Coronary artery diseaseEvaluation of Left Ventricular Function Three Years After Percutaneous Recanalization of Chronic Total Coronary Occlusions
Section snippets
Methods
Patients scheduled for percutaneous revascularization of a CTO of a native coronary artery were prospectively studied. Of these patients, 75% had a positive exercise test result and the remaining 25% had progressive anginal symptoms. All successfully treated patients received a drug-eluting stent. Forty-seven patients were included in this study. In 34 patients, percutaneous coronary intervention was successful. Follow-up at 3 years was obtained in 21 patients; 1 patient died, 1 patient had a
Results
The patient population consisted of 21 patients. In 11 patients, the CTO was located in the left anterior descending; in 8 patients, in the right coronary artery; and in 2 patients, in the circumflex artery. All images were good for analysis. Mean duration of occlusion was 7 ± 5 months. At follow-up, medication was similar to baseline except for clopidogrel, which was discontinued after 6 months.
A total of 336 myocardial segments were available for analysis, of which 106 were in the perfusion
Discussion
We report here that SWT improved in dysfunctional but viable segments 5 months after CTO recanalization, with even further improvement after 3 years of follow-up. Second, a reduction in remodeling was observed up to 3 years after recanalization, shown by decreased end-diastolic and end-systolic volumes. Third, improvement in regional function was related to the extent of myocardial fibrosis and could be predicted using delayed enhancement magnetic resonance imaging before revascularization.
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