[Significance of percutaneous transluminal coronary intervention for chronic total occlusions assessed as non-viable by myocardial scintigraphy].
OBJECTIVE
The effectiveness of percutaneous transluminal coronary intervention (PCI) was evaluated for chronic total occlusion (CTO) assessed as non-viable by myocardial scintigraphy.


METHODS
In the period from January 2003 to October 2006, 17 patients who had successful reopening of the artery through revascularization by PCI for CTO assessed as non-viable were classified as the P group, and 30 patients whose course was observed while undergoing medical therapy after being assessed as nonviable formed the M group. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV) and SD/chord were measured in both groups before the procedure and at the chronic phase (mean 6.2 months). The incidences of chronic cardiac events at mean 20.5 months were compared.


RESULTS
No significant differences were revealed between the two groups in LVEF and LVEDV prior to the procedure. No significant differences between the groups were revealed for Delta LVEF or Delta LVEDV. A significant improvement (p < 0.05) was revealed for SD/chord in the P group with - 1.50 +/- 0.25 before the procedure, becoming - 1.34 +/- 0.33 in the chronic phase, but the M group revealed no significant change. No significant difference was revealed in the avoidance of chronic cardiac events with 94.1% for the P group and 86.0% for the M group.


CONCLUSIONS
Improvement in local left ventricular wall motion by revascularization is possible even in patients with chronic total occlusions assessed as non-viable by myocardium scintigraphy.
Nii
Hideo
H
Division of Interventional Cardiology, Cardiovascular Center, Toho University Omori Medical Center, Ota-ku, Tokyo, Japan. hideni543213@xg7.so-net.ne.jp
Wagatsuma
Kenji
K
Kabuki
Takayuki
T
Uchida
Yasuto
Y
Amano
Hideo
H
Toda
Mikihito
M
Yamashina
Shohei
S
Yamazaki
Junichi
J
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000628:therapy*; D003643:Death; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D011877:Radionuclide Imaging; D013318:Stroke Volume; D016277:Ventricular Function, Left