Background: The presence of proximal left anterior descending artery (LAD) stenosis is an important independent predictor of mortality & major adverse cardiovascular events (MACE). Speckle tracking is highly sensitive for the detection of subclinical impact of both ischemia and revascularization on global and regional myocardial function.
Objective: The study aims to assess global and regional left ventricular strain, in patients with significant proximal left anterior descending coronary artery stenosis, before and after percutaneous revascularization, and its relation with MACE.
Methods: A total of 53 patients were admitted to Mansoura University's Cardiovascular Department between December 2017 and November 2018 for elective proximal left anterior descending artery (LAD) stenting. 2D echocardiography and speckle tracking were done before and one month after percutaneous coronary intervention (PCI), assessing left ventricular ejection fraction (LVEF). Global Longitudinal Strain (GLS), mean LAD territorial strain & left ventricular (LV) function with clinical follow-up for cardiovascular MACE after one year.
Results: There was presenting significant impaired GLS and mean LAD strain even with normal EF (median -13.5 /-11.9) respectively with significant recovery The mean LAD territorial strain one month after PCI than GLS, with p-value <0.001/ <0.01 respectively. However, GLS recovery was found to be the most valuable predictor for the occurrence of MACE one-year follow-up (p-value: 0.019).
Conclusion: GLS & mean LAD territorial strain provided a more precise objective quantification of successful global and regional recovery of LV function after proximal LAD revascularization & predictor for MACE.