Evidence for left ventricular remodeling after percutaneous coronary intervention: Effect of percutaneous coronary intervention on left ventricular ejection fraction and volumes

Background: Post-stress ejection fraction (EF), end-diastolic (EDV) and end-systolic (ESV) volumes by gated myocardial perfusion SPECT (MPS) are well validated, reproducible and of prognostic significance. However, little is known about the impact of percutaneous coronary intervention (PCI) on left ventricular volumes and remodeling. Methods: Thirty-eight patients who underwent MPS before and 6 months after PCI were evaluated. MPS were interpreted deriving summed stress (SSS), rest (SRS) and difference (SDS=SSS-SRS; extent of ischemia) scores. EF, EDV and ESV were generated by QGS™. Pre-PCI MPS were compared to post-PCI MPS. Results: Single vessel disease was present in 63% of patients. PCI of one vessel was performed in 82% of patients. After 6 months, SSS (10.6±6.3 vs. 2.8±4.3, p<0.001) and SDS (8.2±5.6 vs. 1.4±2.3, p<0.001) had improved; however, EF did not change significantly (55±10 vs. 57±13, p=ns). Still, EDV (105±25 ml vs. 96±25 ml, p=0.006) and ESV (49±19 ml vs. 41±18 ml, p=0.001) were significantly reduced. Conclusion: Results of MPS documented the beneficial effect of PCI on symptoms and extent of ischemia. In addition, the findings showed a significant decrease in ESV and EDV after PCI as compared to pre-PCI findings which points to a positive effect on left ventricular remodeling even in the absence of significant changes in EF.