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Meta-analysis of the impact of successful chronic total occlusion percutaneous coronary intervention on left

Michael Megaly1,2, Marwan Saad3, Peter Tajti1

  • 1Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota.

Journal of Interventional Cardiology
|July 6, 2018
PubMed

Insights

Successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) significantly improves left ventricular (LV) ejection fraction and reduces LV end-systolic volume. These findings suggest CTO PCI benefits LV remodeling.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Coronary chronic total occlusion (CTO) poses challenges in cardiac care.
  • The impact of successful CTO percutaneous coronary intervention (PCI) on left ventricular (LV) function requires detailed examination.

Purpose of the Study:

  • To systematically review and meta-analyze the effects of successful CTO PCI on LV function.
  • To quantify changes in LV ejection fraction and volumes following successful CTO PCI.

Main Methods:

  • Systematic review and meta-analysis of observational studies.
  • Inclusion criteria: studies published from January 1980 to November 2017 on successful CTO PCI and LV function.
  • Data synthesis to assess changes in LV ejection fraction and volumes.

Main Results:

  • 34 studies with 2735 patients were analyzed.
  • Successful CTO PCI increased LV ejection fraction by 3.8% (P < 0.0001).
  • LV end-systolic volume decreased by 4 mL (P < 0.0001), while LV end-diastolic volume showed no significant change.

Conclusions:

  • Successful CTO PCI leads to significant improvements in LV ejection fraction and reductions in LV end-systolic volume.
  • These functional improvements may indicate a beneficial effect of CTO recanalization on LV remodeling.
  • Further research is needed to explore the clinical implications of these findings.
Abstract

Keywords:
chronic total occlusionejection fractionleft ventricular functionleft ventricular reverse remodeling

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