Assessment of Recanalization of Chronic Total Occlusions on Left Ventricular Function in Patients With or Without Previous Myocardial Infarction by Real-time Three-Dimensional Echocardiography

The changes of left ventricular ejection fraction (LVEF) were assessed after successful recanalization of chronic total occlusions (CTO) with or without previous myocardial infarction (MI) by real-time three-dimensional echocardiography (RT3DE). 32 patients with a successfully recanalyzed CTO were included in the present prospective study. The patients were divided into group 1 without previous MI and group 2 with previous MI in the territories of total occlusion vessel that was recanalized. In addition, there was a subgroup composed of 14 patients with collateral flow or retrograde flow in group 2. In all patients, LVEF was determined by RT3DE at baseline and after 6 weeks. In group 1, the evolution of LVEF increased significantly from 59.9 ± 7.2–67.5 ± 8.7% (P < 0.05). In group 2, the evolution of LVEF increased from 48.6 ± 6.1–50.1 ± 6.4%, however, it was without statistic significance (P > 0.05). The evolution of LVEF increased from 46.8 ± 7.1–53.0 ± 7.2% (P < 0.05) in the subgroup of group 2. Left ventricular function in patients with CTO can be feasibility and actually evaluated by RT3DE. The influence of recanalization of CTO on the improvement of left ventricular function was different between MI and non-MI patients. The left ventricular function did not improve in MI patients, but improved significantly in the patients having rich collateral circulation.