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Evaluation of Left Ventricular Function after Percutaneous Recanalization of Chronic Coronary Occlusions: The Role of Two-Dimensional Speckle Tracking Echocardiography

DOI: 10.4236/wjcd.2019.912080, PP. 899-914

Keywords: Chronic Total Occlusions, Left Ventricular Function, Percutaneous Coronary Intervention, Ejection Fraction, Speckle Tracking Echocardiography

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Abstract:

Background: The recanalization of a chronic total coronary occlusion is the possible way to improve left ventricular (LV) function through the recovery of hibernating myocardium. Aim: The aim of this study is to evaluate the role of 2D speckle tracking in evaluation of the left ventricular (LV) systolic function in chronic total occlusion (CTO) patients before and at 1 day as well as 3 months after percutaneous coronary intervention (PCI). Patients and Methods: A prospective observational study included 40 patients diagnosed with coronary angiography to have a chronic total occlusion. Percutaneous coronary revascularization was performed according to standard practices with the femoral approach. Conventional 2D echocardiography was used to assess LV functions and wall motion abnormalities scoring index (WMAI). Using speckle-tracking echocardiography was to measure global longitudinal strain (GLS) and. Follow-up of patients was done at day 1 and 3 months later after PCI. Results: Forty patients were included in this study, with a mean age of 58.55 ± 7.98 years. GLS and 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 value of baseline GLS (-14.26 ± 0.93) significantly improved at follow-up as GLS was (-15.66 ± 0.92) with p-value < 0.001. Periprocedural complications were contrast induced nephropathy (CIN) in 2 (5%), Cardiac tamponade 1 (2.5%) and Emergency re-PCI 1 (2.5%). Conclusion: The results of this study provide evidence to support the clinical use of 2D-STE to monitor the early changes of LV function. In patients undergoing

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