Document Detail


Improvement of myocardial function and perfusion after successful percutaneous revascularization in patients with chronic total coronary occlusion.
MedLine Citation:
PMID:  24120215     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of a coronary artery can provide benefits in terms of myocardial function and survival but the procedure is complex and the success rate is relatively low. To assess these benefits, myocardial function, ischemia and viability should be clearly determined by means of a reliable diagnostic test. This study aimed to assess ventricular function and myocardial ischemia before and after PCI for CTO using cardiac magnetic resonance (CMR). NYHA functional class was also assessed before and after PCI.
METHODS AND RESULTS: CMR studies were performed in 43 consecutive patients (7 females; aged 64±9.6y.o.) with CTO scheduled for PCI and repeated 6months post-PCI. PCI was successful in 33 (77%) of them. In this group CMR had shown inducible perfusion defects in 26 (79%) before PCI, while they were observed in 10 (30%) post-PCI CMR study (p<0.001). The number of segments showing inducible perfusion defect (3.4±2 prevs. 2.9±4.5 post-PCI, p=0.002) was significantly reduced in this group. Regional contractile function of segments showing viability also improved significantly in the group with successful CTO PCI compared to the group with an unsuccessful procedure. NYHA functional class for angina also improved in patients with successful revascularization while it remained unchanged in the group with unsuccessful procedures.
CONCLUSIONS: A successful CTO PCI leads to a reduction in inducible myocardial ischemia and to an improvement in regional wall motion, which results in clinical improvement.
Authors:
Sandra Pujadas; Victoria Martin; Xavier Rosselló; Francesc Carreras; Antonio Barros; Ruben Leta; Xavier Alomar; Juan Cinca; Manel Sabate; Guillem Pons-Llado
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-15
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-10-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013.
Affiliation:
Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Electronic address: sandrapujadas@gmail.com.
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