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Left Anterior Descending CTO Revascularization: Short-Term Effects on Left Ventricular Function Assessed by Speckle Tracking Echocardiography

Year: 2026

Type: article

Abstract: Background: Chronic total occlusion (CTO) of the left anterior descending (LAD) artery is a common and clinically significant form of coronary artery disease (CAD), often associated with impaired myocardial function and adverse outcomes. Although percutaneous coronary intervention (PCI) has shown clinical benefits in CTO, its short-term effects on left ventricular (LV) function remain underexplored. This study aimed to evaluate the early impact of LAD CTO revascularization on LV systolic function, using global longitudinal strain (GLS) and global circumferential strain (GCS) as sensitive imaging biomarkers. Methods: A prospective single-arm trial was conducted on 120 patients diagnosed with LAD CTO at Ain Shams University and Mabrah Masr Alqadima hospitals in Egypt, and indicated to receive PCI during the period from January 2023 to June 2024. All patients underwent baseline and 6-month post-PCI echocardiography and speckle tracking analysis. LV diameters and volumes, FS%, EF%, GLS, and GCS were measured. PCI procedural data and clinical characteristics were also recorded. Results: This group included 120 patients with an average age of 58.2 years and male dominance (82.5%). The success rate of all revascularization procedures was 100% with most of them being done through anterograde access (62.5%) with minimal complications (12.5%). There was a significant reduction in LVED volume (5.8 19.4 ml, p = 0.040), heart rate (4.3 8.9 bpm, p = 0.005), and GCS (0.3 1.3, p = 0.042) at the 6-month follow-up, but the EF and GLS were unchanged. Also, LAD diameter did not change significantly. Conclusion: LAD CTO revascularization with PCI is associated with early reverse remodeling, reflected in the reduced LVED volume, improved GCS, and lower heart rate. These findings suggest early myocardial recovery post-revascularization, particularly in circumferential function, though more pronounced.

Source: International Journal of Cardiology Research

DOI: 10.33545/26634104.2026.v8.i1a.92