Abstract

AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery.

METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischaemia and viability with [15O]H2O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function. After PCI, stress MBF in the CTO area increased from 1.22±0.36 to 2.40±0.90 mL·min-1·g-1 (p<0.001), whilst stress MBF in the remote area also increased significantly between baseline and follow-up PET (2.58±0.68 to 2.77±0.77 mL·min-1·g-1, p=0.01). The ratio of stress MBF between CTO and remote area was 0.49±0.13 at baseline and increased to 0.87±0.24 at follow-up (p<0.001). The MBF defect size of the CTO area decreased from 5.12±1.69 to 1.91±1.75 myocardial segments after PCI (p<0.001). Left ventricular ejection fraction (LVEF) increased significantly (46.4±11.0 vs. 47.5±11.4%, p=0.01) at follow-up.

CONCLUSIONS: The vast majority of CTO patients with documented ischaemia and viability showed significant improvement in stress MBF and a reduction of ischaemic burden after successful percutaneous revascularisation with only minimal effect on LVEF.

Original languageEnglish
Pages (from-to)345-354
Number of pages10
JournalEuroIntervention
Volume13
Issue number3
DOIs
Publication statusPublished - 20 Jun 2017

Cite this

@article{3441406ee6484eeeb37250af986c746d,
title = "Effects of successful percutaneous coronary intervention of chronic total occlusions on myocardial perfusion and left ventricular function",
abstract = "AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery.METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischaemia and viability with [15O]H2O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function. After PCI, stress MBF in the CTO area increased from 1.22±0.36 to 2.40±0.90 mL·min-1·g-1 (p<0.001), whilst stress MBF in the remote area also increased significantly between baseline and follow-up PET (2.58±0.68 to 2.77±0.77 mL·min-1·g-1, p=0.01). The ratio of stress MBF between CTO and remote area was 0.49±0.13 at baseline and increased to 0.87±0.24 at follow-up (p<0.001). The MBF defect size of the CTO area decreased from 5.12±1.69 to 1.91±1.75 myocardial segments after PCI (p<0.001). Left ventricular ejection fraction (LVEF) increased significantly (46.4±11.0 vs. 47.5±11.4{\%}, p=0.01) at follow-up.CONCLUSIONS: The vast majority of CTO patients with documented ischaemia and viability showed significant improvement in stress MBF and a reduction of ischaemic burden after successful percutaneous revascularisation with only minimal effect on LVEF.",
keywords = "Adult, Aged, PET imaging, Chronic Disease, Coronary Circulation/physiology, Coronary Occlusion/physiopathology, Female, Heart/physiopathology, Humans, Magnetic Resonance Imaging/methods, Male, Middle Aged, Percutaneous Coronary Intervention/methods, Stroke Volume/physiology, Ventricular Function, Left/immunology, myocardial blood flow, Myocardial ischemia, Coronary angiography, PET quantification, Coronary flow, perfusion defect, Perfusion Imaging",
author = "Stuijfzand, {Wijnand J} and Biesbroek, {P Stefan} and Raijmakers, {Pieter G} and Driessen, {Roel S} and Schumacher, {Stefan P} and {van Diemen}, Pepijn and {van den Berg}, Jeffrey and Robin Nijveldt and Lammertsma, {Adriaan A} and Walsh, {Simon J} and Hanratty, {Colm G} and Spratt, {James C} and {van Rossum}, {Albert C} and Alexander Nap and {van Royen}, Niels and Paul Knaapen",
year = "2017",
month = "6",
day = "20",
doi = "10.4244/EIJ-D-16-01014",
language = "English",
volume = "13",
pages = "345--354",
journal = "EuroIntervention",
issn = "1774-024X",
publisher = "EuroPCR",
number = "3",

}

TY - JOUR

T1 - Effects of successful percutaneous coronary intervention of chronic total occlusions on myocardial perfusion and left ventricular function

AU - Stuijfzand, Wijnand J

AU - Biesbroek, P Stefan

AU - Raijmakers, Pieter G

AU - Driessen, Roel S

AU - Schumacher, Stefan P

AU - van Diemen, Pepijn

AU - van den Berg, Jeffrey

AU - Nijveldt, Robin

AU - Lammertsma, Adriaan A

AU - Walsh, Simon J

AU - Hanratty, Colm G

AU - Spratt, James C

AU - van Rossum, Albert C

AU - Nap, Alexander

AU - van Royen, Niels

AU - Knaapen, Paul

PY - 2017/6/20

Y1 - 2017/6/20

N2 - AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery.METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischaemia and viability with [15O]H2O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function. After PCI, stress MBF in the CTO area increased from 1.22±0.36 to 2.40±0.90 mL·min-1·g-1 (p<0.001), whilst stress MBF in the remote area also increased significantly between baseline and follow-up PET (2.58±0.68 to 2.77±0.77 mL·min-1·g-1, p=0.01). The ratio of stress MBF between CTO and remote area was 0.49±0.13 at baseline and increased to 0.87±0.24 at follow-up (p<0.001). The MBF defect size of the CTO area decreased from 5.12±1.69 to 1.91±1.75 myocardial segments after PCI (p<0.001). Left ventricular ejection fraction (LVEF) increased significantly (46.4±11.0 vs. 47.5±11.4%, p=0.01) at follow-up.CONCLUSIONS: The vast majority of CTO patients with documented ischaemia and viability showed significant improvement in stress MBF and a reduction of ischaemic burden after successful percutaneous revascularisation with only minimal effect on LVEF.

AB - AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery.METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischaemia and viability with [15O]H2O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function. After PCI, stress MBF in the CTO area increased from 1.22±0.36 to 2.40±0.90 mL·min-1·g-1 (p<0.001), whilst stress MBF in the remote area also increased significantly between baseline and follow-up PET (2.58±0.68 to 2.77±0.77 mL·min-1·g-1, p=0.01). The ratio of stress MBF between CTO and remote area was 0.49±0.13 at baseline and increased to 0.87±0.24 at follow-up (p<0.001). The MBF defect size of the CTO area decreased from 5.12±1.69 to 1.91±1.75 myocardial segments after PCI (p<0.001). Left ventricular ejection fraction (LVEF) increased significantly (46.4±11.0 vs. 47.5±11.4%, p=0.01) at follow-up.CONCLUSIONS: The vast majority of CTO patients with documented ischaemia and viability showed significant improvement in stress MBF and a reduction of ischaemic burden after successful percutaneous revascularisation with only minimal effect on LVEF.

KW - Adult

KW - Aged

KW - PET imaging

KW - Chronic Disease

KW - Coronary Circulation/physiology

KW - Coronary Occlusion/physiopathology

KW - Female

KW - Heart/physiopathology

KW - Humans

KW - Magnetic Resonance Imaging/methods

KW - Male

KW - Middle Aged

KW - Percutaneous Coronary Intervention/methods

KW - Stroke Volume/physiology

KW - Ventricular Function, Left/immunology

KW - myocardial blood flow

KW - Myocardial ischemia

KW - Coronary angiography

KW - PET quantification

KW - Coronary flow

KW - perfusion defect

KW - Perfusion Imaging

U2 - 10.4244/EIJ-D-16-01014

DO - 10.4244/EIJ-D-16-01014

M3 - Article

VL - 13

SP - 345

EP - 354

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

IS - 3

ER -