumes by gated myocardial perfusion SPECT (MPS) are well validated, reproducible and of prognostic significance. However, little is known about the impact of percutaneous coronary intervention (PCI) on left ventricular volumes and remodeling. Thirty-eight patients who underwent MPS before and 6 months after PCI were evaluated. MPS were interpreted deriving summed stress (SSS), rest (SRS) and difference (SDS = SSS-SRS; extent of ischemia) scores. EF, EDV and ESV were generated by QGS trade mark. Pre-PCI MPS were compared to post-PCI MPS. Single vessel disease was present in 63% of patients. PCI of one vessel was performed in 82% of patients. After 6 months, SSS (10.6 +/- 6.3 vs. 2.8 +/- 4.3, p < 0.001) and SDS (8.2 +/- 5.6 vs. 1.4 +/- 2.3, p < 0.001) had improved; however, EF did not change significantly (55 +/- 10 vs. 57 +/- 13, p = ns). Still, EDV (105 +/- 25 ml vs. 96 +/- 25 ml, p = 0.006) and ESV (49 +/- 19 ml vs. 41 +/- 18 ml, p = 0.001) were significantly reduced. Results of MPS documented the beneficial effect of PCI on symptoms and extent of ischemia. In addition, the findings showed a significant decrease in ESV and EDV after PCI as compared to pre-PCI findings which points to a positive effect on left ventricular remodeling even in the absence of significant changes in EF.