Impact of Coronary Revascularization on Left Ventricular Global Longitudinal Strain in Chronic Total Occlusion

Abstract Background Ischemia is the cause of decreased ventricular relaxation and diastolic dysfunction, which is followed by reduced systolic function. This sequence of events is the outcome of a chain reaction that starts with metabolic and biochemical changes. A temporary impairment in ventricular relaxation is brought on by ischaemia. Even in cases when there are coronary collaterals present, the majority of patients who have a CTO still have some degree of LV dysfunction. PCI to CTO lesions is a technically complex treatment that is performed in the hope of a functional recovery, which has been found to enhance the possibility of survival. Objective To investigate the impact of CTO revascularization on LV function using LV GLS. Methods This study is a prospective observational study that was conducted at Ain Shams university hospitals, in the time interval from October 2022 till October 2023. The study included 30 consecutive patients with CTO lesions who underwent successful PCI. All the patient underwent assessment of GLS of LV before PCI and two months after. Results There was a significant improvement in GLS in the follow up study; P value was <0.001, and significant improvement in the EF; p value was <0.023. There were no associations of gender and age with the percentage of improvement; there were insignificant P values 0.361 and 0.640 among gender and age respectively. We found no associations of risk factors with the percentage of improvement in EF and GLS in hypertensive patients (P value was 0.426), in smokers (0.426), in diabetic patients (0.666), and in dyslipidemic patients (0.580) which were all insignificant. Regarding the relationship between the improvement in LV GLS and angiographic characteristics post PCI, all the P values were insignificant since all the CTO PCI sessions resulted in TIMI III flow Conclusion Our study showed significant improvement in LV systolic function after successful CTO PCI during follownup period of two months (The LV GLS and LVEF). Also, we found no impact of predictors on GLS Improvement.