Assessment of the left ventricular longitudinal deformation failed to detect early changes after the second-stage percutaneous coronary intervention in patients with the acute coronary syndrome

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Primary intervention in acute coronary syndrome (ACS) is often followed by the second-stage procedure when other atherosclerotic lesions are present. However, there is no data regarding the early effects of such a strategy on left ventricular function. Speckle-tracking echocardiography has been proven a sensitive method in assessing myocardial function. Purpose The study aimed to assess the early results of the second stage of percutaneous coronary intervention (PCI) in patients with ACS. Methods The study group consisted of 61 patients aged from 47 to 92 (mean age 66,3± 9,8) years, 21 women (34,4%) and 40 men (65,6%) who had ACS. Primary treatment involved culprit-lesion only. All pts were optimally treated regarding ischemic heart disease. The second-stage PCI was performed up to four months after ACS. Patients underwent transthoracic echocardiography 48 hours before and after the second-stage PCI. Using automated functional imaging (AFI), we analyzed the global longitudinal strain (GLS) of the left ventricle, GLS in the four-chamber view (GLS-4CH), the two-chamber view (GLS-2CH), and the three-chamber view (GLS-3CH). We also assessed the mean of the peak longitudinal strain of the myocardial segments according to the standard assignment to coronary artery territories, i.e. left anterior descending (LAD), right coronary artery (RCA) and circumflex coronary artery (LCX). Results The following second-stage PCI were performed in the study group: 33 procedures regarding the left anterior descending artery, 15 procedures regarding the left circumflex artery and 13 procedures regarding the right coronary artery. The mean value of the GLS of the left ventricle before the second-stage PCI was slightly reduced compared to the currently established norm (GLS= −16.7%). The second-stage PCI did not result in early changes in the GLS. We also did not observe any significant changes in the mean peak longitudinal strain according to the coronary artery territories (Table 1). Conclusions Despite the proven sensitivity of the deformation imaging technique in assessing left ventricular function, the present work does not show an early effect of the percutaneous coronary intervention on either the global longitudinal strain of the left ventricle or the longitudinal strain of the segments allocated to each coronary arterial territory.