The Effect of Percutaneous Coronary Intervention on Cerebral Blood Flow
Background and aim of the study:Ischemic heart disease is now the leading cause of death worldwide.It has been expected that the mortality rate of coronary artery disease will be increased in the developing countries.Percutaneous coronary intervention (PCI) provides an effective symptomatic treatment. Cerebral blood flow constitutes about 14% of resting cardiac output. The aim of the study is to see the effect of percutaneous coronary intervention on cerebral blood flow status.The study was conducted at Al Sader Medical City in Najaf City during the period from April 2017 to March 2018. Cerebral blood flow of bilateral middle cerebral artery was measured before and day14 after percutaneous coronary intervention by Trans cranial Doppler (TCD) in 32 patients eligible for study .The left ventricular ejection fraction also measured by transthoracic echocardiography at same time of TCD examination.There was a statistically significant increase in the ejection fraction value after PCI compared to its value before PCI with a mean difference of 1.7 ± 1.3, (P< 0.001). The TCD parameters; peak systolic velocity (PSV), end diastolic velocity (EDV) and mean flow velocity (MFV), all are increased significantly after PCI. The changes in plasticityindex (PI) and resistive index (RI) were reduced from its baseline value before PCI. There was a positive correlation between the changes in middle cerebral artery (MCA) flow velocity with the changes in ejection fraction. Percutaneous coronary intervention significantly increases cerebral blood flow through an increase in middle cerebral artery (MCA) flow velocity and a decrease in its resistance.