Assessment of Left Ventricular Function by Echocardiographic Imaging in Patients Non-ST Segment Elevation ACS Undergoing Successful Percutaneous Revascularization Therapy.

Background: There are insufficient studies on beneficial outcomes of successful percutaneous coronary intervention (PCI) in the evaluation of contractile left ventricular (LV) function for acute coronary syndrome (ACS) patients without ST elevation. The study aimed to detect the effect of revascularization on LV recovery using non-invasive biomechanical markers.

Methods: A total of 30 successful PCI patients (mean age 56 ± 9 years) with preserved ejection fraction (EF) underwent two-dimensional (2D)-echocardiography before PCI, as early as 1 day after PCI, and 3 months follow-up. LV function assessment was carried out using conventional echocardiographic parameters. Global longitudinal and circumferential strain with 2D speckle tracking echocardiography (2D-STE) and elastic modulus (E) parameters were calculated to evaluate myocardial function.

Results: There were significant improvements in the value of global strain and E parameters, 1 day after PCI (p < 0.05) and also 3 months after PCI (p < 0.05) as compared to values before PCI (p < 0.05). Strain changes 1 day after PCI and also 3 months after PCI as compared to values before PCI (p < 0.05) with changes in EF, demonstrated moderate correlation with a significant statistical difference (r = 0.6, p < 0.05). GLS and GCS parameters significantly improved LV recovery from before PCI to follow-up (AUC 0.86 and 0.91 with 87% sensitivity, respectively, and p < 0.001).

Conclusions: Calculated global strain and elastic modulus parameters were more sensitive and superior non-invasive markers to evaluate early LV improvement after coronary revascularization and helpful to differentiate the pre-PCI from the post-PCI group.