Related Experiment Video
Updated: May 6, 2026
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Early assessment of percutaneous coronary interventions for chronic total occlusions analyzed by novel
Ercan Erdogan1, Mehmet Akkaya, Ahmet Bacaksiz
1Bezmialem Foundation University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey.
Insights
Revascularization of chronic total occlusions significantly improves heart function, reducing left ventricular volumes and enhancing ejection fraction and global longitudinal strain. This highlights the benefits of restoring blood flow in these patients.
Area of Science:
- Cardiology
- Echocardiography
- Interventional Cardiology
Background:
- Chronic total occlusions (CTO) impact left ventricular (LV) function.
- Successful revascularization is linked to improved LV systolic function, reduced angina, and increased survival.
- Novel echocardiographic techniques offer advanced assessment of LV function.
Purpose of the Study:
- To evaluate the impact of revascularization in CTO on LV function.
- To utilize advanced echocardiographic methods for precise functional assessment.
- To quantify changes in LV ejection fraction, volumes, and dyssynchrony post-revascularization.
Main Methods:
- 129 patients with CTO undergoing revascularization were studied.
- Two-dimensional speckle tracking and 3D echocardiography were used pre- and post-procedure.
- Key metrics included LV ejection fraction, LV volumes, and 3D systolic dyssynchrony index.
Main Results:
- Successful revascularization achieved in 91.5% of patients.
- Significant improvements observed in LV ejection fraction and global longitudinal strain.
- Significant reductions in LV end-diastolic and end-systolic volumes and systolic dyssynchrony index.
Conclusions:
- Restoring coronary blood flow in CTO patients improves LV function.
- Novel echocardiography confirms reduced LV volumes and enhanced LV ejection fraction and global longitudinal strain.
- Hibernating myocardium function is improved post-revascularization.
Objective:
Successful revascularization of chronic total occlusions has been associated with improved left ventricular systolic function, reduced anginal symptoms, increased exercise capacity, and increased survival. This study was conducted to determine the impact of revascularization in chronic total occlusion on left ventricular function using novel echocardiographic techniques.
Methods:
A total of 129 patients with chronic total occlusion who underwent revascularization between April 2011 and November 2012 were included in this study. Echocardiographic assessments with two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography were performed before the procedure and one month after the procedure. The left ventricular ejection fraction, left ventricular volumes, and three-dimensional systolic dyssynchrony index were quantified.
Results:
An immediate procedural success was obtained in 118 patients (91.5%). There were no acute or subacute stent thromboses during follow-up. The mean left ventricular ejection fraction significantly increased (p<0.001), while the left ventricular end-diastolic and end-systolic volumes significantly decreased (p = 0.001 and p<0.001, respectively). The three-dimensional systolic dyssynchrony index also decreased significantly (p<0.001). The global longitudinal strain showed a significant increase after successful revascularization (p<0.001). An increase in the global longitudinal strain was correlated with an increase in the left ventricular ejection fraction (r = 0.27, p = 0.02). The patients with a left ventricular ejection fraction ≥50% displayed a greater improvement in the global longitudinal strain, and the patients with diabetes showed less improvement.
Conclusions:
Using novel echocardiographic techniques, our results showed that restoring the coronary blood flow in chronic total occlusion patients reduces the left ventricular volumes and improves the left ventricular ejection fraction and the global longitudinal strain of hibernating myocardium.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...