title: Early recovery of wall motion abnormalities after recanalization of chronic totally occluded coronary arteries: a dobutamine echocardiographic, prospective, single-center experience.
abstract: BACKGROUND
  Patients with symptomatic myocardial ischemia from a chronic totally occluded coronary (TOC) artery are usually referred for coronary artery bypass surgery. Because guide wire technology has improved considerably in recent years, percutaneous coronary angioplasty has become a useful technique in opening chronic TOC arteries. We evaluated the early functional results of successful percutaneous recanalization by performing dobutamine stress echocardiography (DSE).
  
  
  METHODS
  Fifteen patients with a chronic TOC artery who underwent a successful recanalization were prospectively studied. Each patient had a DSE within 24 hours before and 48 hours after the procedure. Wall motion was scored according to a 16-segment/5-point model. A clinical and angiographic follow-up of 6 months was obtained.
  
  
  RESULTS
  The wall motion score index at rest improved from 1.26+/-0.23 before to 1.22+/-0.21 after the procedure (P < .05). Of those 10 segments that improved at rest, 7 were collateral recipients and 3 were collateral donors. The number of ischemic segments decreased from 46 before to 4 after the procedure (P < .0001). Wall motion score index at peak stress improved from 1.34+/-0.20 before to 1.15+/-0.12 after the procedure (P < .05). DSE was positive for ischemia in 15 patients before and 2 patients after the procedure (P < .0001). Angina was present in 12 patients before and in 2 patients after recanalization (P < .0001). Two patients (13%) had angiographic reocclusion and 5(33%) restenosis after 6 months of follow-up.
  
  
  CONCLUSIONS
  Successful percutaneous recanalization of chronic TOC artery results in an early improvement of both clinical status and resting or stress-induced wall motion abnormalities, as detected by DSE.
authors.affiliation: Thoraxcenter, University Hospital Rotterdam-Dijkzigt, and Erasmus University, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Rambaldi
authors.forename: J N
authors.initials: JN
authors.lastname: Hamburger
authors.forename: M L
authors.initials: ML
authors.lastname: Geleijnse
authors.forename: D
authors.initials: D
authors.lastname: Poldermans
authors.forename: G J
authors.initials: GJ
authors.lastname: Kimman
authors.forename: A A
authors.initials: AA
authors.lastname: Aiazian
authors.forename: P M
authors.initials: PM
authors.lastname: Fioretti
authors.forename: F J
authors.initials: FJ
authors.lastname: Ten Cate
authors.forename: J R
authors.initials: JR
authors.lastname: Roelandt
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine