Improvement in left ventricular ejection fraction and wall motion after successful recanalization of chronic coronary
P A Sirnes1, Y Myreng, P Mølstad
1Feiring Heart Clinic, Norway. psirnes@online.no
Insights
Successful angioplasty of chronic coronary occlusions improved left ventricular ejection fraction and regional function. Long-term artery patency after recanalization enhances cardiac performance, supporting this intervention.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Physiology
Background:
- Chronic coronary occlusions often lead to impaired left ventricular function.
- Angioplasty aims to restore blood flow and improve cardiac performance.
Purpose of the Study:
- To assess changes in left ventricular ejection fraction and regional radial shortening after successful angioplasty of chronic coronary occlusions.
- To evaluate the impact of long-term artery patency on cardiac function post-recanalization.
Main Methods:
- 95 patients with chronic coronary occlusions underwent successful recanalization, with 71% receiving intracoronary stents.
- Left ventriculograms were analyzed at baseline and follow-up (6.7 ± 1.4 months) using a computer-assisted method.
- Left ventricular ejection fraction and regional radial shortening were quantified.
Main Results:
- Left ventricular ejection fraction significantly increased from 0.62 ± 0.13 to 0.67 ± 0.11 (P < 0.001).
- Regional radial shortening in the recanalized artery territory improved by 16% (P < 0.001) in patients with a patent artery at follow-up.
- Improvements were associated with patent arteries, while reocclusion led to unchanged function.
Conclusions:
- Long-term patency following recanalization of chronic coronary occlusions improves both global and regional left ventricular function.
- This functional recovery may stem from the reactivation of hibernating myocardium.
- The findings support the clinical strategy of recanalizing chronic coronary occlusions to improve cardiac outcomes.
Aims:
This study assessed changes in left ventricular ejection fraction and regional radial shortening after successful angioplasty of chronic coronary occlusions.
Methods:
We studied 95 patients with angina pectoris or exercise-induced ischaemia with a successfully recanalized chronic (median duration 4.3 months) coronary occlusion. Intracoronary stents were implanted in 71%. Left ventriculograms were obtained at baseline and after 6.7 +/- 1.4 months. Left ventricular ejection fraction and regional radial shortening were determined by a computer-assisted method.
Results:
Left ventricular ejection fraction increased from 0.62 +/- 0.13 at baseline to 0.67 +/- 0.11 at follow-up (P < 0.001). The change in left ventricular ejection fraction in patients with a patent artery and in patients with reocclusion (n = 8) was 0.05 +/- 0.06 and 0.01 +/- 0.04, respectively (P = 0.04). Regional radial shortening in the territory of the recanalized artery increased by 16% (from 0.28 +/- 0.11 to 0.32 +/- 0.11, P < 0.001) in patients with a patent artery at follow-up, but was unchanged in patients with reocclusion.
Conclusion:
Long-term patency after recanalization of old, chronic coronary occlusions in patients with angina pectoris is associated with improvement in global and regional left ventricular function. This may be a result of recovery of hibernating myocardium and supports the strategy of recanalizing chronic coronary occlusions.
