[The influence of percutaneous coronary intervention on mitral apparatus function in unstable coronary heart disease].

BACKGROUND

mitral apparatus (MA) is a very complex structure consisting of as many as six elements. Its correct function depends on the anatomical and mechanical integrity of all its parts, and is manifested by tight closure of the valve during systole. The destructive influence of coronary heart disease (CHD) on left ventricle function is well known and also as there are many observations confirming the beneficial effect of revarcularisation (percutaneous coronary intervention-PCI) on this pathology. However there is lack of long term observations on the influence of PCI on the function of the MA and mitral regurgitation.

AIM: comparison of the influence of the PCI on MA function in stable and unstable CHD.

METHODS

The study group consisted of 55 patients (mean age 58.79 +/- 8.06) with documented CHD, qualified to PCI. MA function was estimated by echocadiographic examination, performed 1 day before and 6 months after PCI in patients (pts) with at least I or II degree of mitral regurgitation. The subgroup of stable angina patients consisted of 40 pts (Group I) and unstable--15 pts (Group II).

RESULTS

in group II we revealed adecrease of LVEDd and LVESd (p < 0.001), an increase of EF by 9.21%, p = 0.004 (vs. 3.71% p = 0.006 in group I), a decrease of mitral valve regurgitation (MVR--9.57 ml vs. 1.23 ml was in group I). We also observed an increase of the mitral ring presystolic dimension reduction (0.11 p = 0.01 vs. 0.05 in group I).

CONCLUSIONS

PCI has beneficial effects on mechanisms responsible for ischemic MVR (depending on the grade of possible reversal/persistence of damge and range of revascularisation. In patients with unstable angina PCI is universally beneficial for MA function and statistically decreases mitral regurgitation.