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Abstract
Total coronary artery occlusion represents 10 – 20% of cath lab activity and is still a technical challenge (Zoran Olivari et al; 2002). Patients with coronary artery disease have impaired left ventricular systolic and diastolic functions, that can be related to myocardial hibernation (poorly contractile but viable myocardium) that can be restored toward normal by coronary revascularization (Rahimtoola ;1999 The aim of this thesis was to search for echocardiographic evidence of possible short term improvement of left ventricular systolic as well as diastole function following PCI in patients with total coronary artery occlusion. Forty patients with total coronary artery occlusion, who underwent successful PCI and followed up after one month by echocardiography were included in the study. Resting echocardiography-Doppler study before and one month following intervention to evaluate LV systolic function, measured by volumes ,ejection fraction and by segmental wall motion score index (SWMSI) recommended by American Society of Echocardiography as well as diastolic function measured by E, A, E/A ratio and IVRT. Patients was divided into two group according to duration of occlusion (less or more than 6 weeks). There was significant improvement in global LV systolic function as indicated by the improvement in volumes and ejection fraction post-PCI and also, there was improvement in regional function detected by improvement in SWMSI. Improvement was better in the group with duration less than 6 weeks than in the group with duration more than 6 weeks & patients with lower baseline EF, had greater improvement post- PCI. There was also significant improvement in diastolic function parameters but no significant difference in both groups. The one month period to follow up was quite sufficient period for detection of improvement in left ventricular function.