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Published on: February 16, 2016
Assessment of percutaneous coronary intervention on regional and global left ventricular function in patients with
Cengiz Ermis1, Adil Boz, Venkat Tholakanahalli
1University of Akdeniz Medical School, Antalya, Turkey.
Insights
Percutaneous coronary intervention (PCI) significantly improved left ventricular function in patients with chronic total coronary occlusion. This intervention also offered symptom relief for selected individuals.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- While percutaneous coronary intervention (PCI) benefits in acute myocardial infarction are known, its effects on chronic coronary artery occlusion are less understood.
- This study investigates the impact of late recanalization on left ventricular function in chronic occlusions.
Purpose of the Study:
- To determine if PCI enhances regional and global left ventricular function in patients with chronic coronary artery occlusions.
Main Methods:
- Prospective study of 35 patients with coronary arteries occluded for ≥6 weeks.
- 19 patients underwent successful PCI; assessments included exercise thallium-201 myocardial perfusion scintigraphy, multiple-gated acquisition ventriculography, and echocardiography before and six weeks after PCI.
Main Results:
- Ejection fraction improved significantly post-PCI (51±7% to 58±6% by echocardiography, P<0.001; 45±1% to 53±1% by MUGA, P=0.01).
- Wall motion score improved (24±9 to 15±6, P<0.001), as did exercise (P=0.01) and rest perfusion scores (P=0.02).
- Angina presence correlated with improved left ventricular function and wall motion (P<0.01).
Conclusions:
- PCI significantly enhances regional and global left ventricular function in chronic total coronary occlusion.
- The procedure may offer symptomatic benefits in carefully selected patients.
Background:
The improvement of regional and global ventricular function following percutaneous coronary intervention (PCI) with reperfusion of the artery supplying the infarct area in acute myocardial infarction is well-described. However, little is known of the potential effects of late recanalization of chronic coronary artery occlusion on left ventricular function.
Objective:
To determine whether PCI improves regional and global left ventricular function in patients with chronic coronary artery occlusions.
Patients And Methods:
Thirty-five patients having at least one coronary artery occluded for six weeks or longer were included in the present prospective study. Exercise thallium-201 myocardial perfusion scintigraphy, multiple-gated acquisition ventriculography and two-dimensional echocardiography were performed in 19 patients (16 men; mean age of 58+/-5 years) who underwent a successful PCI to assess both regional and global left ventricular function before and six weeks following the procedure.
Results:
The mean ejection fractions before and after reperfusion were 51+/-7% and 58+/-6% using Simpson's method (P<0.001) by echocardiography, and 45+/-1% and 53+/-1% (P=0.01) by multiple-gated acquisition ventriculography, respectively. The echocardiographic wall motion score was 24+/-9 before and 15+/-6 after PCI (P<0.001). The exercise perfusion score (21+/-1 and 14+/-1 [P=0.01]), rest perfusion score (15+/-1 and 12+/-1 [P=0.02]) and reinjection perfusion score (14+/-1 and 11.1+/-1 [P=0.07]) also improved after PCI. The presence of angina was strongly associated with an improvement in left ventricular function and wall motion score (P<0.01).
Conclusions:
PCI significantly improved the regional and global left ventricular function in patients with chronic total coronary occlusion. This procedure may provide symptom benefits in selected patients.
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