Results
From July 2021 to July 2023, a total of 150 patients with non-acute coronary syndrome angina underwent echocardiographic examinations following PCI. Among them, 3 patients had pulmonary arterial hypertension, 2 had concomitant valvular heart disease, 2 had a history of myocardial infarction, and 2 had atrial fibrillation. Additionally, 5 patients were excluded due to poor image quality, which precluded obtaining clear three-dimensional full-volume images. Ultimately, 136 patients with non-acute coronary syndrome angina undergoing PCI were included in this study, with a mean age of 50 ± 12 years, of whom 69 were male. Among these patients, lesions with >70% vessel occlusion were observed predominantly in the left anterior descending artery (LAD) in 106 (77.9%) cases, followed by the left circumflex artery (LCX) in 20 (14.7%) cases, and the right coronary artery (RCA) in 39 (28.7%) cases (Table 1).
Echocardiographic examinations were performed at post-PCI intervals of 1 week (7 [5-9] days), 6 months (180 ± 5.9 days), and 12 months (362 ± 6.7 days), respectively. Table 2 and figure 2 depict a series of changes in echocardiographic parameters among PCI patients. TAPSE, S’, RVFAC, RVFWLS, RVGLS, RVSV, and RVEF all increased from 1 week to 6 months post-PCI: TAPSE (18.68 ± 3.591 mm vs. 19.63 ± 3.253 mm, P = 0.017); S’ (8.61 ± 2.119 cm/s vs. 10.57 ± 2.643 cm/s, P < 0.001); RV FAC (39.81 ± 3.582% vs. 47.85 ± 3.939%,P < 0.001); RVFWLS (16.66 ± 2.234% vs. 18.64 ± 2.745%, P < 0.001); RVGLS (18.21 ± 5.79% vs. 20.85 ± 4.992%, P < 0.001); RVSV (40.07 ± 4.891% vs. 42.21 ± 4.788%, P < 0.001); RVEF (42.40 ± 7.524% vs. 48.70 ± 5.700%, P < 0.001). From 6 to 12 months post-PCI, RV FAC, RVGLS, RVSV, and RVEF showed no significant changes (P > 0.05), while TAPSE, S’, and RVFWLS remained significantly increased: TAPSE (19.63 ± 3.253% vs. 22.603 ± 2.885%, P < 0.001); S’ (10.57 ± 2.643 cm/s vs. 12.61 ± 2.189 cm/s,P < 0.001); RVFWLS (18.64 ± 2.745% vs. 19.926 ± 3.291%, P = 0.002).
At 12 months post-PCI, S’, RV FAC, RVFWLS, RVGLS, and RVEF were lower compared to the healthy control group: S’ (12.61 ± 2.189 cm/s vs. 13.20 ± 1.946 cm/s, P < 0.001), RVFAC (48.469 ± 2.402% vs. 49.20 ± 3.222%, P < 0.001), RVFWLS (19.926 ± 3.291% vs. 22.10 ± 1.994%, P < 0.001), RVEF (49.191 ± 5.801% vs. 50.15 ± 4.844%, P < 0.001) (Table 3; Fig. 3).
To mitigate the impact of left ventricular systolic dysfunction on RV, we conducted subgroup analysis based on left ventricular ejection fraction (LVEF). Both subgroups exhibited significant improvements in RV functional parameters. Compared to patients with LVEF > 50%, those with LVEF ≤ 50% demonstrated lower RVFWLS at 12 months post-PCI (19.1 ± 3.696% vs. 20.66 ± 2.659%, P = 0.009) (Table 4; Fig.4).
The intraobserver and interobserver variabilities, assessed using intraclass correlation coefficient (95% confidence interval), for measurements of right ventricular function parameters were as follows: TAPSE: 0.88 (0.76–0.94) and 0.82 (0.65–0.91), S’: 0.94 (0.87–0.97) and 0.93 (0.85–0.97), RVFAC: 0.85 (0.70–0.92) and 0.80 (0.62–0.90), RVFWLS: 0.88 (0.76–0.94) and 0.86 (0.73–0.93), RVGLS: 0.91 (0.83–0.96) and 0.90 (0.80–0.95), and RVEF: 0.92 (0.84–0.96) and 0.85 (0.71–0.93), respectively.