Key result
Global constructive work was the most powerful predictor of early left ventricular reverse remodeling 3 months after PCI in patients with multivessel CAD (AUC = 0.867).
Why the study?
CAD can cause LV remodeling linked to heart failure and mortality, but the predictive value of NIMWI for LV reverse remodeling after PCI in multivessel CAD was unproven.
Does the echocardiographic noninvasive myocardial work index predict left ventricular reverse remodeling in patients with multivessel CAD after PCI?
Cohort (n=88)
Does the echocardiographic noninvasive myocardial work index predict left ventricular reverse remodeling in patients with multivessel CAD after PCI?
Global constructive work measured by noninvasive myocardial work index is a strong predictor of early left ventricular reverse remodeling after PCI in patients with multivessel CAD.
Answers are grounded in this paper and cite their sources.
GCW may aid post-PCI risk stratification in multivessel CAD; leaves open prospective validation of incremental value over standard parameters.
Background: Coronary artery disease (CAD) can lead to left ventricular (LV) remodeling, which, in adverse cases, has been associated with heart failure and increased mortality. Here, we aimed to evaluate the predictive value of the noninvasive myocardial work index (NIMWI) for LV reverse remodeling in patients with multivessel CAD after percutaneous coronary intervention (PCI). Methods: A total of 88 consecutive patients with multivessel CAD treated with PCI were identified and categorized according to the presence of LV reverse remodeling 3 months after PCI [≥15% decrease in the LV end diastolic volume (LVEDV)]. With the LV pressure-strain loop (PSL) technique, NIMWIs, including the global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were statistically compared between the reverse LV remodeling group and nonreverse LV remodeling group 1 week before PCI. Results: Significantly lower GWI, GCW, and GWE, and significantly higher GWW were observed in the reverse LV remodeling group compared with the nonreverse LV remodeling group (P<0.05). Left ventricular mass index (LVMI), GCW, and GWE were independently associated with early LV reverse remodeling. Receiver operating characteristic (ROC) curve analysis demonstrated that GCW was the most powerful predictor of early LV reverse remodeling in patients with CAD [area under the curve (AUC) =0.867]. The optimal cutoff GCW value predictive of early LV reverse remodeling was 1,438.5 mmHg% (sensitivity, 85%; specificity, 70%). Conclusions: GCW, among the NIMWIs, may be the major predictor of LV reverse remodeling in patients with multivessel CAD after PCI. NIMWI could potentially provide a new reference index for the quantitative evaluation of LV myocardial work.
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Liu et al. (2022) conducted a cohort in Multivessel coronary artery disease (n=88). Noninvasive myocardial work index (NIMWI) was evaluated on Early left ventricular reverse remodeling (≥15% decrease in left ventricular end diastolic volume) (AUC 0.867, p=<0.05). Global constructive work was the most powerful predictor of early left ventricular reverse remodeling 3 months after PCI in patients with multivessel CAD (AUC = 0.867).
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