Increased left ventricular myocardial relaxation velocities after coronary angioplasty

Impaired left ventricular (LV) relaxation is a clinical significant feature in ischemic heart disease. We sought to determine whether myocardial revascularization by coronary angioplasty (PTCA) improves LV relaxation. Methods: 23 patients without resting wall motion abnormalities undergoing single or two-vessel PTCA were studied immediately before and 24 hours after by 2-D and Doppler echocardiography. Peak LV myocardial contraction (S), early (Ew) and late (Aw) diastolic longitudinal axial velocities were measured in the anterior, lateral, inferior and septal walls using pulsed Doppler Tissue Imaging (DTI). Peak early (E) and late (A) transmitral flow velocities and E wave deceleration time were measured by pulsed Doppler at the same intervals. Results (cm/s): pre-PTCA post-PTCA p S 7.0±1.9 8.0 ±3.5 0.08 Ew 7.8 ±1.9 10.0 ±3.1 <0.001 Aw 11.0 ±2.9 11.5 ± 3.2 NS E 75 ±26 76 ±26 NS A 79 ± 21 76±16 NS DT (ms) 230 ±80 210 ±60 NS Conclusions: LV myocardial early relaxation velocities increase following coronary angioplasty without detectable changes in transmitral filling. These results suggest that wall velocities may be a more sensitive index of LV relaxation and indicate that myocardial relaxation may improve early after revascularization even without changes in wall motion.