Key result
Endovascular revascularization in LEAD linked to a ~0.78 cm/s increase in mitral e' velocity.
Why the study?
The early effects of endovascular revascularization for lower extremity arterial disease on echocardiographic indices of left ventricular diastolic dysfunction and their clinical significance remained unclear.
Does endovascular revascularization improve echocardiographic indices of left ventricular diastolic dysfunction in patients with lower extremity arterial disease?
Observational (n=74)
Blinded outcome assessment
No
Does endovascular revascularization improve echocardiographic indices of left ventricular diastolic dysfunction in patients with lower extremity arterial disease?
Successful endovascular revascularization in patients with lower extremity arterial disease is associated with early improvements in echocardiographic parameters of left ventricular diastolic function.
May signal early diastolic recovery in LEAD; hypothesis-generating and should not yet change practice.
Background: Lower extremity arterial disease (LEAD) is a systemic atherosclerotic condition associated with increased arterial stiffness, impaired ventricular-arterial coupling, and a higher prevalence of left ventricular diastolic dysfunction (LVDD). Although endovascular revascularization improves limb perfusion, its early effects on echocardiographic indices of LVDD function and their clinical significance remain unclear. This study aimed to evaluate early changes in selected echocardiographic indices of LVDD function following successful revascularization in patients with LEAD. Methods: This prospective single-center study included 74 patients who underwent endovascular revascularization for aortoiliac or femoropopliteal disease. Transthoracic echocardiography was performed 24-48 hours before and 48-120 hours after the intervention. Diastolic indices, including e' velocity, E/e' ratio, isovolumetric relaxation time (IVRT), and IVRT/TE-e' ratio, were measured according to American Society of Echocardiography/EACVI guidelines. Longitudinal changes were analyzed using linear mixed-effects models incorporating lesion location and lesion laterality as covariates. Results: Statistically significant early changes were observed in selected diastolic parameters following revascularization. Mitral annular e' velocity increased from 7.91±2.43 to 8.69±2.35 cm/s (p=0.036), while the E/e' ratio decreased from 8.97±2.44 to 7.53±2.27 (p<0.001). IVRT (p=0.029) and the IVRT/TE-e' ratio (p=0.018) also decreased significantly. No changes were observed in blood pressure, heart rate, or left ventricular systolic function. Lesion location did not influence changes in e' velocity or E/e' ratio; however, aortoiliac disease was associated with a greater reduction in the IVRT/TE-e' ratio (p=0.021). Lesion laterality did not affect diastolic outcomes. Conclusion: Successful endovascular revascularization in patients with LEAD was associated with early changes in selected echocardiographic indices of LVDD. The clinical significance of these changes and whether they translate into long-term outcomes warrant further investigation.
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Balaban et al. (2026) conducted an observational in Lower extremity arterial disease (LEAD) (n=74). Endovascular revascularization vs. Pre-revascularization baseline was evaluated on Mitral annular e' velocity (cm/s) (Mean difference 0.78, 95% CI 0.09-1.51, p=0.036). Endovascular revascularization in patients with lower extremity arterial disease significantly increased mitral annular e' velocity by 0.78 cm/s and decreased the E/e' ratio by 1.44.
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