Left ventricular systolic function is a major predictor of long-term survival in patients with coronary artery disease. Evaluation of regional and global subclinical left ventricular (LV) systolic dysfunction could be a good strategy to identify myocardial regions with impaired coronary artery flow and reduced myocardial perfusion .
Improving the myocardial perfusion and LV systolic function are among the objectives of a successful percutaneous coronary intervention (PCI). Over the past several years, there has been a profound evolution in the techniques used for PCI. It is clear that the availability of coronary stents, and platelet glycoprotein (GP) IIb/IIIa receptor inhibitors has dramatically changed the early and late clinical outcomes associated with PCI.
The management of long coronary lesions by PCI has become increasingly important because of the rising incidence of long or complex lesions in aging populations. Management of long lesions with single long stent is a preferred strategy of PCI. Stent length has been considered an important predictor of adverse events after PCI. Long lesions have been associated with adverse outcomes in percutaneous coronary interventions treated with bare metal stents (BMS). However, the exact impact of lesion length on the short- and long-term clinical outcomes of drug-eluting stent (DES) implantations is not clear as yet.
Assessment of cardiac function by measuring left ventricular ejection fraction using echocardiography is the most common in the daily clinical practice. However, this technique has limitation related with its intra- and interobserver variability. A recent technique, 2D speckle tracking for assessing global longitudinal strain, has been introduced to reduce the variability and potentially has a higher accuracy.
Evaluation of systolic function of the myocardium has mainly depended on detection of global function or the local myocardial contraction force. New approaches have been developed to investigate local myocardial conduction and systolic function, such as Doppler tissue imaging, strain rate imaging, and especially TSI
How do stent diameter and stent length affect recovery of left ventricular function after percutaneous coronary intervention? There is no clear data till now study this relation.
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