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[Myocardial function before and after reopening of chronic coronary occlusion]
M Gyöngyösi1, H Klepzig, F D Maul
1Klinikum der Inneren Medizin No. 1, Szentgyörgyi Albert Medizinische Universität (SZOTE), Szeged, Ungarn.
Insights
Reopening chronically occluded coronary arteries significantly improves heart function. This procedure enhanced myocardial function at rest and during exercise in patients with coronary artery disease.
Area of Science:
- Cardiology
- Interventional Cardiology
- Nuclear Cardiology
Background:
- Chronic coronary artery occlusions significantly impair myocardial function.
- Revascularization strategies are crucial for managing advanced coronary artery disease.
Purpose of the Study:
- To evaluate the impact of reopening chronic coronary artery occlusions on myocardial function.
- To assess changes in left ventricular ejection fraction (LVEF) at rest and during exercise post-recanalisation.
Main Methods:
- Investigated 20 patients using ECG and equilibrium radionuclide ventriculography.
- Chronic occlusions were reopened via Rotacs-catheter, recanalisation-catheter with guide wire, or guide wire alone, followed by balloon angioplasty.
- Assessed changes in coronary artery stenosis and LVEF before and after percutaneous transluminal coronary angioplasty (PTCA).
Main Results:
- Successful PTCA reduced average stenosis from 100% to 34 +/- 6%.
- 83% of patients experienced improvement in angina pectoris and/or dyspnea during exercise.
- Global LVEF increased significantly at rest (55% to 59%) and during exercise (52% to 61%).
Conclusions:
- Reopening chronically occluded coronary arteries improves global left ventricular function.
- The procedure leads to significant functional recovery at rest and during physical activity.
- Selected patients demonstrate substantial benefits in myocardial performance post-recanalisation.
Abstract:
To assess the myocardial function before and after reopening of chronic coronary artery occlusions, 20 patients were investigated at rest and during exercise with ECG and equilibrium radionuclide ventriculography. The recanalisation of the chronically occluded vessel was carried out by means of Rotacs-catheter in 17 patients, of a guide wire enforced by recanalisation-catheter in 2 patients and of a thin guide wire alone in 1 patient, always followed by conventional balloon angioplasty. After successful PTCA the average coronary artery stenosis diameter decreased from 100% to 34 +/- 6%. Angina pectoris and/or dyspnea observed during exercise were improved in 83% of the patients. The radionuclide global left ventricular ejection fraction at rest increased from 55 +/- 9% to 59 +/- 10% (p < 0.05), and during exercise from 52 +/- 12% to 61 +/- 12% (p < 0.05). The improvement in global ejection fraction at rest was more pronounced in 5 patients, who suffered from angina pectoris at rest before PTCA (from 56 +/- 4% to 65 +/- 9%, p < 0.05). It is concluded that reopening of chronically occluded coronary arteries in properly selected patients leads to a significant improvement of the global left ventricular function at rest and during exercise.