Analysis of Myocardial Layer Specific Systolic and Diastolic Function During and After PCI
Condition: Percutaneous Coronary Intervention; Myocardial Ischemia; Anginal Pain
MeSH terms: Myocardial Ischemia; Ischemia
Study type: Interventional

Summary: 
      Investigators will analyzed systolic and diastolic function during and after ischemia induced
      by percutaneous coronary intervention.Also will be analyzed a local work index during acute
      ischemia induced by percutaneous coronary intervention.
    

Detailed description: 
      PART 1: ANALYSIS OF LAYER SPECIFIC SYSTOLIC AND DIASTOLIC FUNCTION DURING ACUTE ISCHEMIA
      INDUCED BY PERCUTANEOUS CORONARY INTERVENTION 35 patients with normal systolic left
      ventricular function at baseline with indication for elective percutaneous coronary
      angioplasty will be included in the study. In these patients acute ischemia will be induced
      by elective percutaneous coronary angioplasty with balloon inflation and thus vessel
      occlusion for 60 sec. During these 60 seconds ischemia will develop throughout all layers of
      the myocardium affecting diastolic systolic and diastolic function. During the subsequent
      reperfusion period signs of ischemia with systolic and diastolic dysfunction of all layers
      will subside. Echocardiographic imaging at short intervals of 10 sec during ischemia and at
      intervals of 20 sec during reperfusion up to 10 min after reopening of the vessel as well as
      1 hour and 24 hours later will allow serial comparison of strain curves and thereby allow
      definition of the time sequence systolic and diastolic function abnormalities occur in three
      myocardial layers as well as the resolution of abnormalities during reperfusion. The analysis
      of circumferential as well as radial strain will allow definition of differences between
      radial and circumferential strain during ischemia induction and resolution.

      PART 2: ANALYSIS OF LOCAL WORK INDEX DURING ACUTE ISCHEMIA INDUCED BY PERCUTANEOUS CORONARY
      INTERVENTION.

      In the same 35 patients as in Clinical step 1 the local work index of the ischemic area as
      well as the contralateral non-ischemic areas will be determined in serial studies to
      determine the onset of abnormality, the amount of abnormality and the resolution of
      abnormality. Changes in local work index in the ischemic area will be related to changes in
      peak systolic strain and strain imaging diastolic index.
    

Intervention name(s): Percutaneous Coronary Intervention
Intervention type(s): Procedure
Intervention description(s): Percutaneous coronary intervention is performed according to standard practice. Direct stenting is required for the procedure as it is done in most coronary interventions today. After insertion of the non-inflated stent into the coronary lesion there should still be flow to the distal vessel. The stent should be implanted at high-pressure with balloon inflation lasting for 60 seconds to allow adequate expansion of the stent. Post-dilatation should be performed if required. However, this should be done more than 5 minutes after stent implantation.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: percutaneous coronary intervention; ischemia; strain; coronary stenosis