Delayed improvement of myocardial function after recanalization of a chronic coronary occlusion in a patient with intractable heart failure.
This case report describes the delayed improvement of left ventricular function by recanalization of an occluded coronary artery in a patient with intractable heart failure and three-vessel disease. The left anterior descending coronary artery was occluded distal to the first septal branch, the dominant right coronary artery had a diameter stenosis of 70-80% in its middle part, and the circumflex artery a proximal stenosis of 50%. Ventriculography revealed globally depressed left ventricular function with an ejection fraction of 16%. Successful recanalization and angioplasty of the occluded coronary artery resulted in a slow improvement of left ventricular function. Ultimate recovery of systolic performance (increase of ejection fraction from 16% to 48-51%) required more than half a year. It is speculated that stunned myocardium following chronic ischaemia is a consequence of vascular dysfunction.
Klein
H H
HH
Department of Cardiology, University of Göttingen, West Germany.
Neuhaus
K L
KL
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000503:physiopathology; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013997:Time Factors