The Effect of Successful Percutaneous Coronary Intervention of Chronic Coronary Total Occlusion on Regional Left Ventricular Deformation by Speckle Tracking Echocardiography

Abstract Background Percutaneous coronary intervention (PCI) is an invasive percutaneous procedure aiming to relieve coronary obstruction or occlusion, thus improving blood supply to ischemic territory. The study aims to assess the effect of successful PCI of chronic coronary total occlusion on regional left ventricle deformation using two-dimensional speckle tracking echocardiography (STE). Methods This prospective observational cohort study was conducted on 50 patients who had been admitted to the Cardiology Department, Helwan University, and underwent successful PCI for coronary chronic total occlusion (CTO). All patients were subjected to complete demographic data collection, complete clinical history and risk factors, complete clinical presentation, general and local examination, and routine laboratory investigations. Echocardiography, including STE, was conducted before and three months after PCI. Results After 3-month follow-up compared to pre-procedural data, the RLS, GLS, LVESV, LEDDV, WMSI, and EF were significantly improved (-15.77 ± 3.34 vs -17.63 ± 3.54), (-16.52 ± 1.74 vs -17.84 ± 2.42), (62.36 ± 20.64 vs 56.10 ± 19.54), (142.66 ± 39.74 vs 133.72 ± 37.76), (1.51 ± 0.30 vs 1.36 ± 0.29), and (51.94 ± 9.24 vs 54.86 ± 8.64), respectively, with a p-value of 0.001 for each. The improvement of these parameters was found in LAD, LCX, and RCA interventions; however, it was significantly more prominent in the LAD CTO intervention. The improvement of these parameters was also found in all the patients’ subgroups. Conclusions We observed that CTO-PCI improved LV global and regional longitudinal strain rates, particularly in LAD intervention, across all patient subgroups.