Correlation of quantitative angiographic parameters with changes in left ventricular diastolic function after angioplasty of the left anterior descending coronary artery.

This study evaluates the changes in left ventricular (LV) diastolic filling after percutaneous transluminal coronary angioplasty and the relation of such changes to quantitative angiographic measurements of the severity of coronary narrowings. Pulsed Doppler echocardiographic measurements were performed in 40 patients with single left anterior descending artery narrowing before, and 10 and 30 days after angioplasty. Minimal luminal diameter and percent diameter stenosis of coronary lesions were measured by computer-assisted quantitation. The ratio of early to late diastolic flow velocities (E/A ratio), time velocity integral of early diastolic filling period (Ei) and the ratio of early and late diastolic filling periods (Ei/Ai ratio) increased gradually after angioplasty. Minimal luminal diameter correlated significantly with the percent changes in E/A ratio (r = 0.59 at 10 days, r = 0.57 at 30 days), Ei (r = 0.53 at 10 days, r = 0.55 at 30 days) and Ei/Ai ratio (r = 0.41 at 10 days, r = 0.49 at 30 days). Percent diameter stenosis showed overall weaker correlations than minimal diameter with the percent changes in E/A ratio (r = 0.39 at 10 days, r = 0.32 at 30 days) and Ei (r = 0.38 at 10 days, r = 0.31 at 30 days). Thus, LV diastolic filling improves serially after coronary angioplasty in patients with 1-vessel disease. The magnitude of improvement in diastolic filling correlates better with minimal luminal diameter than percent diameter stenosis. Therefore, minimal luminal diameter is a better predictor of changes in Doppler transmitral flow parameters after angioplasty than percent diameter stenosis.