Assessment of early left ventricular function changes after percutaneous coronary intervention by non-invasive myocardial work / 中华超声影像学杂志

ABSTRACT

Objective:To assess the left ventricular myocardial function in non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) patients with normal wall motion and left ventricular ejection fraction (LVEF) after percutaneous coronary intervention(PCI) by noninvasive myocardial work technology, and to explore the evolution of left ventricular myocardial function recovery.Methods:A total of 92 NSTE-ACS patients from July to December 2019 in Beijing Chao Yang Hospital with normal wall motion and LVEF (>55%) after PCI were recruited. Echocardiography was performed 1 day before PCI, 1 day, 2 weeks, 1 month, and 3 months after PCI. Global longitudinal strain (GLS) was analyzed, and Brachial cuff systolic pressure was used as left ventricular pressure to construct a non-invasive left ventricular pressure-strain loop. Global myocardial work index (GWI), global constructive work (GCW), global waste work (GWW), global myocardial work efficiency (GWE) among groups were compared and their correlations with strain parameters were explored.Results:GWI, GCW, GWE were improved ( P<0.05) at 1 day after PCI, GLS improved ( P<0.05) and GWW decreased ( P<0.05) at 2 weeks, LVEF improved ( P<0.05) at 1 month. Baseline GWI and GCW had a moderately negative correlation with GLS ( r=-0.67, -0.66; both P<0.05); GWW had a moderately positive correlation with mechanical dispersion(MD) and postsystolic shortening index(PSI) ( rs=0.45, 0.50; both P<0.05); GWE had a moderately negative correlation with GLS, MD and PSI ( rs=-0.47, -0.55, -0.56; all P<0.05). Conclusions:Left ventricular myocardial function gradually improves in NSTE-ACS patients with normal wall motion and LVEF after PCI. Myocardial work parameters changes are more sensitive than GLS and LVEF, and can assess early left ventricular myocardial function changes after PCI.