title: Effects of successful percutaneous coronary intervention of chronic total occlusions on myocardial perfusion and left ventricular function.
abstract: OBJECTIVE
  The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery.
  
  
  RESULTS
  Patients with a documented CTO were prospectively examined for ischaemia and viability with [15O]H2O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function. After PCI, stress MBF in the CTO area increased from 1.22±0.36 to 2.40±0.90 mL·min-1·g-1 (p<0.001), whilst stress MBF in the remote area also increased significantly between baseline and follow-up PET (2.58±0.68 to 2.77±0.77 mL·min-1·g-1, p=0.01). The ratio of stress MBF between CTO and remote area was 0.49±0.13 at baseline and increased to 0.87±0.24 at follow-up (p<0.001). The MBF defect size of the CTO area decreased from 5.12±1.69 to 1.91±1.75 myocardial segments after PCI (p<0.001). Left ventricular ejection fraction (LVEF) increased significantly (46.4±11.0 vs. 47.5±11.4%, p=0.01) at follow-up.
  
  
  CONCLUSIONS
  The vast majority of CTO patients with documented ischaemia and viability showed significant improvement in stress MBF and a reduction of ischaemic burden after successful percutaneous revascularisation with only minimal effect on LVEF.
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Wijnand J
authors.initials: WJ
authors.lastname: Stuijfzand
authors.forename: P Stefan
authors.initials: PS
authors.lastname: Biesbroek
authors.forename: Pieter G
authors.initials: PG
authors.lastname: Raijmakers
authors.forename: Roel S
authors.initials: RS
authors.lastname: Driessen
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Schumacher
authors.forename: Pepijn
authors.initials: P
authors.lastname: van Diemen
authors.forename: Jeffrey
authors.initials: J
authors.lastname: van den Berg
authors.forename: Robin
authors.initials: R
authors.lastname: Nijveldt
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Lammertsma
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Walsh
authors.forename: Colm G
authors.initials: CG
authors.lastname: Hanratty
authors.forename: James C
authors.initials: JC
authors.lastname: Spratt
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.forename: Alexander
authors.initials: A
authors.lastname: Nap
authors.forename: Niels
authors.initials: N
authors.lastname: van Royen
authors.forename: Paul
authors.initials: P
authors.lastname: Knaapen
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D002908:Chronic Disease; D003326:Coronary Circulation / Q000502:physiology; D054059:Coronary Occlusion / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000276:immunology* / Q000502:physiology