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. 2024 Dec 5;16(12):e75133.
doi: 10.7759/cureus.75133. eCollection 2024 Dec.

Effects of Elective Percutaneous Coronary Intervention on Subtle Left Ventricular Systolic Dysfunction in Patients With Stable Coronary Artery Disease as Assessed by Global Longitudinal Strain Imaging

Swargam Venu  1 , Ramnath Venkitasubramonia Iyer  2 , Prabath Kumar Dash  2
Affiliations

Effects of Elective Percutaneous Coronary Intervention on Subtle Left Ventricular Systolic Dysfunction in Patients With Stable Coronary Artery Disease as Assessed by Global Longitudinal Strain Imaging

Swargam Venu et al. Cureus. .

Abstract

Aim The study aimed to detect subtle left ventricular (LV) systolic dysfunction, reflected by abnormal global longitudinal strain (GLS), in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) and to evaluate any improvement in GLS at 24 hours and six months post-PCI. Methods A total of 94 patients with stable CAD scheduled for elective PCI at our hospital were evaluated using conventional 2D echocardiography and GLS prior to the procedure. Follow-up assessments were conducted at 24 hours and six months post-PCI. Results Our study revealed evidence of subclinical LV dysfunction in the form of reduced baseline GLS (-16.72 ± 1.98) despite a normal ejection fraction (59.21 ± 2%). Baseline GLS showed a significant correlation with the severity of CAD, declining progressively with an increasing number of stenotic coronary vessels. Notably, there was significant improvement in subclinical LV dysfunction following PCI, as evidenced by enhanced GLS values at the six-month follow-up (-21.87 ± 1.70; p < 0.001). Among patients stratified into single-vessel disease (SVD, 63.8%), double-vessel disease (29.8%), and triple-vessel disease (3VD, 6.4%), GLS improved significantly at both 24 hours and six months post-PCI compared to baseline. Conclusions Patients with stable CAD, normal LVEF, and no regional wall motion abnormalities on 2D echocardiography were found to exhibit subtle LV dysfunction as detected by GLS. GLS parameters showed significant improvement following successful PCI. The degree of GLS impairment progressively worsened with the severity of CAD, increasing from SVD to 3VD.

Keywords: cardiovascular diseases; coronary artery disease; global longitudinal strain; left ventricular systolic dysfunction; percutaneous coronary intervention.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Sri Sathya Sai Institute of Higher Medical Sciences issued approval 305-12149-181-216619. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Study flow chart
CAD: coronary artery disease; CAG: coronary angiography; PCI: percutaneous coronary intervention
Figure 2
Figure 2. Comparison of LVEF (%) measured by the modified Simpson's method at 24 hours and six months post-PCI
LAD: left anterior descending artery; LCX: left circumflex artery; LVEF: left ventricular ejection fraction; PCI: percutaneous coronary intervention; RCA: right coronary artery
Figure 3
Figure 3. Distribution of study participants according to coronary arteries with stenosis
DVD: double-vessel disease; SVD: single-vessel disease; TVD: triple-vessel disease
Figure 4
Figure 4. Comparison of GLS according to the number of coronary arteries stenosed before the intervention
GLS: global longitudinal strain
See this image and copyright information in PMC

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