Background : Chronic total occlusions (CTOs) present in 52% of patients with significant coronary artery disease, but percutaneous coronary intervention (PCI) is attempted in only a fraction of these lesions. When successful intervention has achieved, these patients with CTOs have a marked benefit in long-term outcome, including survival. We sought to determine the clinical characteristics of patients with improvement of left ventricular systolic function after recanalisation of CTOs.
Methods and Results : From January 2004 to June 2006, there were 199 cases of CTO intervention and 60 patients underwent myocardial SPECT at baseline and 6 month follow-up after intervention. We assessed the change of perfusion for CTO territory and ejection fraction on myocardial SPECT at baseline and follow-up time. The mean change of perfusion score of CTO���s territory was 9.6% and ejection fraction was 7.9%. We divided the patients into two groups as change of EF; group 1 showed no improvement of EF and group 2 showed significant improvement of EF (>8%). In binary logistic regression analysis, regional wall motion abnormality and wall-thining in echocardiography and reversibility of perfusion in myocardial SPECT had significant correlation with improvement of EF. (Table 1.)
Conclusion : After recanalisation of chronic total occlusion, cardiac functional improvement is associated with baseline regional wall motion abnormality, wall-thining and reversibility of perfusion defect.