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Echocardiographic parameters for left ventricular function assessment and predictive value in coronary heart disease
Jing Qin1, Haijian Guo1, Yu Zhang1
1Department of Cardiac Ultrasound, Affiliated Hospital of Nantong University Nantong 226001, Jiangsu, China.
Insights
Echocardiography, particularly myocardial strain indices like global longitudinal and radial strain, can predict outcomes in coronary heart disease patients after percutaneous coronary intervention. These measurements aid in risk stratification and guiding early interventions.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Coronary heart disease (CHD) poses significant cardiovascular risk.
- Percutaneous coronary intervention (PCI) is a common treatment for CHD.
- Prognostic assessment in CHD patients post-PCI requires refined tools.
Purpose of the Study:
- To assess the prognostic capability of echocardiographic parameters in CHD patients undergoing elective PCI.
- To specifically evaluate the role of myocardial strain indices in predicting patient outcomes.
- To identify key echocardiographic markers for risk stratification post-PCI.
Main Methods:
- Retrospective analysis of 135 CHD patients post-PCI and 100 healthy controls.
- Measurement of echocardiographic parameters including cardiac output, ventricular volumes, ejection fraction, and myocardial strain (GLSP, GRSP).
- 12-month follow-up to assess major adverse cardiovascular events (MACE) for prognosis determination.
Main Results:
- CHD patients exhibited impaired cardiac function pre-PCI compared to controls.
- Post-PCI, cardiac function improved but remained suboptimal.
- Worse post-PCI myocardial strain (lower GLSP, higher GRSP) and ventricular dimensions correlated with poor prognosis (MACE).
- A combined GLSP and GRSP model demonstrated strong predictive accuracy (AUC 0.865) for poor prognosis.
Conclusions:
- Echocardiographic parameters, especially combined myocardial strain indices (GLSP, GRSP), are valuable predictors of prognosis in CHD patients post-PCI.
- Strain imaging offers significant potential for risk stratification and guiding timely interventions in this patient group.
- These findings support integrating advanced echocardiography into routine clinical practice for CHD management.
Objective:
To evaluate the prognostic value of specific echocardiographic parameters, particularly myocardial strain indices, in patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention (PCI).
Methods:
This retrospective study included 135 CHD patients who underwent PCI (observation group) and 100 healthy controls. Echocardiographic parameters (cardiac output [CO], left ventricular volumes [LVESV, LVEDV], ejection fraction [LVEF], cardiac index [CI], global longitudinal strain peak [GLSP], and global radial strain peak [GRSP]) were measured. Patients were followed up for 12 months post-PCI. Prognosis was determined based on the occurrence of major adverse cardiovascular events (MACE) during this follow-up period, including recurrent angina, acute coronary syndrome, arrhythmia, or heart failure. A good prognosis was defined as event-free survival with improved quality of life, while a poor prognosis was defined by the occurrence of any MACE. Parameters were compared between groups and correlated with prognosis.
Results:
Pre-PCI, CHD patients had impaired parameters (lower CO, LVEF, CI; higher LVESV, LVEDV) versus controls (all P<0.05). Post-PCI, these parameters improved but remained suboptimal. Patients with a poor prognosis had significantly worse post-PCI parameters (lower GLSP, higher GRSP, LVESV, LVEDV) than those with a good prognosis (all P<0.05). A predictive model combining GLSP and GRSP showed an AUC of 0.865 for poor prognosis. Left ventricular diameters (LVESD, LVEDD) were negatively correlated with GRSP and positively correlated with GLSP (all P<0.05).
Conclusion:
Echocardiographic parameters, especially the combined model of myocardial strain indices (GLSP and GRSP), provide significant predictive value for prognosis in CHD patients after elective PCI. These findings support the use of strain imaging for risk stratification and early intervention.
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