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Usefulness of layer-specific strain for evaluating and predicting recovery of left ventricular myocardial function in patients undergoing hybrid coronary revascularization

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This study aimed to determine if layer-specific strain (LSS) can be used to evaluate and predict left ventricular (LV) recovery in patients with multi-vessel coronary artery disease (CAD) undergoing hybrid coronary revascularization (HCR) using speckle tracking echocardiography (STE).


A total of 187 consecutive CAD patients who received HCR in our hospital were prospectively enrolled. 30 healthy individuals with matched age and gender were enrolled as a control group. Echocardiography was performed for CAD patients before and 1, 2, and 6 months after HCR. Comprehensive conventional and LSS echocardiography parameters were collected. LV recovery was defined as improvement in LV ejection fraction (LVEF) > 5% at 6-months follow-up compared with baseline. Logistic regression analysis was used to test the correlates of LV recovery. Receiver operating characteristic curve analysis was used to determine the optimal cutoff value of correlates for predicting LV recovery.


LVEF and LV strain in CAD patients were significantly decreased compared with control subjects. Endocardial global longitudinal strain (Endo-GLS) improved significantly at 1-month follow-up (14.2 ± 1.6% vs. 13.8 ± 1.5%, P < 0.05), and LVGLS and global circumferential strain (GCS) improved significantly at 2-months follow-up. Multivariate regression revealed that Endo-GLS, GLS, and SYNTAX score before HCR were independently correlated to LV recovery. Endo-GLS had an optimal cutoff value of 13.2% for predicting LV recovery with sensitivity of 91% and specificity of 78%.


LV myocardial systolic function in CAD patients was impaired before HCR and significantly improved after HCR. Endo-GLS was independently correlated to and has optimal predictive value for LV recovery.

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We thank all participants in this study and colleagues for their heap.


This work was supported by Beijing Municipal Administration of Hospitals Incubating Program (No. XMLX201827).

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Authors and Affiliations



XiuZhang Lu and YiDan Li designed the experiment.

Zhe Jiang, Miao Zhang, and YunYun Qin recruited patients.

Zhe Jiang analyzed data.

Zhe Jiang wrote the article.

XiuZhang lu and YiDan Li revised it.

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Correspondence to XiuZhang Lu.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Capital Medical University (No. 2017-department-196).

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Informed consent was obtained from all individual participants included in the study.

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Jiang, Z., Zhang, M., Qin, Y. et al. Usefulness of layer-specific strain for evaluating and predicting recovery of left ventricular myocardial function in patients undergoing hybrid coronary revascularization. Int J Cardiovasc Imaging 39, 491–499 (2023).

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