IMPROVEMENT IN LEFT-VENTRICULAR EJECTION FRACTION AND WALL-MOTION AFTER SUCCESSFUL RECANALIZATION OF CHRONIC CORONARY OCCLUSIONS

Aims This study assessed changes in left ventricular ejection fraction and regional radial shortening after successful angioplasty of chroni c coronary occlusions. Methods We studied 95 patients with angina pect oris or exercise-induced ischaemia with a successfully recanalized chr onic (median duration 4.3 months) coronary occlusion. Intracoronary st ents were implanted in 71%. Left ventriculograms were obtained at base line and after 6.7 +/- 1.4 months. Left ventricular ejection fraction and regional radial shortening were determined by a computer-assisted method. Results Left ventricular ejection fraction increased from 0.62 +/- 0.13 at baseline to 0.67 +/- 0.11 at follow-up (P<0.001). The cha nge in left ventricular ejection fraction in patients with a patent ar tery and in patients with reocclusion (n=8) was 0.05 +/- 0.06 and 0.01 +/- 0.04, respectively (P=0.04). Regional radial shortening in the te rritory of the recanalized artery increased by 16% (from 0.28 +/- 0.11 to 0.32 +/- 0.11, P<0.001) in patients with a patent artery at follow -up, but was unchanged in patients with reocclusion. Conclusion Long-t erm patency after recanalization of old, chronic coronary occlusions i n patients with angina pectoris is associated with improvement in glob al and regional left ventricular function. This may be a result of rec overy of hibernating myocardium and supports the strategy of recanaliz ing chronic coronary occlusions.