Abstract
OBJECTIVE: To evaluate the prognostic value of specific echocardiographic parameters, particularly myocardial strain indices, in patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention (PCI). METHODS: This retrospective study included 135 CHD patients who underwent PCI (observation group) and 100 healthy controls. Echocardiographic parameters (cardiac output [CO], left ventricular volumes [LVESV, LVEDV], ejection fraction [LVEF], cardiac index [CI], global longitudinal strain peak [GLSP], and global radial strain peak [GRSP]) were measured. Patients were followed up for 12 months post-PCI. Prognosis was determined based on the occurrence of major adverse cardiovascular events (MACE) during this follow-up period, including recurrent angina, acute coronary syndrome, arrhythmia, or heart failure. A good prognosis was defined as event-free survival with improved quality of life, while a poor prognosis was defined by the occurrence of any MACE. Parameters were compared between groups and correlated with prognosis. RESULTS: Pre-PCI, CHD patients had impaired parameters (lower CO, LVEF, CI; higher LVESV, LVEDV) versus controls (all P<0.05). Post-PCI, these parameters improved but remained suboptimal. Patients with a poor prognosis had significantly worse post-PCI parameters (lower GLSP, higher GRSP, LVESV, LVEDV) than those with a good prognosis (all P<0.05). A predictive model combining GLSP and GRSP showed an AUC of 0.865 for poor prognosis. Left ventricular diameters (LVESD, LVEDD) were negatively correlated with GRSP and positively correlated with GLSP (all P<0.05). CONCLUSION: Echocardiographic parameters, especially the combined model of myocardial strain indices (GLSP and GRSP), provide significant predictive value for prognosis in CHD patients after elective PCI. These findings support the use of strain imaging for risk stratification and early intervention.