Key result
Percutaneous coronary intervention to the LAD resulted in significantly higher global longitudinal strain and global circumferential strain compared to CABG at 1 month post-procedure (P < 0.001).
Why the study?
The study aimed to compare the assessment of left ventricular function after percutaneous coronary intervention versus coronary artery bypass grafting to the LAD using speckle-tracking echocardiography.
Does percutaneous coronary intervention improve left ventricular function assessed by speckle-tracking echocardiography compared to coronary artery bypass grafting in patients with left anterior descending artery lesions?
Observational (n=100)
Yes
Does percutaneous coronary intervention improve left ventricular function assessed by speckle-tracking echocardiography compared to coronary artery bypass grafting in patients with left anterior descending artery lesions?
Absolute Event Rate: -21.2% vs -18.1%
p-value: p=<0.001
Speckle-tracking echocardiography reveals that PCI to the LAD results in significantly better early recovery of global longitudinal and circumferential strain compared to CABG at 1 month post-procedure.
Should not yet change revascularization choices; supports hypothesis of differential early LV recovery needing RCT confirmation.
Background: Speckle-tracking echocardiography (STE) is a noninvasive imaging technique that analyzes global and regional myocardial function. Aims: This study aims to compare the assessment of the left ventricular (LV) function after percutaneous coronary intervention (PCI). Settings and Design: One hundred patients presented to the catheterization laboratory and cardiothoracic operating room in Benha University Hospital and Kasr Al–Ainy University Hospital for PCI and coronary artery bypass grafting (CABG) to left anterior descending artery (LAD). Patients and Methods: This study enrolled 100 patients. They were divided into two groups: Group I: 50 patients with PCI to LAD and Group II: 50 patients with CABG to LAD. Echocardiography (conventional echocardiography and two-dimensional STE) was performed for all patients 24 h before and 1 month after the procedures. Statistical Analysis Used: Data management and statistical analysis were done using SPSS version 25. Results: There were significant increases in global circumferential strain (GCS) after CABG surgery with mean value of −17.8 before the procedure and −23.8 after it while there were no significant increases in global longitudinal strain (GLS) after the same procedure with mean value of −17.5 before the procedure and −18.1 after it. There were significant increases in GLS with mean value of −17.0 before PCI and −21.2 after it, and there were significant increases in GCS with mean value of −17.1 before PCI and −25.4 after it with improvement in myocardial function after this procedure. GLS and GCS were significantly higher in patients with PCI than patients with CABG with P < 0.001. Conclusions: GLS and GCS are more effective than the parameters of standard echocardiography such as the LV end-diastolic volume, LV end-systolic volume, wall motion score index, and ejection fraction for evaluating LV function after PCI and CABG surgery. GLS and GCS are significantly higher in patients with PCI than patients with CABG surgery to LAD.
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Ahmed et al. (2019) conducted an observational in Coronary artery disease with left anterior descending artery (LAD) lesion (n=100). Percutaneous coronary intervention (PCI) vs. Coronary artery bypass grafting (CABG) was evaluated on Post-procedural Global Longitudinal Strain (GLS) (p=<0.001). Percutaneous coronary intervention to the LAD resulted in significantly higher global longitudinal strain and global circumferential strain compared to CABG at 1 month post-procedure (P < 0.001).
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