Electrocardiographic Predictors of Improvement for Systolic and Diastolic Functions in Ischemic Cardiomyopathy Patients undergoing Percutaneous Coronary Intervention

Background: Coronary artery disease (CAD) is a significant contributor to 50%-70% of cardiac failure cases. Successful reperfusion is linked to improved systolic and diastolic functions. Aim and Objectives: This study aimed to detect the correlation between ECG parameters (QRS duration and fragmentation, QTc, Tpe, and Tpe / QTc ratio), which were proved to be correlated with improved reperfusion post-PCI and associated with the improvement in systolic and diastolic function. Methods: This prospective research was performed on 54 ischemic cardiomyopathic cases from March 2019 to September 2022. All patients with Ischemic cardiomyopathy (ICM) and an EF less than 40%, along with viable myocardium determined by Dobutamine stress Echocardiography, underwent Complete revascularization of PCI amenable vessels. Results: There was a statistically significant positive correlation between the QTc interval and EF% after 1 month (r=0.29) and between the QTc interval and the percentage of improvement in both systolic and diastolic functions (EF& E/é) with a more positive correlation with improvement in EF (r=0.35 and 0.27 respectively). A stronger positive and significant correlation between the percentage of improvement in EF% with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.57, 0.50, and 0.58, respectively) was found. Also, there was a positive significant correlation between the percentage of improvement in E/é with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.37, 0.26, and 0.32 respectively) Conclusion: ECG parameters are capable of predicting improvement of systolic and diastolic functions in ischemic cardiomyopathic patients as observed by improvement in ejection fraction and E/é after PCI compared to before PCI.