Two-Dimensional Speckle-Tracking Echocardiography to Monitor Left Ventricular Function After Percutaneous Coronary Intervention

Background: Conventional 2 D Doppler echocardiographic parameters are inadequate for evaluation and monitoring Left ventricle systolic function recovery of patients with ischemic heart disease (IHD) treated by Percutaneous coronary intervention (PCI). Hence, New strain imaging parameters are studied by using 2 D speckle Tracking Echocardiography. The aim is to compare the conventional echocardiographic parameters (Left ventricle ejection fraction, Wall motion score index, regional wall motion score) with speckle tracking echocardiographic parameters (Global longitudinal strain, Regional longitudinal strain) in patients with ischemic heart disease undergo Percutaneous Coronary Intervention (PCI).Method and patient: A prospective Interventional Hospital Based study enrolled 50 patients who had ischemic heart disease (IHD), Percutaneous coronary intervention (PCI) was done for them at IbN Al-Bittar Cardiac Surgery Center from October 2014 to April 2015. Both conventional echocardiographic parameters (Left ventricle ejection fraction, Wall motion score index, regional wall motion score according to coronary artery territory) and Speckle tracking echocardiographic parameters (Global longitudinal strain, Regional longitudinal strain according to coronary artery territory) done for them pre PCI, one day post PCI, and one month post PCI.Result: Regarding conventional echocardiographic parameters: Global LVEF pre PCI 52.34±90% , one month post PCI was (54.00±6.9), there was no significant difference statistically (P value 0.79), also Wall motion score index ,Regional wall motion score according to coronary artery territory were (1.22±0.25,1.44±1.52) respectively, one month post PCI were (1.98±0.26,1.40±0.58) respectively where there's no significant differences statistically (P value 0.25,0.22) respectively.Regarding speckle tracking parameters :Global Longitudinal strain for all patients pre PCI was (-14.30±3.54%) ,one day post PCI was (-14.78±3.81%) ;there was no significant differences (p value 0.77).After one month Global Longitudinal Strain was (-16.38±4.15%) where this consider highly significant differences (p value 0.001).Regional Longitudinal Strain according to the coronary artery territory pre PCI was (-14.49±4.47%),post one day post PCI was (-15.08±4.92%) where there's no significant differences (p value 0.10), while one month post PCI was (-17.70±5.27%),this was highly significant different statistically (0.001).Only in STEMI patients there was significant difference one day post PCI(P value 0.041 for Global LS,0.016 for Regional LS).Conclusions: In all IHD groups (STEMI, NSTEMI ∕UA, chronic stable angina) Speckle Tracking Echocardiographic parameters (Global Longitudinal Strain and Regional longitudinal strain) more reliable and effective than conventional echocardiographic parameters (Global LWEF,WMSI, RWMS) for monitoring improvement in LV systolic function post Percutaneous coronary intervention.