Usefulness of global longitudinal strain for assessment of left cardiac chambers function after coronary total occlusions revascularization

Background: It is still up for debate whether revascularization with percutaneous coronary intervention (PCI) is beneficial for chronic total occlusions (CTO). Compared to left ventricular ejection fraction and wall motion score index, two-dimensional speckle-tracking echocardiography (2DSTE) provides a more reliable evaluation of left ventricle (LV) and left atrium (LA) systolic function by measuring myocardial deformation. Investigating the effects of CTO revascularization on LV and LA systolic function with 2DSTE was the goal of this study. Methods: Fifty patients took part in this study 44 men and 6 women, aged between 44 and 78, with an average age of 64. They all had chronic total occlusion (CTO), meaning a completely blocked coronary artery with no blood flow (TIMI grade 0). Based on their angiography results, each patient had an occlusion that had been there for at least three months. Results: There was a significant increase in global longitudinal strain (GLS) after 3-month vs 24h after and before PCI. Left ventricular end-systolic volume was significantly mild reduced 3 months after PCI than before PCI. Moreover, left atrial minimum volume, was significantly reduced 3 months after PCI vs 24h after and before PCI. LA reservoir significantly increased 3months after PCI than 24h after and before PCI. Conclusions: Restoring coronary blood flow by PCI in chronic total occlusion patients can effectively improve LV and LA function. Change in GLS in 2D-STE was a sensitive indicator for LV function improvement at 24 hours and 3-month follow-up after CTO revascularization.