Why was it a heartache for Paul that the Asian churches turned away from him?
It grieved Paul because he had spent so much and poured out his life starting churches throughout Asia Minor, yet those people turned their backs on his gospel by the time he was martyred. The outcome was evident: those cities faded from the scene, while many areas in Greece remained.
Les explains that the Asia in view is Asia Minor, not Greece. Paul had started numerous churches there—cities like Thyatira, Pergamos, and Smyrna—and by the time he was martyred they had evidently turned away from his gospel. Les notes the sorrow: Paul had spent so much and poured out his life, yet those people turned their back on him. He sees the result in that none of those little cities remain, while many Greek areas associated with Paul's journeys are still valid.