Electrocardiographic Predictors of Improvement of Systolic and Diastolic Functions in Ischemic Cardiomyopathy Patients undergoing Percutaneous Coronary Intervention

Background:
Coronary artery disease (CAD) is a significant contributor to 50%-70% of cardiac failure cases. Successful reperfusion is linked to improved
systolic and diastolic functions.


Aim and Objectives:
This study aimed to detect the correlation between ECG parameters (QRS duration and fragmentation, QTc, Tpe, and Tpe / QTc ratio), which were
proved to be correlated with improved reperfusion post-PCI and associated with the improvement in systolic and diastolic function.


Methods:
This prospective research was performed on 54 ischemic cardiomyopathic cases from March 2019 to September 2022. All patients with Ischemic
cardiomyopathy (ICM) and an EF less than 40%, along with viable myocardium determined by Dobutamine stress Echocardiography, underwent
Complete revascularization of PCI amenable vessels.


Results:
There was a statistically significant positive correlation between the QTc interval and EF% after 1 month (r=0.29) and between the QTc interval
and the percentage of improvement in both systolic and diastolic functions (EF& E/é) with a more positive correlation with improvement in EF
(r=0.35 and 0.27 respectively). A stronger positive and significant correlation between the percentage of improvement in EF% with both Tpe
interval, Tpe/QTc ratio, and QRS duration (r= 0.57, 0.50, and 0.58, respectively) was found. Also, there was a positive significant correlation
between the percentage of improvement in E/é with both Tpe interval, Tpe/QTc ratio, and QRS duration (r= 0.37, 0.26, and 0.32 respectively)


Conclusion:
ECG parameters are capable of predicting improvement of systolic and diastolic functions in ischemic cardiomyopathic patients as observed by
improvement in ejection fraction and E/é after PCI compared to before PCI.