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.