Assessment of percutaneous coronary intervention on regional and global left ventricular function in patients with chronic total occlusions.
BACKGROUND
The improvement of regional and global ventricular function following percutaneous coronary intervention (PCI) with reperfusion of the artery supplying the infarct area in acute myocardial infarction is well-described. However, little is known of the potential effects of late recanalization of chronic coronary artery occlusion on left ventricular function.


OBJECTIVE
To determine whether PCI improves regional and global left ventricular function in patients with chronic coronary artery occlusions.


METHODS
Thirty-five patients having at least one coronary artery occluded for six weeks or longer were included in the present prospective study. Exercise thallium-201 myocardial perfusion scintigraphy, multiple-gated acquisition ventriculography and two-dimensional echocardiography were performed in 19 patients (16 men; mean age of 58+/-5 years) who underwent a successful PCI to assess both regional and global left ventricular function before and six weeks following the procedure.


RESULTS
The mean ejection fractions before and after reperfusion were 51+/-7% and 58+/-6% using Simpson's method (P<0.001) by echocardiography, and 45+/-1% and 53+/-1% (P=0.01) by multiple-gated acquisition ventriculography, respectively. The echocardiographic wall motion score was 24+/-9 before and 15+/-6 after PCI (P<0.001). The exercise perfusion score (21+/-1 and 14+/-1 [P=0.01]), rest perfusion score (15+/-1 and 12+/-1 [P=0.02]) and reinjection perfusion score (14+/-1 and 11.1+/-1 [P=0.07]) also improved after PCI. The presence of angina was strongly associated with an improvement in left ventricular function and wall motion score (P<0.01).


CONCLUSIONS
PCI significantly improved the regional and global left ventricular function in patients with chronic total coronary occlusion. This procedure may provide symptom benefits in selected patients.
Ermis
Cengiz
C
University of Akdeniz Medical School, Antalya, Turkey.
Boz
Adil
A
Tholakanahalli
Venkat
V
Yalcinkaya
Selim
S
Semiz
Ender
E
Sancaktar
Oktay
O
Benditt
David G
DG
Deger
Necmi
N
D000787:Angina Pectoris / Q000209:etiology; D000789:Angina, Unstable / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods; D002908:Chronic Disease; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016037:Single-Blind Method; D015607:Stents; D013318:Stroke Volume; D013794:Thallium Radioisotopes; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D016277:Ventricular Function, Left
D013794:Thallium Radioisotopes