Functional recovery after percutaneous revascularization of coronary chronic total occlusions: insights from cardiac magnetic resonance tissue tracking

Henk Everaars, Stefan P. Schumacher, Wijnand J. Stuijfzand, Martijn van Basten Batenburg, Jennifer Huynh, Pepijn A. van Diemen, Michiel J. Bom, Ruben W. de Winter, Peter M. van de Ven, Ramon B. van Loon, Albert C. van Rossum, Maksymilian P. Opolski, Alexander Nap, Paul Knaapen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

To evaluate the effect of percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTOs) on left ventricular (LV) strain assessed using cardiac magnetic resonance (CMR) tissue tracking. In 150 patients with a CTO, longitudinal (LS), radial (RS) and circumferential shortening (CS) were determined using CMR tissue tracking before and 3 months after successful PCI. In patients with impaired LV strain at baseline, global LS (10.9 ± 2.4% vs 11.6 ± 2.8%; P = 0.006), CS (11.3 ± 2.9% vs 12.0 ± 3.5%; P = 0.002) and RS (15.8 ± 4.9% vs 17.4 ± 6.6%; P = 0.001) improved after revascularization of the CTO, albeit to a small, clinically irrelevant, extent. Strain improvement was inversely related to the extent of scar, even after correcting for baseline strain (B = − 0.05; P = 0.008 for GLS, B = − 0.06; P = 0.016 for GCS, B = − 0.13; P = 0.017 for GRS). In the vascular territory of the CTO, dysfunctional segments showed minor improvement in both CS (10.8 [6.9 to 13.3] % vs 11.9 [8.1 to 15.0] %; P < 0.001) and RS (14.2 [8.4 to 18.7] % vs 16.0 [9.9 to 21.8] %; P < 0.001) after PCI. Percutaneous revascularization of CTOs does not lead to a clinically relevant improvement of LV function, even in the subgroup of patients and segments most likely to benefit from revascularization (i.e. LV dysfunction at baseline and no or limited myocardial scar).

Original languageEnglish
Pages (from-to)3057-3068
Number of pages12
JournalInternational Journal of Cardiovascular Imaging
Volume37
Issue number10
Early online date2021
DOIs
Publication statusPublished - Oct 2021

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