Assessment of Left Ventricular Function by Echocardiographic Imaging in Patients Non-ST Segment Elevation ACS
Zeinab Alsadat Ahmadi1, Manijhe Mokhtari-Dizaji1, Hamideh Khesali2
1Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Insights
Successful percutaneous coronary intervention (PCI) significantly improves left ventricular (LV) function in acute coronary syndrome (ACS) patients. Non-invasive biomechanical markers like global strain and elastic modulus effectively assess this early LV recovery post-PCI.
Area of Science:
- Cardiology
- Echocardiography
- Biomechanical analysis
Background:
- Limited studies evaluate left ventricular (LV) function recovery after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients without ST elevation.
- Assessing contractile LV function post-PCI is crucial for understanding treatment outcomes.
Purpose of the Study:
- To evaluate the effect of successful PCI on LV recovery using non-invasive biomechanical markers.
- To assess early changes in myocardial function after revascularization in ACS patients.
Main Methods:
- 30 ACS patients with preserved ejection fraction (EF) underwent 2D-echocardiography before PCI, 1 day after, and 3 months post-PCI.
- LV function assessed using conventional echocardiography, 2D speckle tracking echocardiography (2D-STE) for global longitudinal and circumferential strain, and elastic modulus (E) parameters.
Main Results:
- Significant improvements in global strain and elastic modulus (E) were observed 1 day and 3 months post-PCI (p < 0.05).
- Strain changes correlated moderately with ejection fraction (EF) changes (r = 0.6, p < 0.05).
- Global longitudinal strain (GLS) and global circumferential strain (GCS) demonstrated high sensitivity (87%) in detecting LV recovery (AUC 0.86-0.91, p < 0.001).
Conclusions:
- Global strain and elastic modulus are sensitive, non-invasive markers for evaluating early LV improvement after coronary revascularization.
- These parameters effectively differentiate pre-PCI from post-PCI states in ACS patients.
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.
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