Longitudinal change in cardiac structure and function following acute coronary syndrome according to culprit coronary artery lesion

Kirstine Ravnkilde*, Kristoffer Grundtvig Skaarup, Gabriela Lladó Grove, Daniel Modin, Anne Bjerg Nielsen, Mathilde Musoni Falsing, Allan Zeeberg Iversen, Sune Pedersen, Thomas Fritz-Hansen, Søren Galatius, Amil Shah, Tor Biering-Sørensen

*Corresponding author for this work


Acute coronary syndrome (ACS) may lead to adverse remodelling and impaired cardiac function. Limited data exists on the effect of culprit coronary artery lesion site and impact on longitudinal cardiac remodelling. The present study included a total of 299 patients suffering from ACS treated with percutaneous coronary intervention (PCI). All patients had two echocardiographic examinations. The first echocardiography was median 2(IQR: 1;3) days following PCI, while the follow-up echocardiography (FUE) was median 257(IQR: 96;942) days following the first. Patients were grouped based on coronary artery PCI location; left anterior descending artery (LAD), right coronary artery (RCA) or circumflex artery (Cx). Patients with multiple lesions were excluded. Mean age was 63 ± 11 years and 77% were male. At FUE, mean left ventricular ejection fraction was 42 ± 9% and global longitudinal strain (GLS) was − 13 ± 4%. PCI treatment was allocated as 168 LAD lesions, 95 RCA lesions, and 36 Cx lesions. Linear regression analysis showed that patients with a LAD lesion displayed worsening in E/A (mean ∆ = 0.05, β = − 0.196, p = 0.001) and a larger increase in LVEDV (mean ∆ = 33.18 mL, β = 0.135, p = 0.012). Meanwhile patients with Cx lesion were significantly associated with a larger decrease in E/e′ (mean ∆ = 2.6, β = − 0.120, p = 0.028). Patients with Cx lesion were observed to have elevated E/e′ at baseline, which normalized at FUE. The present study suggests that culprit coronary artery lesion has a differential impact on myocardial remodelling. This information may potentially aid in understanding the pathophysiological differences in cardiac structure and function amongst patients with ACS.

Original languageEnglish
JournalInternational Journal of Cardiovascular Imaging
Issue number5
Pages (from-to)1029-1036
Number of pages8
Publication statusPublished - 2022


  • Acute coronary syndrome
  • Cardiac remodelling
  • Echocardiography
  • Follow-up echocardiography


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