IMPROVED GLOBAL AND REGIONAL LEFT-VENTRICULAR FUNCTION AFTER ANGIOPLASTY FOR CHRONIC CORONARY-OCCLUSION

Percutaneous transluminal coronary angioplasty can be performed safely and effectively in patients with chronic total coronary occlusion. To investigate the effect on left ventricular function, global and regio nal left ventricular ejection fraction were analyzed by contrast angio graphy in 49 patients before and 10 +/- 6 weeks after successful recan alization. Coronary angiography at follow-up showed reocclusion in 12 patients (24%). In 37 patients with patent arteries global ejection fr action increased from 55.8 +/- 7.1% at baseline to 62.5 +/- 11.3% at f ollow-up (P < 0.001), and regional wall motion assessed by the centerl ine method improved from - 1.7 +/- 1.0 to - 0.6 +/- 1.5 standard devia tions/chord (P < 0.001). In contrast, in patients with reocclusion nei ther global ejection fraction nor regional wall motion were significan tly different at follow-up compared with baseline. Changes in global o r regional left ventricular function after coronary recanalization wer e unrelated to other parameters such as severity of angina, duration o f occlusion, history of myocardial infarction, presence or absence of visible collaterals, or baseline left ventricular function. Thus in pa tients with primarily successful recanalization of chronically occlude d coronary arteries persistent vessel patency is the major determinant of global and regional improvement of left ventricular function.