Percutaneous coronary intervention in patients with refractory heart failure secondary to ischemic cardiomyopathy

Objective To evaluate the efficacy and safety of percutaneous coronary intervention(PCI)in patients with refractory heart failure(RHF)secondary to ischemic cardiomyopathy(ICM).Methods For patients sufferring from ischemic cardiomyopathy confirmed by coronary artery angiography with refractory heart failure,PCI were carried out after standard drug therapy,completed at least part of revascularization.To evaluate the influence of PCI on cardiac function,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),X-ray cardiothoracic ratio,NYHA classification heart function and 6 min walking distance were contrasted PCI preoperative and postoperative three months.Results Reascularization by PCI were successful in all the 26 cases of ICM with RHF.Compared with preoperation,all the patients relieved obviously,the patients' NYHA classification cardiae function were improved by 2 levels,6 min walking distance increased obviously from(125±36)m to(385±68)m(P0.01),LVEF increased from(32.5±8.8)% to(49.4±8.6)%(P0.01),LVEDD decreased obviously from(64±18)mm to(61±16)mm(P0.05),X-ray cardiothoracic ratio decreased from 0.69±0.15 to 0.60±0.13(P0.05).And there was no svere complication.Conclusion PCI can significantly improve cardiae function and quality of life in patients with refractory heart failure secondary to ischemic cardiomyopathy.The short-term effect is good.To ensure safety and effectiveness,the reasonable reascularization strategy should be chosen and the right operation method should be grasped in the process.