The 5-year dynamics of cardiac structure and function in patients with coronary artery disease after myocardial...

Area of Science:

• Cardiology
• Cardiac Surgery
• Diagnostic Imaging

Background:

• Coronary artery disease (CAD) management often involves revascularization procedures.
• Understanding long-term cardiac remodeling after revascularization is crucial for patient outcomes.

Purpose of the Study:

• To assess the longitudinal changes in echocardiographic parameters up to five years after revascularization in CAD patients.
• To compare the effects of percutaneous coronary intervention with stenting (PCIwS) versus coronary artery bypass grafting (CABG) on cardiac geometry and mass.

Main Methods:

• A cohort of 50 patients (39 males/11 females, mean age 59.9 years) with CAD underwent either PCIwS (n=38) or CABG (n=12).
• Regular echocardiography was performed to evaluate left ventricular myocardial mass (LVMM) and geometry over five years.
• Patients were stratified based on revascularization method.

Main Results:

• Baseline left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) were more severe in the CABG group.
• Progressive LAE occurred in the PCIwS group, while aortic and left ventricular dilatation were observed in the CABG group within two years.
• Left ventricular myocardial mass index increased significantly in both groups within two years.
• Normal left ventricular geometry normalized in 3 years post-PCIwS and 1.5 years post-CABG.

Conclusions:

• Coronary artery bypass grafting (CABG) was associated with more severe left ventricular hypertrophy (LVH) in the first year post-revascularization compared to percutaneous coronary intervention with stenting (PCIwS).
• After five years, the ratio of concentric to eccentric LVH differed significantly between PCIwS (2:1) and CABG (1:2) patients, indicating distinct remodeling patterns.