Document Detail


Effect of late percutaneous angioplastic recanalization of total coronary artery occlusion on left ventricular remodeling, ejection fraction, and regional wall motion.
MedLine Citation:
PMID:  8857473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical benefit of late recanalization of complete coronary occlusion is debated. Left ventricular (LV) function and volumes are major prognostic determinants in patients with coronary artery disease. We sought to assess comprehensively the evolution of global and regional LV function and LV volumes after percutaneous recanalization of chronic complete coronary artery occlusions. A consecutive series of 55 patients who underwent successful percutaneous recanalization of a chronic (> or = 10 days), total (Thrombolysis in Myocardial Infarction trial flow grade 0) occlusion of the left anterior descending or dominant right coronary arteries, and in whom a complete angiographic evaluation was available before angioplasty and at follow-up was studied. At follow-up, 38 patients had a patent artery (group 1) and 17 had a reocclusion (group 2). Baseline parameters were similar in the 2 groups. In group 1, LV ejection fraction increased from 55 +/- 14% to 62 +/- 13% (p <0.001), with an increase in fractional shortening in the occluded artery territory (0.43 +/- 0.30 to 0.71 +/- 0.34, p <0.001), while LV end-diastolic volume remained unchanged. In group 2, ejection fraction and regional wall motion were unchanged, while LV end-diastolic volume index increased (86 +/- 22 ml/m2 to 99 +/- 34 ml/m2, p <0.02). The evolution in LV global and regional function was similar in patients with or without previous myocardial infarction; however, prevention of LV remodeling was observed only in patients with previous infarction. Maintained potency after successful recanalization of totally occluded coronary arteries improves global and regional LV function and, in patients with previous myocardial infarction, avoids LV remodeling.
Authors:
N Danchin; M Angioï; R Cador; O Tricoche; O Dibon; Y Juillière; M Cuillière; F Cherrier
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-27     Completed Date:  1996-11-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  729-35     Citation Subset:  AIM; IM    
Affiliation:
Services de Cardiologie, CHU Nancy-Brabois, Vandoeuvre-les-Nancy, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Coronary Disease / etiology,  physiopathology,  radiography,  therapy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Contraction / physiology
Myocardial Infarction / complications,  physiopathology
Recurrence
Stroke Volume
Ventricular Function, Left / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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