What question did this study set out to answer?

The study aims to identify patient and lesion characteristics that influence LVEF improvement after CTO-PCI.

January 22, 2026

Determinants of Left Ventricular Ejection Fraction Improvement After Successful Percutaneous Coronary Intervention for Chronic Total Occlusion: A Study Using Myocardial Perfusion Imaging

Q: What does this research mean for the field?

Pre-PCI transient ischemic dilatation is the strongest predictor of left ventricular ejection fraction improvement after successful percutaneous coronary intervention for chronic total occlusion, with an odds ratio of 6.37. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Pre-PCI transient ischemic dilatation was the strongest predictor of LVEF improvement after CTO-PCI, with an odds ratio of 6.37 (p = 0.017).

Key Points

The study aims to identify patient and lesion characteristics that influence LVEF improvement after CTO-PCI.
Analyzed 100 consecutive patients undergoing CTO-PCI from April 2013 to March 2023.
Included 87 patients with patent vessels at 1-year follow-up.
Calculated LVEF improvement for each patient and categorized them into high and low ΔEF groups.
Evaluated associations using group comparisons and multivariate logistic regression analysis.
Pre-PCI transient ischemic dilatation was the strongest predictor of LVEF improvement (OR 6.37, p = 0.017).
Female sex was associated with greater LVEF improvement (OR 0.025, p = 0.002).
Lower baseline LVEF was linked to greater improvement (OR 0.871, p = 0.001).
Lower post-PCI summed stress score also correlated with larger LVEF improvement (OR 0.824, p = 0.005).

Structured PICO

What are the clinical and myocardial perfusion imaging determinants of left ventricular ejection fraction improvement after successful percutaneous coronary intervention for chronic total occlusion?

Population

87 patients with successful chronic total occlusion percutaneous coronary intervention (CTO-PCI) and a patent vessel at 1-year follow-up (selected from 100 consecutive patients)

Intervention

Successful percutaneous coronary intervention for chronic total occlusion (CTO-PCI)

Outcome

Left ventricular ejection fraction (LVEF) improvement (ΔEF) at 1-year follow-up, categorized into highest quartile (high ΔEF group) versus remaining quartiles (low ΔEF group)surrogate

Pre-procedural transient ischemic dilatation on myocardial perfusion imaging is a strong predictor of left ventricular ejection fraction recovery 1 year after successful CTO-PCI.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

ABSTRACT Background Few studies have investigated the factors associated with left ventricular ejection fraction (LVEF) improvement after successful chronic total occlusion percutaneous coronary intervention (CTO‐PCI), as assessed by myocardial perfusion imaging (MPI). Aims This study aimed to identify patient and lesion characteristics, and MPI findings that associated with LVEF improvement following CTO‐PCI. Methods Among 100 consecutive patients who underwent CTO‐PCI at our hospital between April 2013 and March 2023, 87 with a patent vessel at 1‐year follow‐up were included. LVEF improvement (ΔEF) was calculated for each patient. Patients in the highest quartile of ΔEF were defined as the “high ΔEF group,” and the remaining quartiles as the “low ΔEF group.” Factors associated with LVEF improvement were evaluated using group comparisons and multivariate logistic regression analysis. Results Pre‐PCI transient ischemic dilatation (TID) was most strongly associated with inclusion in the high ΔEF group (Odds ratio OR 6.37, p = 0.017). In addition, female sex, lower baseline LVEF, and lower post‐PCI summed stress score (SSS) were significantly associated with greater LVEF improvement (male sex: OR 0.025, p = 0.002; baseline EF: OR 0.871, p = 0.001; post‐PCI SSS; OR 0.824, p = 0.005). Conclusions Positive pre‐PCI TID was the strongest predictor of LVEF improvement. Female sex, lower baseline LVEF, and lower post‐PCI SSS also contributed significantly to greater improvement in LVEF.

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