Evaluation of Left Ventricular Function after Revascularization of Coronary Chronic Total Occlusion using Speckle Tracking Echocardiography

Abstract

Objective: This study evaluated the role of two-dimensional speckle tracking echocardiography (2D-STE) in evaluation of the LV systolic function in patients had CTO of LAD at 1 day as well as at 3 months after revascularization Methodology: This prospective observational study included 100 patients diagnosed by coronary angiography to have a chronic complete occlusion of the left anterior descending artery. Percutaneous coronary intervention (PCI) was performed. When the residual stenosis was less than 30% of the intraluminal diameter and thrombolysis in myocardial infarction (TIMI) grade III flow was achieved without any major complications, the operation was considered a success. Using speckle-tracking echocardiography was to measure global longitudinal strain and left ventricular functions. Follow-up of patients was done at day 1 and 3 months later after PCI. Results: Global longitudinal strain (GLS) and wall motion score index (WMAI) difference at baseline and follow-up shows a positive correlation with left ventricular ejection fraction (LVEF) changes at baseline and follow-up (p˂0.001). Mean baseline left ventricular end systolic volume (LVESV) was 58.22±11.65 and follow-up LVESV was 50.60±14.07 with statistical difference (p=0.047). Mean value of baseline GLS (-14.26±0.93) and follow-up GLS was (-15.66±0.92) (p˂0.001). Periprocedural complications were contrast induced nephropathy in 3 %, cardiac tamponade 1 % and Emergency re-PCI 1 % Conclusion: Revascularization via PCI to CTO of LAD can improve LV function. These results of the study provide evidence to support the clinical use of 2D-STE to assess the early changes of LV function.