February 1, 1998
View Full PaperImprovement in left ventricular ejection fraction and wall motion after successful recanalization of chronic coronary occlusions
Key Result
Long-term patency after recanalization of chronic coronary occlusions significantly improved left ventricular ejection fraction compared to reocclusion (change of 0.05 vs 0.01; P=0.04).
Study Design
Type
Cohort (n=95)
Structured PICO
Does successful recanalization of chronic coronary occlusions improve left ventricular ejection fraction and regional radial shortening in patients with angina pectoris or exercise-induced ischaemia?
P
Population
95 patients with angina pectoris or exercise-induced ischaemia and a successfully recanalized chronic coronary occlusion, followed for a mean of 6.7 months.
E
Exposure
Successful angioplasty/recanalization of chronic coronary occlusions (intracoronary stents implanted in 71%)
C
Comparator
Baseline measurements and patients with reocclusion (n=8) at follow-up
O
Outcome
Changes in left ventricular ejection fraction and regional radial shortening at 6.7 +/- 1.4 monthssurrogate
Successful recanalization of chronic coronary occlusions is associated with significant improvements in global and regional left ventricular function at 6 months, provided the artery remains patent.
Main Result
Absolute Event Rate: 0.05% vs 0.01%
p-value: p=0.04
Abstract
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.