ARYA Atherosclerosis Journal

Evaluation of the early effect of elective percutaneous coronary intervention on left ventricular diastolic and systolic function

Document Type : Original Article

Authors

Seyed Abdolhossein Tabatabaei
Hakimeh Sadeghian
Ramin Negin Taji
Ali Abbasi
Atoosa Mostafavi

Department of Cardiology, Dr Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.48305/arya.2024.42792.2978
Abstract
BACKGROUND: Percutaneous coronary intervention (PCI) is an effective treatment for coronary artery disease. Previous studies have demonstrated the delayed effects of PCI on left ventricular diastolic and systolic function. However, the early impact on these parameters has not been systematically examined. Moreover, no study has compared the impact of revascularization on the global longitudinal (GLS) and circumferential (GCS) strains of the left ventricle. Using echocardiographic parameters, the present study aimed to investigate the reversibility of diastolic and systolic abnormalities in patients with significant coronary artery stenosis within 1 to 2 days after PCI. Additionally, this study will compare the effects on both global and longitudinal strains.
METHODS: This study included 80 consecutive patients admitted to the angiography department for elective PCI with normal left ventricular function. Echocardiography was performed before PCI and 1 to 2 days post-procedure to assess left ventricular diastolic and systolic function indices in these patients.
RESULTS: The mean age of the patients was 58.0±11.9 years, with a predominantly male cohort (65%). All the patients exhibited normal left ventricular systolic function and various degrees of diastolic dysfunction. One to 2 days after revascularization, significant improvements were observed in all diastolic function indices and GLS. However, no significant improvement was found in GCS.
CONCLUSION: Revascularization of a significantly stenotic coronary artery can enhance diastolic function and systolic longitudinal strain of the left ventricular myocardium as early as 1 to 2 days, with no significant impact on GCS.

Keywords

Left ventricular function
PCI
Strain
Systolic
Diastolic
1. Luis SA, Chan J, Pellikka PA. Echocardiographic Assessment of Left Ventricular Systolic Function: An Overview of Contemporary Techniques, Including Speckle-Tracking Echocardiography. Mayo Clin Proc. 2019 Jan;94(1):125-38. https://doi.org/10.1016/j.mayocp.2018.07.017
2. Chengode S. Left ventricular global systolic function assessment by echocardiography. Ann Card Anaesth. 2016 Oct;19(Supplement):S26-S34. https://doi.org/10.4103/0971-9784.192617
3. Abou R, van der Bijl P, Bax JJ, Delgado V. Global longitudinal strain: clinical use and prognostic implications in contemporary practice. Heart. 2020 Sep;106(18):1438-44. https://doi.org/10.1136/heartjnl-2019-316215
4. Malagoli A, Fanti D, Albini A, Rossi A, Ribichini FL, Benfari G. Echocardiographic Strain Imaging in Coronary Artery Disease: The Added Value of a Quantitative Approach. Cardiol Clin. 2020 Nov;38(4):517-26. https://doi.org/10.1016/j.ccl.2020.06.005
5. Kumar D, Saha M, Guha S, Roy T, Kumar R, Sinha AK. Strain imaging as an early predictor in acute myocardial infarction - An augmented cross-sectional study. Indian Heart J. 2024 Jan-Feb;76(1):31-5. https://doi.org/10.1016/j.ihj.2024.01.001
6. Cameli M. Echocardiography strain: why is it used more and more? Eur Heart J Suppl. 2022 Nov 12;24(Suppl I):I38-I42. https://doi.org/10.1093/eurheartjsupp/suac070
7. Gaibazzi N, Pigazzani F, Reverberi C, Porter TR. Rest global longitudinal 2D strain to detect coronary artery disease in patients undergoing stress echocardiography: a comparison with wall-motion and coronary flow reserve responses. Echo Res Pract. 2014 Dec 1;1(2):61-70. https://doi.org/10.1530/erp-14-0020
8. Chimura M, Yamada S, Yasaka Y, Kawai H. Improvement of left ventricular function assessment by global longitudinal strain after successful percutaneous coronary intervention for chronic total occlusion. PLoS One. 2019 Jun 12;14(6):e0217092. https://doi.org/10.1371/journal.pone.0217092
9. Khaled S, Shalaby G. Myocardial recovery after percutaneous coronary intervention in coronary artery disease patients with impaired systolic function- predictive utility of global longitudinal strain. Indian Heart J. 2022 Nov-Dec;74(6):488-93. https://doi.org/10.1016/j.ihj.2022.11.004
10. Sikora-Frac M, Zaborska B, Maciejewski P, Budaj A, Bednarz B. Improvement of left ventricular function after percutaneous coronary intervention in patients with stable coronary artery disease and preserved ejection fraction: Impact of diabetes mellitus. Cardiol J. 2021;28(6):923-31. https://doi.org/10.5603/cj.a2019.0066
11. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020 Jan 14;41(3):407-77. https://doi.org/10.1093/eurheartj/ehz425
12. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 Jan 18;145(3):e18-e114. https://doi.org/10.1161/cir.0000000000001038
13. Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). Circulation. 2003 Sep 2;108(9):1146-62. https://doi.org/10.1161/01.cir.0000073597.57414.a9
14. Wang P, Liu Y, Ren L. Evaluation of left ventricular function after percutaneous recanalization of chronic coronary occlusions : The role of two-dimensional speckle tracking echocardiography. Herz. 2019 Apr;44(2):170-74. https://doi.org/10.1007/s00059-017-4663-1
15. Sotomi Y, Okamura A, Iwakura K, Date M, Nagai H, Yamasaki T, et al. Impact of revascularization of coronary chronic total occlusion on left ventricular function and electrical stability: analysis by speckle tracking echocardiography and signal-averaged electrocardiogram. Int J Cardiovasc Imaging. 2017 Jun;33(6):815-23. https://doi.org/10.1007/s10554-017-1064-8
16. Hoebers LP, Claessen BE, Elias J, Dangas GD, Mehran R, Henriques JP. Meta-analysis on the impact of percutaneous coronary intervention of chronic total occlusions on left ventricular function and clinical outcome. Int J Cardiol. 2015;187:90-6. https://doi.org/10.1016/j.ijcard.2015.03.164
17. Chbini K, Belkhou W, Benzeroual D. Evaluation of changes of global longitudinal strain in patients with coronary artery disease after PCI. Arch Cardiovasc Dis Suppl. 2019;11(3):e326. https://doi.org/10.1016/j.acvdsp.2019.04.050
18. Ionac I, Lazăr MA, Șoșdean R, Văcărescu C, Simonescu M, Luca CT, et al. Considering Both GLS and MD for a Prognostic Value in Non-ST-Segment Elevated Acute Coronary Artery Syndrome. Diagnostics (Basel). 2023 Feb 16;13(4):745. https://doi.org/10.3390/diagnostics13040745
19. Gheorghiade M, Sopko G, De Luca L, Velazquez EJ, Parker JD, Binkley PF, et al. Navigating the crossroads of coronary artery disease and heart failure. Circulation. 2006 Sep 12;114(11):1202-13. https://doi.org/10.1161/circulationaha.106.623199
20. Román-Fernández I, Pérez-Barreda A, Naranjo-Domínguez A, Rodríguez-Navarro AY, Alfonso-Montero OA. Global circumferential strain in patients with ischemic heart disease. CorSalud. 2021 Jan-Mar;13(1):9-18.
21. Subramaniyan S, Pandit N, Kumar Nath R, Raj A, Kamal A, Vatsa D. Acute effect of primary PCI on diastolic dysfunction recovery in anterior wall STEMI - A non-invasive evaluation by echocardiography. Egypt Heart J. 2018 Dec;70(4):427-32. https://doi.org/10.1016/j.ehj.2018.10.004
22. Aggarwal P, Sinha SK, Marwah R, Nath RK, Pandit BN, Singh AP. Effect of Percutaneous Coronary Intervention on Diastolic Function in Coronary Artery Disease. J Cardiovasc Echogr. 2021 Apr-Jun;31(2):73-6. https://doi.org/10.4103/jcecho.jcecho_128_20
23. Talaat AKM, El-Menshawy MD, El-Zaiat AM, El-Dosouky I. Short term evolution of left ventricular diastolic function following primary percutaneous coronary intervention. Egypt J Hosp Med. 2022;87:1027-33.
24. Kavirayani HP, Gudivada JM. Echocardiographic evaluation of left ventricular diastolic function after percutaneous coronary intervention in patients with acute STEMI. J Evid Based Med Healthc. 2020;7(8):409-14. https://doi.org/10.18410/jebmh/2020/88
ARYA Atherosclerosis Journal
Volume 20, Issue 5
September and October 2024
Pages 46-51

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