Author/Editor     Pust, Borut; Šurlan, Miloš
Title     Pre-PTCA detection of chronic but reversible postischemic myocardial dysfunction by nicardipine
Type     članek
Source     Angiology
Vol. and No.     Letnik 49, št. 2
Publication year     1998
Volume     str. 115-27
Language     eng
Abstract     The aim of the study was to find out whether in patients (n = 24) with one-vessel coronary artery disease, reversibility of related left ventricular (LV) wall motion abnormalities after successful percutaneous transluminal coronary angioplasty (PTCA) can be predicted by the immediate effect of calcium antagonist nicardipine. Dynamic quantitative left cineventriculography performed four times successively (as the control, 30 minutes after oral nicardipine,10 minutes after PTCA, and 6 months after PTCA) and hemiaxis method (mean relative hemiaxis shortening or X delta r %) were used for wall motion analysis of 48 poststenotic LV myocardial segments divided into three groups: hypokinetic noninfarcted (PNHS, n = 25), infarcted (PIS, n =12), and normokinetic noninfarcted (PNNS, n=11) and of 24 normal LV myocardial segments (NS). In PNHS and PIS close correlation (r = 0.75, P < 0.0001 and r = 0.71, P < 0.005) was demonstrated between postnicardipine improvement (21 +-4% to 37 +-9%, P < 0.0001, and 16 +-7% to 20 +-8%, P < 0.0005) and 6 months after PTCA improvement (21 +-4% to 33 +-7%, P < 0.0001, and 16 +-7% to 19 +-9%, P < 0.0005) of wall motion. It was loose in PNNS and absent in all three groups immediately after PTCA. The sensitivity of the nicardipine test for 6 months after PTCA reversible LV segmental hypokinesia was high in PNHS (95%) and lower in PIS and PNNS (67% and 60%, respectively). The specificity was 100% in PIS, lower in PNNS (67%), and absent in PNHS (owing to lack of true nonresponders). Immediately after PTCA, contraction significantly improved only in PNHS; the nicardipine test was 100% sensitive but nonspecific. Significant improvement of contraction of all groups of poststenotic LV wall segments is expected 6 months after successful PTCA of related artery stenosis, being well predictable by the pre-PTCA effect of nicardipine, at least in PNHS and in PIS. (Abstract truncated at 2ooo charact.)
Descriptors     MYOCARDIAL ISCHEMIA
NICARDIPINE
ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY
CALCIUM CHANNEL BLOCKERS
VENTRICULAR DYSFUNCTION, LEFT
ADULT
MIDDLE AGE
AGED
MYOCARDIAL CONTRACTION
CINERADIOGRAPHY
FOLLOW-UP STUDIES
PREDICTIVE VALUE OF TESTS
RECURRENCE
SENSITIVITY AND SPECIFICITY