Assessment of Left Ventricular Strain in Ischemic Heart Failure Patients Following Revascularization Using Speckle Tracking Echocardiography

Background: Heart failure (HF) is a major global health burden, with ischemic heart disease (IHD) being a leading cause due to myocardial damage and impaired cardiac function. While left ventricular ejection fraction (LVEF) is the conventional measure of cardiac performance, two-dimensional speckle-tracking echocardiography (2D-STE) provides a more sensitive assessment of myocardial strain, allowing early detection of dysfunction. Revascularization procedures, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), may enhance cardiac outcomes in ischemic HF. This study evaluated the impact of revascularization on LVEF and left ventricular strain using 2D-STE. Methods: A follow-up study was conducted at Kobri Al-Kobba Specialized Cardiology Hospital, Egypt, in 2023, involving 78 ischemic HF patients with LVEF ≤50%. Patients were allocated into a control group (30 patients) receiving optimal medical therapy and an interventional group (48 patients) undergoing PCI (27) or CABG (21). Echocardiography with 2D-STE was performed before and after treatment to assess LVEF, global longitudinal strain (LVGLS), and global circumferential strain (LVGCS). Results: After treatment, the interventional group showed significant improvement in LVEF (P=0.017), ΔLVEF (P=0.02), LVGLS (P<0.001), and LVGCS (P<0.001) versus the control group. Within the interventional group, PCI patients demonstrated higher post-treatment LVEF (P<0.001), LVGLS (P<0.001), and LVGCS (P=0.006), while CABG patients showed superior ΔLVGCS (P=0.014). No significant baseline differences existed between groups.