Impact of Residual Coronary Artery Disease on Left Ventricular Function After Percutaneous Coronary Intervention: A two-dimensional Strain Echocardiography Study

Overview

Journal Herz

Specialty Cardiology & Vascular Diseases

Date 2022 Dec 30

PMID 36583753

Authors

Fatih Levent

Fatih Koca

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to investigate the relationship between the residual SYNTAX score (rSS) and recovery of left ventricular function after percutaneous coronary intervention (PCI) in stable symptomatic patients.

Method: Overall, 81 patients (mean age: 62.3 ± 9.1 years, 72.8% male) were included in the study. Echocardiographic parameters were measured before PCI (baseline) and 3 months after PCI (follow-up). The patients were divided into two groups based on rSS: complete revascularized group (CR) with rSS = 0 (n =32; 39.5%) and incomplete revascularized group (iCR) with rSS > 0 (n = 49; 60.5%).

Results: The median (25th-75th percentile) SYNTAX score (SS) and rSS values were 8 (5-11) and 2 (0-3), respectively. The difference between basal and follow-up global longitudinal strain (GLS) values (∆ GLS) was significantly higher in the CR group (1.25% ± 1.52 vs. 0.11% ± 1.66% p = 0.003). At the follow-up, there was a significant increase in left ventricular ejection fraction (58.41 ± 6.91% vs. 61.74 ± 5.76%, p < 0.001), a significant decrease in Tei index (0.46 ± 0.18 vs. 0.35 ± 0.16%, p < 0.001), and a significant increase in GLS (14.92 ± 2.76% vs. -15.49 ± 2.66%, p = 0.004). In the linear regression analysis, the only variable related to ∆ GLS was rSS (β = -0.113, 95% CI: -0.217--0.010; p = 0.033).

Conclusion: Increased residual coronary artery disease burden has a negative impact on recovery of left ventricular function after PCI.

Citing Articles

Predictors of left ventricular ejection fraction in high-risk percutaneous coronary interventions.

Panoulas V, Escaned J, Hill J, Barker E, Butler K, Almedhychy A Front Cardiovasc Med. 2024; 11:1342409.

PMID: 38370154 PMC: 10869567. DOI: 10.3389/fcvm.2024.1342409.

References

Genereux P, Palmerini T, Caixeta A, Rosner G, Green P, Dressler O . Quantification and impact of untreated coronary artery disease after percutaneous coronary intervention: the residual SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) score. J Am Coll Cardiol. 2012; 59(24):2165-74. PMC: 3725642. DOI: 10.1016/j.jacc.2012.03.010. View

Farooq V, Serruys P, Bourantas C, Zhang Y, Muramatsu T, Feldman T . Quantification of incomplete revascularization and its association with five-year mortality in the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) trial validation of the residual SYNTAX score. Circulation. 2013; 128(2):141-51. DOI: 10.1161/CIRCULATIONAHA.113.001803. View

Singbal Y, Fryer M, Garrahy P, Lim R . Baseline and residual SYNTAX score in predicting outcomes after acute infarct angioplasty. EuroIntervention. 2016; 12(16):1995-2000. DOI: 10.4244/EIJ-D-15-00269. View

Aggarwal V, Rajpathak S, Singh M, Romick B, Srinivas V . Clinical outcomes based on completeness of revascularisation in patients undergoing percutaneous coronary intervention: a meta-analysis of multivessel coronary artery disease studies. EuroIntervention. 2011; 7(9):1095-102. DOI: 10.4244/EIJV7I9A174. View

Luis S, Chan J, Pellikka P . Echocardiographic Assessment of Left Ventricular Systolic Function: An Overview of Contemporary Techniques, Including Speckle-Tracking Echocardiography. Mayo Clin Proc. 2019; 94(1):125-138. DOI: 10.1016/j.mayocp.2018.07.017. View

Abraham T, Dimaano V, Liang H . Role of tissue Doppler and strain echocardiography in current clinical practice. Circulation. 2007; 116(22):2597-609. DOI: 10.1161/CIRCULATIONAHA.106.647172. View

Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F . Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr. 2010; 23(4):351-69. DOI: 10.1016/j.echo.2010.02.015. View

Onishi T, Saha S, Delgado-Montero A, Ludwig D, Onishi T, Schelbert E . Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging: comparison with left ventricular ejection fraction. J Am Soc Echocardiogr. 2015; 28(5):587-96. DOI: 10.1016/j.echo.2014.11.018. View

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. 2019; 28(6):923-931. PMC: 8747832. DOI: 10.5603/CJ.a2019.0066. View

10.

Campeau L . The Canadian Cardiovascular Society grading of angina pectoris revisited 30 years later. Can J Cardiol. 2002; 18(4):371-9. View

11.

Thygesen K, Alpert J, Jaffe A, Chaitman B, Bax J, Morrow D . Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018; 72(18):2231-2264. DOI: 10.1016/j.jacc.2018.08.1038. View

12.

Cockcroft D, GAULT M . Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16(1):31-41. DOI: 10.1159/000180580. View

13.

Feldman T, Hirshfeld Jr J, Kern M, King 3rd S, Morrison D, ONeill W . ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for.... J Am Coll Cardiol. 2006; 47(1):e1-121. DOI: 10.1016/j.jacc.2005.12.001. View

14.

Sianos G, Morel M, Kappetein A, Morice M, Colombo A, Dawkins K . The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention. 2009; 1(2):219-27. View

15.

Schiller N, Shah P, Crawford M, DeMaria A, Devereux R, FEIGENBAUM H . Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989; 2(5):358-67. DOI: 10.1016/s0894-7317(89)80014-8. View

16.

Tei C . New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol. 1995; 26(2):135-6. View

17.

Grenne B, Eek C, Sjoli B, Dahlslett T, Uchto M, Hol P . Acute coronary occlusion in non-ST-elevation acute coronary syndrome: outcome and early identification by strain echocardiography. Heart. 2010; 96(19):1550-6. DOI: 10.1136/hrt.2009.188391. View

18.

Galderisi M, Esposito R, Schiano-Lomoriello V, Santoro A, Ippolito R, Schiattarella P . Correlates of global area strain in native hypertensive patients: a three-dimensional speckle-tracking echocardiography study. Eur Heart J Cardiovasc Imaging. 2012; 13(9):730-8. DOI: 10.1093/ehjci/jes026. View

19.

Addetia K, Takeuchi M, Maffessanti F, Nagata Y, Hamilton J, Mor-Avi V . Simultaneous Longitudinal Strain in All 4 Cardiac Chambers: A Novel Method for Comprehensive Functional Assessment of the Heart. Circ Cardiovasc Imaging. 2016; 9(3):e003895. DOI: 10.1161/CIRCIMAGING.115.003895. View

20.

Stoylen A, Molmen H, Dalen H . Left ventricular global strains by linear measurements in three dimensions: interrelations and relations to age, gender and body size in the HUNT Study. Open Heart. 2019; 6(2):e001050. PMC: 6802996. DOI: 10.1136/openhrt-2019-001050. View