Aims To determine the effects of percutaneous coronary intervension (PCI) on cardiac perfusion, cardiac function and quality of life in patients with chronic total occlusion (CTO) lesion in left anterior descending (LAD) coronary artery.
Methods 37consecutive patients with CTO lesion in LAD coronary artery who underwent PCI as well as SPECT/CTA fusion imaging were divided into the following three groups based on the myocardial perfusion index before PCI: (A) no severe cardiac perfusion defects (n=4); (B) reversible cardiac perfusion defects (n=18); (C) irreversible cardiac perfusion defects (n=15).
Results Overall successful rate of recanalisation for CTO was 75.7% (28/37). No statistical difference of perfusion abnormality was observed 6 months after PCI in group A. In group B, SPECT/CTA fusion imaging demonstrated that cardiac perfusion abnormality was significantly decreased 6 months after PCI (21±7.9% vs 28±9.8%, p<0.05). Left ventricular ejection fraction (LVEF) significantly enhanced as evaluated by echocardiography (51±8.3 % vs 43±6.2 %, p <0.05) as well as SPECT (50±7.7% vs 45±8.5%, p<0.05) compared with baseline. Quality of life improved as evidenced by 6-min walk distance (6MWD) (426.4±33.8 m vs 347.3±24.6 m, p<0.05) and angina pectoris score index (60.8±13.5 vs 53.7±11.2, p<0.05). Moreover, patients in group C also benefited from PCI therapy: a decrease in cardiac perfusion abnormality, an increase in LVEF and an improvement in quality of life.
Conclusion PCI exerts long-term functional and clinical benefits in patients with CTO lesion in LAD coronary artery, particularly in patients with reversible cardiac perfusion defects. SPECT/CTA fusion imaging may serve as a gatekeeper to evaluate the outcomes of patients with CTO lesion in LAD coronary artery.
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