Assessment of left ventricular systolic function in patients with chronic coronary syndrome and heart failure with reduced ejection fraction after percutaneous coronary intervention

Abstract

Objective: Describe the characteristic and change of left ventricular systolic function after percutaneous coronary intervention in patients with chronic coronary syndrome and heart failure with reduced ejection fraction after percutaneous coronary intervention. Methods: This prospective study involved the monitoring of 40 patients who had an ejection fraction of 40% or less and were diagnosed with chronic coronary artery disease. These patients underwent a successful percutaneous coronary intervention at the Vietnam National Heart Institute and Hanoi Medical University Hospital between September 2022 and August 2023. The main objective is to evaluate the left ventricular systolic function following the intervention using 2D echocardiography. Results: A total of 40 patients (34 male and 6 females) with a mean age of 68.3 ± 10.2, were assessed for left ventricular systolic function using 2D echocardiography before and after the intervention. In paired assessment at 90-day follow-up, baseline LVEF improved significantly (before intervention: 32.8 ± 7.2% and after: 38,7 ± 7,3%, p < 0.01). Left ventricular longitudinal strain improved significantly on all cross-sections such as: 4-chamber GLS (before: -10.4 ± 3.97%, after: -13.6 ± 4.3%, p < 0.01), 2-chamber GLS (before: -10.6 ± 3.8%, after: -13.1 ± 4.2%, p < 0.01), 3-chamber GLS (before: -9.8 ± 3.7%, after: -12.3 ± 4.6%, p < 0.01), GLS Avg (before: -10.3 ± 3.6%, after: -13 ± 4.1%, p< 0.01), basal GLS (before: -11.2 ± 3.8%, after: -14 ± 4.5%, p < 0.01), middle GLS (before: -9.3 ± 4.4%, after: -11.8 ± 3.9%, p < 0.01), apical GLS (before: -11.5 ± 5.1%, after: -14.3 ± 5.9%, p < 0.01). In comparison with the incomplete-revascularization group, there was a significant improvement in left ventricular systolic function in the complete-revascularization group (OR= 22.17, p < 0.01). Conclusions: In patients with chronic coronary syndrome and a reduced left ventricular ejection fraction, the systolic function of the left ventricle was enhanced following percutaneous coronary intervention, particularly in the group that underwent complete revascularization.