Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries

Objective: Viability and functional assessments are recommended for indication and intervention for chronic coronary total occlusion (CTO). We aimed to evaluate myocardial viability and left ventricular (LV) functional status by using cardiovascular magnetic resonance (CMR) and to investigate the re...

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Autores principales:	Xueyao Yang, Jinfan Tian, Lijun Zhang, Wei Dong, Hongzhi Mi, Jianan Li, Jiahui Li, Ye Han, Huijuan Zuo, Jing An, Yi He, Xiantao Song
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	chronic total occlusion myocardial viability coronary artery disease cardiovascular magnetic resonance cardiac function Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/139af7133cc048fcab8378717967e819
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spelling	oai:doaj.org-article:139af7133cc048fcab8378717967e8192021-11-12T05:06:45ZMyocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries2297-055X10.3389/fcvm.2021.754826https://doaj.org/article/139af7133cc048fcab8378717967e8192021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.754826/fullhttps://doaj.org/toc/2297-055XObjective: Viability and functional assessments are recommended for indication and intervention for chronic coronary total occlusion (CTO). We aimed to evaluate myocardial viability and left ventricular (LV) functional status by using cardiovascular magnetic resonance (CMR) and to investigate the relationship between them and collaterals in patients with CTO.Materials and Methods: We enrolled 194 patients with one CTO artery as detected by coronary angiography. Patients were scheduled for CMR within 1 week after coronary angiography.Results: A total of 128 CTO territories (66%) showed scar based on late gadolinium enhancement (LGE) imaging. There were 1,112 segments in CTO territory, while only 198 segments (18%) subtended by the CTO artery showed transmural scar (i.e., >50% extent on LGE). Patients with viable myocardium had higher LV ejection fraction (LVEF) (56.7 ± 13.5% vs. 48.3 ± 15.4%, p < 0.001) than those with transmural scar. Angiographically, well-developed collaterals were found in 164 patients (85%). There was no significant correlation between collaterals and the presence of myocardial scar (p = 0.680) or between collaterals and LVEF (p = 0.191). Nevertheless, more segments with transmural scar were observed in patients with poorly-developed collaterals than in those with well-developed collaterals (25 vs. 17%, p = 0.010).Conclusion: Myocardial infarction detected by CMR is widespread among patients with CMO, yet only a bit of transmural myocardial scar was observed within CTO territory. Limited number of segments with transmural scar is associated with preserved LV function. Well-developed collaterals are not related to the prevalence of myocardial scar or systolic functioning, but could be related to reduce number of non-viable segments subtended by the CTO artery.Xueyao YangJinfan TianLijun ZhangWei DongHongzhi MiJianan LiJiahui LiYe HanHuijuan ZuoJing AnYi HeXiantao SongFrontiers Media S.A.articlechronic total occlusionmyocardial viabilitycoronary artery diseasecardiovascular magnetic resonancecardiac functionDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic total occlusion myocardial viability coronary artery disease cardiovascular magnetic resonance cardiac function Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	chronic total occlusion myocardial viability coronary artery disease cardiovascular magnetic resonance cardiac function Diseases of the circulatory (Cardiovascular) system RC666-701 Xueyao Yang Jinfan Tian Lijun Zhang Wei Dong Hongzhi Mi Jianan Li Jiahui Li Ye Han Huijuan Zuo Jing An Yi He Xiantao Song Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
description	Objective: Viability and functional assessments are recommended for indication and intervention for chronic coronary total occlusion (CTO). We aimed to evaluate myocardial viability and left ventricular (LV) functional status by using cardiovascular magnetic resonance (CMR) and to investigate the relationship between them and collaterals in patients with CTO.Materials and Methods: We enrolled 194 patients with one CTO artery as detected by coronary angiography. Patients were scheduled for CMR within 1 week after coronary angiography.Results: A total of 128 CTO territories (66%) showed scar based on late gadolinium enhancement (LGE) imaging. There were 1,112 segments in CTO territory, while only 198 segments (18%) subtended by the CTO artery showed transmural scar (i.e., >50% extent on LGE). Patients with viable myocardium had higher LV ejection fraction (LVEF) (56.7 ± 13.5% vs. 48.3 ± 15.4%, p < 0.001) than those with transmural scar. Angiographically, well-developed collaterals were found in 164 patients (85%). There was no significant correlation between collaterals and the presence of myocardial scar (p = 0.680) or between collaterals and LVEF (p = 0.191). Nevertheless, more segments with transmural scar were observed in patients with poorly-developed collaterals than in those with well-developed collaterals (25 vs. 17%, p = 0.010).Conclusion: Myocardial infarction detected by CMR is widespread among patients with CMO, yet only a bit of transmural myocardial scar was observed within CTO territory. Limited number of segments with transmural scar is associated with preserved LV function. Well-developed collaterals are not related to the prevalence of myocardial scar or systolic functioning, but could be related to reduce number of non-viable segments subtended by the CTO artery.
format	article
author	Xueyao Yang Jinfan Tian Lijun Zhang Wei Dong Hongzhi Mi Jianan Li Jiahui Li Ye Han Huijuan Zuo Jing An Yi He Xiantao Song
author_facet	Xueyao Yang Jinfan Tian Lijun Zhang Wei Dong Hongzhi Mi Jianan Li Jiahui Li Ye Han Huijuan Zuo Jing An Yi He Xiantao Song
author_sort	Xueyao Yang
title	Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
title_short	Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
title_full	Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
title_fullStr	Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
title_full_unstemmed	Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries
title_sort	myocardial viability, functional status, and collaterals of patients with chronically occluded coronary arteries
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/139af7133cc048fcab8378717967e819
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Myocardial Viability, Functional Status, and Collaterals of Patients With Chronically Occluded Coronary Arteries

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