Abstract 917: Prediction of Improvement iun Left Ventricular Function in Patients with Multivessel Disease Treated with Percutaneous Coronary Intervention
We studied the effect of multivessel PCI on left ventricular volumes and function and assessed the predictive value of magnetic resonance imaging before revascularization MRI was performed before and 6 months after PCI in 24 patients with at least 2 treated vessels. Segmental wall thickening (SWT) and left ventricular volumes and function were quantified on cine images and the transmural extent of infarction (TEI) was quantified on delayed enhancement images. A segment was considered dysfunctional if SWT was <45%. During PCI an average of 2.9 drug eluting stents were implanted. Mean ejection fraction increased significantly (41±11% to 46±12%; p<0.05). Mean end diastolic volume index (107±38 ml/m2 and 104±40 ml/m2; p=0.37) and end systolic volume index (65±37 ml/m2 to 61±40 ml/m2; p=0.09) decreased. A total of 143 dysfunctional segments in the perfusion territory of a significant lesion were included in the analysis. SWT improved significantly in segments with a TEI 0% (24±17% vs. 49±29%: p<0.0001), between 1–25%(28±12% vs. 41±27%; p<0.05) and between 25–50% (15±18% vs. 18±23%; p<0.05). SWT remained unchanged in segments with TEI 50–75%(10±21% vs. 18±23%; p=ns) and TEI>75% 1±12% vs. 2±12%; p=ns). An improvement of SWT of >10% was considered clinically important. Therefore we used a cut of value for the presence of viability of <25%. Improvement in left ventricular function was related to amount of dysfunctional but viable segments (R=0.44; p<0.05). A mean of dysfunctional but viable segments corresponded to an improvement of >5% in ejection fraction. Left ventricular function improves after multivessel PCI and can be predicted by pre treatment MRI.