Value of Speckle Tracking Echocardiography in Prediction of Left Ventricular Reverse Remodeling in Patients with Chronic total Occlusion Undergoing Percutaneous Coronary Interventions

Background: Revascularization procedures for chronic complete occlusion (CTO) are technically challenging but aim to improve left ventricular (LV) function. The aim of this study is to evaluate the value of global longitudinal strain (GLS) measured by 2D-speckle tracking echocardiography( 2D-STE) in the assessment of LV reverse remodeling in patients with CTO undergoing revascularization by percutaneous coronary intervention (PCI). Methods: Our study included 54 patients with CTO treated by PCI. We evaluate LV systolic function by measurement of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and the GLS within 24 hours before the PCI and after 3 months post-procedure. Results: The mean age of the patients was 56.65 ± 7.65 years; 74.1% were males. There was a significant improvement in the LVESV (p < 0.001), LVEF (p < 0.001), and GLS (p < 0.001) at 3 months post-PCI, and by multivariate regression analysis, the GLS was the single most significant predictor of LV reverse remodeling post revascularization (p < 0.001). Conclusion: Revascularization of coronary CTO lesions by PCI is associated with a significant improvement in regional and global LV function. The GLS measured by 2D-STE is a strong predictor of LV reverse remodeling post-CTO interventions.