Changes In Myocardial Work Index Before And After Complex Percutaneous Coronary Intervention In Patients With Chronic Coronary Syndrome

Abstract

Background: Complex coronary lesions in chronic coronary syndrome (CCS) may cause persistent myocardial dysfunction despite successful revascularization. Myocardial work index (MWI) integrates myocardial deformation with estimated left ventricular pressure and may provide additional information beyond conventional echocardiographic measures.
Objective: To evaluate changes in global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) before and three months after complex PCI.
Methods: This prospective observational analytic study included 30 patients with CCS who underwent successful elective complex PCI. Echocardiography was performed within 24 hours before PCI and at three months. MWI parameters were primary outcomes, while EF and GLS were secondary outcomes. Paired comparisons used the paired-samples t-test or Wilcoxon signed-rank test as appropriate.
Results: GWI increased from 1266.90 ± 81.08 to 1483.40 ± 188.71 mmHg%, and GCW from 1542.70 ± 180.95 to 1849.60 ± 206.58 mmHg%. GWW decreased from 248.50 to 214.00 mmHg%, while GWE increased from 88.00% to 91.00%. All changes were significant (p<0.001). EF increased from 54.50% to 58.50%, and GLS improved from −13.00% to −17.50% (both p<0.001).
Conclusion: Successful complex PCI was associated with significant improvement in MWI parameters, EF, and GLS at three months, suggesting improved myocardial mechanical performance after revascularization