Prediction of functional recovery after percutaneous coronary revascularization for chronic total occlusion using late gadolinium enhanced magnetic resonance imaging

Abstract

The cut-off value of the extent of LGE MRI is 50% to detect segments that will functionally recover after CTO PCI. Change in LS was more sensitive for removal of ischemia by CTO PCI, indicating the utility of LS to monitor the therapeutic effects of CTO recanalization.

Meta‐analysis of the impact of successful chronic total occlusion percutaneous coronary intervention on left ventricular systolic function and reverse remodeling

“…Thirty‐four observational studies [including two abstracts ] with a total of 2804 patients met our inclusion criteria . Cardiac magnetic resonance imaging (CMR) was used to assess LVEF in nine studies while echocardiography was used in 10 studies . Other studies used left ventriculography or nuclear imaging, or did not specify the method used for assessing LVEF .…”

“…Successful CTO PCI was associated with a significant decrease in LVESV (−4.0 mL, 95%CI −6.0, −2.1, P < 0.0001, I 2 = 0%) (Figure ). LVEDV was analyzed in nine studies including 403 patients . Successful CTO PCI was not associated with a decrease in LVEDV (−2.2 mL, 95%CI −5.7 to 1.1, P = 0.19, I 2 = 0%) (Figure ).…”

“…Furthermore, in a sensitivity analysis including only studies with documented CTO duration of at least 3 months and follow‐up duration of at least 3 months after CTO PCI (15 studies, 1248 patients), successful CTO PCI remained associated with significant improvement in LVEF (4.3%, 95%CI 3.0, 5.5, P < 0.00001).…”

“…Some of the studies included in the meta‐analysis defined “CTOs” as lesions with <3 months occlusion duration, which is the currently accepted threshold for a lesion to be characterized as CTO. When restricting our analyses to studies with documented CTO duration of at least 3 months and with follow up duration of at least 3 months significant improvement in LVEF was shown (4.31%, 95%CI [3.08, 5.55], P < 0.00001) in 1248 patients 15 studies …”

“…Cardiac magnetic resonance imaging (CMR) was used to assess LVEF in nine studies [14][15][16][17]29,32,33,40,41 while echocardiography was used in 10 studies. 22,24,26,31,36,37,39,[43][44][45] Other studies used left ventriculography 13,20,21,23,25,28,34,35,42,46 or nuclear imaging, 27,38 or did not specify the method used for assessing LVEF. 18,19,30 The…”