Pressure–strain loop evaluation of myocardial work in patients with coronary artery disease and preserved left ventricular ejection fraction: a retrospective study based on propensity score matching

OBJECTIVE: To quantify left ventricular function changes in stable coronary artery disease (SCAD) patients with preserved left ventricular ejection fraction using left ventricular pressure-strain loop (LV-PSL) technology. And to evaluate the independent correlation between myocardial work (MW) parameters and SYNTAX score. METHODS: We enrolled 126 patients with suspected SCAD. Forty-five had significant stenosis (SYNTAX score calculated). Seventy-two without significant stenosis served as controls. LV-PSL provided global longitudinal strain (GLS) and MW parameters Including global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), global work index (GWI) Propensity score matching balanced baseline characteristics. We used paired t-tests, Wilcoxon signed-rank tests, and chi-square tests for group comparisons. Correlation analysis assessed links between SYNTAX scores and GLS/MW parameters. Receiver Operating Characteristic (ROC) curve analysis determined diagnostic performance. RESULTS: Forty-two patient pairs were successfully matched. Significant differences (P < 0.05) were found in GLS and MW parameters between SCAD patients and controls. SCAD patients exhibited lower GCW, GWI, and GWE compared to controls (P < 0.05). Correlation analysis revealed moderate positive correlations between SYNTAX scores and GWW, and moderate negative correlations with GCW. Strong negative correlations were observed between the SYNTAX score and GWE, GWI, and GLS (P < 0.01). ROC analysis identified GWI as a strong SCAD predictor (AUC = 0.713). CONCLUSION: LV-PSL technology effectively monitors left ventricular function and assesses disease severity in SCAD patients, offering practical guidance for clinical decision-making.