LAUSR

Objective: Myocardial strain detected by transthoracic echocardiography is a more sensitive method for systolic function evaluation than ejection fraction. Impact of coronary revascularisation on systolic function in stable coronary artery disease (SCAD) patients remains an object of research. Design and method: 36 SCAD patients with single lesion in left anterior descending artery (LAD) undergoing percutaneous coronary intervention (PCI) were included in a single center prospective cohort study from December 2015 to December 2017. Patients with previous myocardial infarction, coronary vessel occlusions, stents in LAD or left main artery, PCI in previous 3 months time in left circumflex or right coronary artery, atrial fibrillation at the time of study were excluded. In study group there were no patients with medium or pronounced left ventricular hypertrophy, II – IIIrd degree valvular regurgitation, any valve stenosis, hypo- or akinetic segments visually, or decreased ejection fraction. Transthoracic echocardiography at rest was performed the day before PCI and 3 months after. Acquired images were measured by TOMTEC ARENA, using 16-segment model, and results analysed using SPSS 22. Results: Mean age in the study group was 67 years. Out of 36 patients, 22 (61%) were men. 16 (44%) patients had proximal 1/3 LAD stenosis, 16 (44%) had diastolic dysfunction. Mean GLS before and after the revascularisation was -16.22 ± 1.14% and -19.43 ± 1.35 respectively (delta = 3.21; p < 0.001) and improvement remained statistically significant in each of 16 segments, too. When comparing results in subgroups, delta (change) after revascularisation in proximal LAD group was 3.61% ± 1.79 (p < 0.001) and in middle 1/3 LAD group 2.9% ± 1.33 (p < 0.001). Difference between subgroup results was statistically significant (p = 0.02). Delta in normal diastolic function group and diastolic dysfunction group was 3.18 ± 1.89 (p < 0.001) and 3.26 ± 1.09 (p < 0.001) respectively, and difference between subgroups was not statistically significant. Conclusions: In this small prospective cohort study PCI in SCAD patients was associated with statistically significant LV myocardial strain improvement.