Early recovery of wall motion abnormalities after recanalization of chronic totally occluded coronary arteries: a dobutamine echocardiographic, prospective, single-center experience
| Autor: | Geert J. Kimman, Jos R.T.C. Roelandt, Paolo M. Fioretti, Marcel L. Geleijnse, Don Poldermans, Jaap N. Hamburger, Folkert J. ten Cate, Aric A. Aiazian, Patrick W. Serruys, Riccardo Rambaldi |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Cardiotonic Agents medicine.medical_treatment Coronary Disease Angina Coronary artery bypass surgery Restenosis Internal medicine Angioplasty Dobutamine medicine Humans Prospective Studies Angioplasty Balloon Coronary Aged business.industry Middle Aged medicine.disease Coronary arteries medicine.anatomical_structure Echocardiography Heart Function Tests Cardiology Female Radiology Cardiology and Cardiovascular Medicine business Artery medicine.drug |
| Zdroj: | American heart journal. 136(5) |
| ISSN: | 0002-8703 |
| Popis: | Background Patients with symptomatic myocardial ischemia from a chronic totally occluded coronary (TOC) artery are usually referred for coronary artery bypass surgery. Because guide wire technology has improved considerably in recent years, percutaneous coronary angioplasty has become a useful technique in opening chronic TOC arteries. We evaluated the early functional results of successful percutaneous recanalization by performing dobutamine stress echocardiography (DSE). Methods Fifteen patients with a chronic TOC artery who underwent a successful recanalization were prospectively studied. Each patient had a DSE within 24 hours before and 48 hours after the procedure. Wall motion was scored according to a 16-segment/5-point model. A clinical and angiographic follow-up of 6 months was obtained. Results The wall motion score index at rest improved from 1.26 ± 0.23 before to 1.22 ± 0.21 after the procedure (P < .05). Of those 10 segments that improved at rest, 7 were collateral recipients and 3 were collateral donors. The number of ischemic segments decreased from 46 before to 4 after the procedure (P < .0001). Wall motion score index at peak stress improved from 1.34 ± 0.20 before to 1.15 ± 0.12 after the procedure (P < .05). DSE was positive for ischemia in 15 patients before and 2 patients after the procedure (P < .0001). Angina was present in 12 patients before and in 2 patients after recanalization (P < .0001). Two patients (13%) had angiographic reocclusion and 5 (33%) restenosis after 6 months of follow-up. Conclusions Successful percutaneous recanalization of chronic TOC artery results in an early improvement of both clinical status and resting or stress-induced wall motion abnormalities, as detected by DSE. (Am Heart J 1998;136:831-6.) |
| Databáze: | OpenAIRE |
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