Prompt and consistent improvement of coronary flow velocity reserve following successful recanalization of the coronary chronic total occlusion in patients with viable myocardium.
Chronic Disease
Coronary Occlusion
/ diagnosis
Coronary Vessels
/ diagnostic imaging
Echocardiography
Female
Follow-Up Studies
Fractional Flow Reserve, Myocardial
/ physiology
Humans
Male
Middle Aged
Myocardial Contraction
/ physiology
Percutaneous Coronary Intervention
Prospective Studies
Time Factors
CFVR
CTO
Coronary chronic total occlusion
Coronary flow velocity reserve
Recanalization
Journal
Cardiovascular ultrasound
ISSN: 1476-7120
Titre abrégé: Cardiovasc Ultrasound
Pays: England
ID NLM: 101159952
Informations de publication
Date de publication:
21 Jul 2020
21 Jul 2020
Historique:
received:
04
06
2020
accepted:
16
07
2020
entrez:
23
7
2020
pubmed:
23
7
2020
medline:
10
6
2021
Statut:
epublish
Résumé
Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO. Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO. Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45, p = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS). In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months. ClinicalTrials.gov (Number NCT04060615 ).
Sections du résumé
BACKGROUND
BACKGROUND
Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO.
METHODS
METHODS
Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO.
RESULTS
RESULTS
Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45, p = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS).
CONCLUSIONS
CONCLUSIONS
In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov (Number NCT04060615 ).
Identifiants
pubmed: 32693812
doi: 10.1186/s12947-020-00211-4
pii: 10.1186/s12947-020-00211-4
pmc: PMC7374915
doi:
Banques de données
ClinicalTrials.gov
['NCT04060615']
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
29Subventions
Organisme : Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja
ID : III41022
Organisme : Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja
ID : 175018
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