title: Wall motion and perfusion analysis of transmyocardial laser revascularization.
abstract: OBJECTIVE
  Transmyocardial laser revascularization (TMLR) creates channels in the myocardium. The aim of the treatment is to relieve angina in patients with end-stage coronary artery disease. We studied the effect of TMLR on myocardial function and perfusion with the combination of cine magnetic resonance imaging (MRI) and thallium scintigraphy.
  
  
  METHODS
  Eight patients with severe triple-vessel coronary artery disease were studied with MRI and thallium scintigraphy before and 6 months after laser treatment.
  
  
  RESULTS
  TMLR did not improve global left ventricular (LV) function or myocardial perfusion. However, systolic wall thickening deprived in segments with fixed perfusion defects in 6 months and laser treatment prevented this deprivation (p = 0.03). In addition single photon emission computed tomography (SPECT) imaging indicated that TMLR prevented conversion of reversible into fixed defects.
  
  
  CONCLUSIONS
  In severe, progressing coronary artery disease TMLR does not improve global LV function or myocardial perfusion, but it preserves systolic wall thickening in fixed defects (scar). It also prevents changes from ischemic myocardial regions to scar.
authors.affiliation: Department of Radiology, Helsinki University Central Hospital, Finland. Miia.Holmstrom@hus.fi
authors.forename: Miia
authors.initials: M
authors.lastname: Holmström
authors.forename: Helena
authors.initials: H
authors.lastname: Hänninen
authors.forename: Jarmo
authors.initials: J
authors.lastname: Simpanen
authors.forename: Kari S
authors.initials: KS
authors.lastname: Virtanen
authors.forename: Kalervo
authors.initials: K
authors.lastname: Werkkala
authors.forename: Hannu J
authors.initials: HJ
authors.lastname: Aronen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Lauerma
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D003326:Coronary Circulation; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007834:Lasers; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D010477:Perfusion; D011877:Radionuclide Imaging; D013793:Thallium
chemical_list: D013793:Thallium