Association Between First-Phase Left Ventricular Ejection Fraction and Severity of Coronary Artery Stenosis and...

Myocardial ischemia can impair the speed and intensity of myocardial contractility, frequently undetectable by conventional echocardiography in early stages. The aim of this study was to assess whether first-phase left ventricular ejection fraction (LVEF-1), a sensitive myocardial contractility marker, correlates with ischemia severity and improves following interventional treatment.

Two hundred seven patients were categorized into mild, moderate, and severe groups based on angiographic coronary maximal stenosis. LVEF-1, Gensini scores, and clinical data were compared among these groups. Logistic regression was used to assess the association between LVEF-1 and coronary artery stenosis, and linear regression identified factors linked to postintervention LVEF-1 improvement. The median LVEF-1 in the 3 groups was 29.6% (28.2-31.7), 27.8% (27.0-28.6), and 25.2% (23.6-26.5) (P<0.001). LVEF-1 showed inverse correlation with Gensini score (r=-0.694, P<0.001) and BNP (B-type natriuretic peptide; r=-0.244, P<0.001). LVEF-1 was independently associated with coronary artery stenosis ≥50% or ≥70%. A cutoff value of 26.9% for LVEF-1 had a sensitivity of 89.5% and specificity of 83.9% for predicting coronary artery stenosis ≥70%. Following intervention, LVEF-1 increased from 24.70% (23.30-26.32) to 28.10% (26.80-29.92) in 82 patients. Stent diameter was identified as an independent factor associated with improvement in LVEF-1 post intervention.

LVEF-1 is negatively correlated with the severity of coronary artery stenosis, and it improves significantly after coronary artery intervention therapy, suggesting that LVEF-1 can serve as a novel indicator for assessing coronary artery stenosis severity and monitoring the efficacy of interventional treatment.