31 Assessment of left ventricular function with cardiac MRI after percutaneous coronary intervention for chronic total occlusion

Abstract Background The effect of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) on left ventricular dyssynchrony was unclear. Methods Patients with one CTO vessel were included. Tissue Doppler imaging was used to assess the left ventricular dyssynchrony index (DI) in twelve segments before and after successful CTO PCI. Multiple regression was used to identify independent correlates of DI reduction. Results 41 patients were included with the mean age of 65.88 years. 39(95.12%) had left ventricular DI more than 33. It decreased significantly from 67.48 ± 28.73 to 44.69 ± 23.90 (P < 0.01) after successful CTO PCI. PCI of infarct-relative CTO was associated with less percentage of DI reduction (Coefficient [Coef.], 25.60; 95% confidence interval [CI], 8.13–43.08; P < 0.01). Higher initial DI was associated with more percentage of DI reduction (Coef., -0.35; 95% CI, -0.67- -0.03; P = 0.03). Percentage of DI reduction was associated with ejection fraction (EF) improvement (Coef., -5.09; 95% CI, -7.45- -2.72; P < 0.01) with linear relationship (P < 0.01). Conclusion Left ventricular dyssynchrony was reduced early after successful CTO PCI, which predicted EF improvement. The association between dyssynchrony reduction and long-term benefits of CTO PCI are expected.

Download Full-text

P1964Impact of successful coronary intervention for chronic total occlusion on long-term clinical outcome of patients with impaired and preserved left ventricular ejection fraction

European Heart Journal ◽

10.1093/eurheartj/ehz748.0711 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Tanaka ◽

T Tada ◽

Y Fuku ◽

T Goto ◽

K Kadota

Keyword(s):

Percutaneous Coronary Intervention ◽

Chronic Total Occlusion ◽

Coronary Intervention ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Total Occlusion ◽

Ventricular Ejection Fraction ◽

Percutaneous Coronary ◽

Procedural Success

Abstract Background Successful recanalisation of percutaneous coronary intervention for chronic total occlusion lesions has been associated with improved survival. Purpose This study aimed to assess the impact of successful percutaneous coronary intervention for chronic total occlusion lesions on the long-term outcome of patients with impaired and preserved left ventricular ejection fraction (LVEF). Methods The study sample consisted of 842 consecutive patients (928 chronic total occlusion lesions) undergoing percutaneous coronary intervention at our institution between October 2005 and December 2009. We divided them into 3 groups by the degree of LVEF: less than 40% (severely reduced LVEF, n=140), 40% to 59% (moderately reduced LVEF, n=470), and 60% and above (normal LVEF, n=232). We evaluated mortality during the 10-year follow-up period the basis of procedural success and failure. Results The overall procedural success rate was 89.1%. Median follow-up duration was 7.9 years. The 10-year cumulative incidences of cardiac death in each degree of LVEF are shown in the Figure. Conclusions Successful recanalisation for chronic total occlusion lesions in patients with impaired LVEF may be associated with reduced cardiac mortality.

Download Full-text