Abstract
The aim of this study was to assess the accuracy of echocardiographic techniques in detecting the early recovery of left ventricular (LV) function after revascularization in acute coronary syndrome (ACS). In 80 consecutive patients with ACS (age 55.7 ± 9.4 years, 77% male, 15% with CCS Angina III), an echocardiographic examination of left ventricle regional wall motion abnormalities (LV RWMA), peak systolic strain rate (PSSR), peak systolic strain (PSS) and end systolic strain (ESS) was performed before and after percutaneous intervention (PCI). Of the 80 patients, one vessel stenosis (>70%) was present in 53 (66%), two vessel disease in 12 (15%) and multivessel disease in 15 patients (19%). In total, 51% of patients had hypertension, 40% diabetes and 23% dyslipidemia. After PCI, regional PSS, ESS and PSSR of their segments subtended by the culprit vessel improved; left anterior descending-LAD, circumflex-LCx and right coronary-RCA (p<0.05 for all) as well as global S and SR (p < 0.05 for all). In univariate analysis, hypertension (HTN) (β = −0.294 (−0.313–0.047), p = 0.009, smoking β = −0.244 (−0.289–0.015) =0.03, WMA β = −0.317 (−0.284–0.014), p = 0.004 and the number of diseased vessels β = −0.256 (−0.188– 0.054) p=0.03 were predictors of delta global SR. In multivariate analysis, only HTN β = 0.263 (0.005–3.159) and the number of diseased vessels β =0.263 (0.005 - 3.159), p=0.04) predicted delta global SR. In ACS, the echocardiographic regional myocardial deformation is accurate in detecting early recovery of LV myocardial function after culprit lesion revascularization. Also, the findings of this study support the current practice regarding the crucial importance of proximal epicardial vessel PCI treatment on LV function compared to more distal lesions.
Highlights
Acute coronary syndrome (ACS) remains a major cause of death and morbidity worldwide [1], despite the well-established treatment strategies including direct revascularization with percutaneous coronary intervention (PCI) [2]
The findings of this study support the current practice regarding the crucial importance of proximal epicardial vessel PCI treatment on left ventricular (LV) function compared to more distal lesions
The patients’ mean age was 55.7 ± 9.4 years, 23% were females, 51% had hypertension where hypertension was defined as office SBP values ≥140 mmHg and/or diastolic BP (DBP) values
Summary
Acute coronary syndrome (ACS) remains a major cause of death and morbidity worldwide [1], despite the well-established treatment strategies including direct revascularization with percutaneous coronary intervention (PCI) [2]. The evaluation of cardiac function, in particular left ventricular (LV) function before PCI, adds to the accurate design of treatment strategy. As a global marker of LV function, the evaluation of myocardial deformation by regional or global strain and strain rate (SR) has been introduced in routine clinical practice [4] and in acute cardiac syndromes. Global and regional myocardial deformation assessment by echocardiography is a current non-invasive ultrasound imaging technique that allows for the evaluation of global and regional LV myocardial function [5,6] and their early response to treatment.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
