Impact Of Percutaneous Coronary Intervention On Patients Who Diagnosed With Coronary Artery Disease With Different Level Of Left Ventricular Ejection Fraction

Objective: To explore the clinical benefits of revascularization in patients with different levels of left ventricular ejection fraction(LVEF)from the perspective of quantitative flow ratio(QFR).Methods: Patients who underwent successful percutaneous coronary intervention(PCI)and one-year angiographic follow-up were retrospectively screened and computed by QFR analysis.Based on their LVEF,301 eligible patients were classified into reduced LVEF(≤50%,n=48)and normal LVEF(> 50%,n=253)groups.Pre-PCI QFR,post-PCI QFR,follow-up QFR,late lumen loss(LLL),LVEF and major adverse cardiovascular and cerebrovascular events(MACCE)at one year were compared between groups.Results: The reduced LVEF group had a lower mean pre-PCI QFR than the normal LVEF group(0.67±0.16 vs.0.73±0.15,p=0.004),but no significant difference was found in the post-PCI or one-year follow-up QFR.No association was found between LVEF and QFR at pre-PCI or follow-up.The reduced LVEF group had greater increases in QFR(0.27±0.18 vs.0.22±0.15,p=0.043)and LVEF(6.05±9.45% vs.-0.37±8.11%,p<0.001)than the normal LVEF group.The LLL results showed no difference between the two groups,indicating a similar degree of restenosis.The reduced LVEF group had a higher incidence of MACCEs(14.6% vs.4.3%,p=0.016),which was mainly due to the higher risk of heart failure(6.3% vs.0%,p=0.004).Conclusion: Compared to the corresponding normal LVEF patients,patients with reduced LVEF who underwent successful PCI were reported to have greater increases in QFR and LVEF,a similar degree of restenosis,and a higher incidence of MACCEs due to a higher risk of heart failure.It seems that patients with reduced LVEF gain more coronary benefits from successful revascularization from the perspective of flow physiology evaluations.