Percutaneous transluminal angioplasty for total coronary occlusion: The effect of restenosis on left ventricular function

The study was undertaken to evaluate the effect of restenosis on global and regional left ventricular function after percutaneous transluminal coronary angioplasty (PTCA) for total coronary occlusion. Thirty-one consecutive patients with total coronary occlusion treated successfully with PTCA and had follow-up angiography at 3–6 months formed the study group. Nineteen patients had restenosis (16 males, mean age 48 ± 10 years) and 12 had no restenosis (11 males, mean age 53 ± 10 years). In the LAD group there were increases in anterobasal (35.9 ± 8.5% vs 43.1 ± 5.7%, p=0.05) and apical (24.1 ± 6.8% vs 31.7 ± 2.9%, p=0.03) segment motion scores in patients without restenosis after PTCA. Global ejection fractions (63.1 ± 14.5% vs 68.9 ± 12.4%, p=0.09) and anterolater,al (28.7 ± 11.3% vs 39.7 ± 10.2%, p=0.09) segment scores increased, but did not reach statistical significance. In the LAD restenosis group anterobasal (41.5 ± 14.3% vs 34.3 ± 12.6%, p=0.001), apical (21.1 ± 15.0% vs 17.8 ± 10.9%, p=0.05) and anterolateral (32.7 ± 19.6% vs 26.6 ± 13.8%, p=0.03) segment motion scores decreased but the decrease in the global ejection fraction (60.3 ± 18.5% vs 58.6 ± 17.4, p=0.38) was not significant. In the RCA+LCX group there was a significant increases in global ejection fraction (69.0 ± 7.5% vs 74.2 ± 7.6%, p=0.03) and posterobasal (23.8 ± 7.8 vs 34.4 ± 8.0, p=0.04) segment motion scores in patients without restenosis. The wall motion scores were unchanged in patients with restenosis in the RCA+LCX group. It was concluded that restenosis after a successful PTCA for total coronary occlusion may deteriorate segmental wall motion and treatment modalities with increased patency rates should be used for total coronary occlusions.