الفهرس 
Aim of WorkOnly 14 pages are availabe for public view
 |  | from | 110 |  |  |
| | | from | 110 | | |
Abstract
Stable coronary artery disease is characterized by episodes of
reversible imbalance between blood supply and metabolic demand that
are usually induced by exercise, emotion or other stresses. Such episodes
are commonly associated with transient angina pectoris. Its clinical
presentations are caused by different mechanisms that mainly include:
(1) plaque-related obstruction of coronary arteries; (2) coronary spasm
either focal or diffuse; (3) microvascular dysfunction and (4) left
ventricular dysfunction.
Speckle tracking imaging enabled rapid assessment of Left
ventricular twist and untwist mechanics, which have expanded our
understanding of normal ventricular physiology, adaptation, and
decompensated mechanisms in disease states. Systolic left ventricle twist
and untwist are the main components of normal ventricular function and
play pivotal roles in physiological adaptation and development of
clinically relevant cardiac disease.
Despite percutaneous coronary intervention is an excellent therapy
for coronary artery disease, there is lack of data on efficacy of PCI in
patients with stable angina pectoris. Objective of this study was to assess
left ventricular twist and untwist in patients undergoing elective
percutaneous coronary intervention; by two-dimensional speckle
tracking echocardiography.
This study included 100 patients -who had stable angina pectoris
and/or with abnormal result from non-invasive stress tests- were enrolled
after underwent elective coronary angiography with intervention.
Conventional and two-dimensional speckle tracking echocardiography
were performed within 24 hours of PCI and after 3 months follow up.
The mean age of the studied sample was 53.3±6.68 years. Regard
sex distribution, there were 76 males and 24 females. The mean body
mass index was 25.04±2.3 kg/m². Our studied patients sample showed
that 64.0% were smoker, 54.0% were hypertensive, 58.0% were diabetic,
and 52.0% had dyslipidemia. Non-invasive stress tests in studied patients
showed that 65.0% underwent exercise ECG and 35.0% underwent
stress echocardiography before elective PCI. Furthermore, target vessel
revascularization in studied patients showed that 38 patients had LAD
TVR using one or more PCI, 24 patients had LCX TVR using one or
more PCI, 16 patients had RCA TVR using one or more PCI, and 22
patients had multiple territories TVR using one or more PCI.
The present study showed that some conventional diastolic
parameters were significantly different after PCI as E wave, E/A and
E/e` ratios while other conventional parameters were not significantly
different. STE derived strain parameters only showed significantly
higher of GLS (p-value 0.009). while, there were no statistically
significance for Circumferential and radial strains (p-value 0.683 and
0.557 respectively). Furthermore, STE derived torsional parameters
showed that peak untwist and recoil were significantly higher at follow
up (p-value 0.013 and 0.001 respectively). while, time to peak untwist
was significantly lower at follow up (p-value 0.004). other strain derived
torsional parameters of significance were apical rotation (p-value
<0.001), basal rotation (p-value <0.001), torsion (p-value <0.001), and
peak twist (p-value 0.009).