Quantification of strain analysis and late gadolinium enhancement in coronary chronic total occlusion: a cardiovascular magnetic resonance imaging follow-up study

BACKGROUND: The present study aimed to investigate the benefits of percutaneous coronary intervention (PCI) in patients with chronic total occlusions (CTOs) by using cardiac magnetic resonance imaging (CMR) feature tracking. METHODS: Fifty-five CTOs with successful CTO-PCI underwent CMR at baseline and 12 months. Feature tracking was applied to measure left ventricle strain index in CTOs with decreased and preserved left ventricular ejection fraction (LVEF). CTOs were also divided into two groups according to the infarct size of 10% or combined with multi-vessel disease. We also measured these parameters in 40 healthy subjects. RESULTS: -19.2±3.1, P<0.01), and the subgroup with decreased LVEF, infarct size less than 10%, or multi-vessel disease, but not with the 1-vessel disease. In the LAD and LCX CTO territory, radial and circumferential strain showed treatment effect of CTO-PCI on the recovery of strain parameters (P<0.01 for both). In the RCA CTO territory, circumferential and longitudinal strain showed treatment effect of CTO-PCI on the recovery of strain parameters (P<0.05 for both). CONCLUSIONS: In this single center study, global radial strain and circumferential strain showed treatment effect of successful CTO-PCI at 1-year follow-up in CTOs with the decreased LVEF, infarct size less than 10%, or multi-vessel disease, and the regional strain also showed a similar trend. However, the benefit of CTO-PCI on the strain recovery was not shown in patients with 1-vessel disease. Therefore, whether patients with CTO benefit from PCI still needs further verification.