Assessment of left ventricular global longitudinal strain and echocardiographic changes before and after PCI in Vietnamese patients with stable angina – a single center study

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BACKGROUND: Coronary artery disease (CAD) is a leading cause of death in Vietnam. Global longitudinal strain (LVGLS) is a non-invasive tool for early CAD detection and post-revascularization assessment. This study aimed to measure LVGLS in stable angina patients and assess changes after percutaneous coronary intervention (PCI). METHODS: We conducted a prospective observational study at Kien Giang General Hospital from 5/2021 to 6/2022, enrolling patients ≥ 18 years with stable angina scheduled for elective PCI. Demographic data, lab results, and comorbidities were collected via medical records and interviews. Two-dimensional speckle-tracking echocardiography was performed before coronary angiography and 3 months post-PCI. LVGLS was categorized as normal or abnormal (threshold: 16%). A paired t-test was used to assess LVGLS changes before and after PCI, with statistical significance set at p < 0.05. RESULTS: The study included 60 patients with a mean age of 66.9 ± 9.0 years (1:1 male-to-female). The average LVGLS was 15.1 ± 3.1%. Patients with abnormal LVGLS had a higher percentage of triple vessel disease (40.6% vs. 14.3%, p = 0.05), more CCS class III-IV angina (65.7% vs. 39.3%, p = 0.04), higher resting heart rates (83.2 ± 12.0 bpm vs. 73.1 ± 13.2 bpm, p < 0.05), lower LVEF (49.9 ± 7.2% vs. 56.7 ± 5.7%, p < 0.05), and more frequent wall motion abnormalities (81.3% vs. 53.6%, p = 0.02) compared to those with normal LVGLS. Of the 60 patients, 55 (91.7%) underwent PCI. At three months post-PCI, average LVGLS improved significantly, from 15.0 ± 3.3% to 16.1 ± 2.3% (mean difference 1.1, 95% CI: 0.6–1.6, p < 0.05). LVGLS improvement was consistent across subgroups, regardless of vessel disease, coronary artery territories, or baseline LVEF (except for those with low LVEF), without a corresponding increase in LVEF during the same period. CONCLUSION: Our findings suggest that LVGLS may serve as a complementary marker of early myocardial recovery that could contribute to comprehensive risk assessment post-PCI. Larger studies with extended follow-up are needed to validate these results and evaluate the long-term prognostic value of LVGLS post-PCI.

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