AIM To quantitative evaluate the changes of left ventricular systolic and diastolic function in patients with coronary heart disease without segmental abnormal ventricular wall motion before and after percutaneous coronary intervention (PCI) by conventional echocardiography and three-dimensional strain, and to investigate the efficacy of PCI and the number of stents in patients with coronary heart disease.

METHODS A total of 112 patients with coronary heart disease without abnormal segmental wall motion underwent echocardiography within 3 days before PCI and 6 months after PCI were included in this study, and they were divided into three groups according to the number of stents inserted: 1-stent group (n=55), 2-stent group (n=35) and 3-stent group (n=22). Their basic clinical data, conventional echocardiography data and three-dimensional strain data were collected, and the corresponding direction of strain imaging diastolic index (SI-DI) was calculated to analyze its changes.

RESULTS The comparison of preoperative and postoperative data between the two groups showed that the pro BNP value before PCI was higher than the postoperative value (P<0.05), and there was no statistically significant difference in preoperative and postoperative data for items such as systolic blood pressure, diastolic blood pressure, blood glucose, blood lipids, and body mass index (BMI). Comparison of routine ultrasound parameters between two groups before and after PCI showed that E, e′, EDV, ESV, and E/e′ increased after surgery, while LVEF and SV decreased after surgery, but the differences were not statistically significant. Comparison of three-dimensional parameters between two groups before and after PCI showed statistically significant differences in GLS, GRS, GAS, GCS, L-SI-DI, A-SI-DI, C-SI-DI, and R-SI-DI between the two groups (all P<0.01), with significantly higher levels after PCI compared to before. There was no statistically significant difference in strain and corresponding SI-DI among the three groups before PCI, as compared to the three-dimensional parameters of three groups with different numbers of stents. After PCI, as the number of stents increases, GLS, GAS, GCS, GRS, L-SI-DI, A-SI-DI, C-SI-DI, and R-SI-DI show a decreasing trend. The GCS and L-SI-DI of the 2-stent group were lower than those of the 1-stent group (all P<0.05), while the GLS, GCS, GAS, L-SI-DI, C-SI-DI, and A-SI-DI of the 3-stent group were lower than those of the 1-stent group (all P<0.05). The GLS, GCS, GAS, L-SI-DI, and C-SI-DI of the 3-stent group were lower than those of the 2-stent group (all P<0.05); There was no statistically significant difference in GRS and R-SI-DI among the three groups. The postoperative parameters of different number of stent groups showed an increasing trend compared to preoperative. The GLS, GAS, GCS, GRS, L-SI-DI, A-SI-DI, and C-SI-DI in the one stent group were higher than preoperative (all P<0.05), while the GAS in the two stent group was higher than preoperative (P<0.05). There was no statistically significant difference between the three stent groups before and after surgery.

CONCLUSION Three-dimensional strain is better than conventional echocardiography, three-dimensional strain can quantitatively evaluate the changes of left ventricular systolic and diastolic function after PCI and evaluate the effect of PCI in patients with coronary heart disease. The number of stents inserted is correlated with left ventricular function recovery after PCI.