scholarly journals Circulating Chromogranin B Is Associated With Left Ventricular Functional Recovery After Successful Recanalization of Chronic Total Occlusion

2021 ◽  
Vol 8 ◽  
Author(s):  
Ying Shen ◽  
Muladili Aihemaiti ◽  
Xin Yi Shu ◽  
Chen Die Yang ◽  
Jia Wei Chen ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Chronic Total Occlusion ◽  
Stable Coronary Artery Disease ◽  
Left Ventricular ◽  
Functional Improvement ◽  
Chromogranin B ◽  
Total Occlusion ◽  
Absolute Increase ◽  
Increased Risk ◽  
Recovery Group

Background: Chromogranin B (CgB) is increased in heart failure and proportionate to disease severity. We investigated whether circulating CgB level is associated with left ventricular (LV) functional recovery potential after successful recanalization of chronic total occlusion (CTO).Methods: Serum levels of CgB were assayed in 53 patients with stable angina with LV functional recovery [an absolute increase in LV ejection fraction (EF) of ≥5%] and 53 age- and sex-matched non-recovery controls after successful recanalization of CTO during 12-month follow-up.Results: We found that CgB level was significantly lower in the recovery group than in the non-recovery group (593 [IQR 454–934] vs. 1,108 [IQR 696–2020] pg/ml, P < 0.001), and that it was inversely correlated with changes in LVEF (Spearman's r = −0.31, P = 0.001). Receiver operating characteristic (ROC) analysis showed that the area under the curve of CgB for predicting LVEF improvement was 0.76 (95% CI 0.664–0.856), and that the optimal cutoff value was 972.5 pg/ml. In multivariate analyses, after adjusting for confounding factors, high CgB level remained an independent determinant of impaired LV functional recovery after CTO recanalization. LV functional improvement appeared to be more responsive to CgB in patients with poor than with good coronary collaterals.Conclusions: Elevated circulating CgB level confers an increased risk of impaired LV functional recovery after successful recanalization of CTO in patients with stable coronary artery disease.

Early Improvement of Left Ventricular Dyssynchrony After Percutaneous Coronary Intervention in Patients with Single Chronic Total Occlusion Vessel

2020 ◽  
Author(s):  
Shaoping Wang ◽  
Shiying Li ◽  
Yijia Li ◽  
Yejing Zhao ◽  
Tong Liu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Left Ventricular Dyssynchrony ◽  
Total Occlusion ◽  
Early Improvement ◽  
Ventricular Dyssynchrony ◽  
Percutaneous Coronary

Abstract Background The effect of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) on left ventricular dyssynchrony was unclear. Methods Patients with one CTO vessel were included. Tissue Doppler imaging was used to assess the left ventricular dyssynchrony index (DI) in twelve segments before and after successful CTO PCI. Multiple regression was used to identify independent correlates of DI reduction. Results 41 patients were included with the mean age of 65.88 years. 39(95.12%) had left ventricular DI more than 33. It decreased significantly from 67.48 ± 28.73 to 44.69 ± 23.90 (P < 0.01) after successful CTO PCI. PCI of infarct-relative CTO was associated with less percentage of DI reduction (Coefficient [Coef.], 25.60; 95% confidence interval [CI], 8.13–43.08; P < 0.01). Higher initial DI was associated with more percentage of DI reduction (Coef., -0.35; 95% CI, -0.67- -0.03; P = 0.03). Percentage of DI reduction was associated with ejection fraction (EF) improvement (Coef., -5.09; 95% CI, -7.45- -2.72; P < 0.01) with linear relationship (P < 0.01). Conclusion Left ventricular dyssynchrony was reduced early after successful CTO PCI, which predicted EF improvement. The association between dyssynchrony reduction and long-term benefits of CTO PCI are expected.

P1964Impact of successful coronary intervention for chronic total occlusion on long-term clinical outcome of patients with impaired and preserved left ventricular ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Tanaka ◽  
T Tada ◽  
Y Fuku ◽  
T Goto ◽  
K Kadota
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Total Occlusion ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary ◽  
Procedural Success

Abstract Background Successful recanalisation of percutaneous coronary intervention for chronic total occlusion lesions has been associated with improved survival. Purpose This study aimed to assess the impact of successful percutaneous coronary intervention for chronic total occlusion lesions on the long-term outcome of patients with impaired and preserved left ventricular ejection fraction (LVEF). Methods The study sample consisted of 842 consecutive patients (928 chronic total occlusion lesions) undergoing percutaneous coronary intervention at our institution between October 2005 and December 2009. We divided them into 3 groups by the degree of LVEF: less than 40% (severely reduced LVEF, n=140), 40% to 59% (moderately reduced LVEF, n=470), and 60% and above (normal LVEF, n=232). We evaluated mortality during the 10-year follow-up period the basis of procedural success and failure. Results The overall procedural success rate was 89.1%. Median follow-up duration was 7.9 years. The 10-year cumulative incidences of cardiac death in each degree of LVEF are shown in the Figure. Conclusions Successful recanalisation for chronic total occlusion lesions in patients with impaired LVEF may be associated with reduced cardiac mortality.

scholarly journals A case report of right ventricular compression from a septal haematoma during retrograde coronary intervention to a chronic total occlusion

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Darshan Doshi ◽  
Raja Hatem ◽  
Amirali Masoumi ◽  
Dimitri Karmapaliotis
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Outflow Obstruction ◽  
Assist Device ◽  
Total Occlusion ◽  
Ventricular Outflow Obstruction ◽  
Ventricle Assist Device

Abstract Background Septal haematomas causing left ventricular or biventricular outflow obstruction are rare but known complications of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can be life-threatening. Case summary In this case, we describe the formation of a septal haematoma during retrograde CTO PCI. The patient was initially managed conservatively but became progressively unstable, for which she underwent coiling of the inflow and outflow of the septal perforator. Despite coiling, she developed near complete right ventricular outflow obstruction (based on echocardiography). She was successfully managed with a percutaneous right ventricle assist device, with subsequent resolution of the outflow obstruction. Discussion Septal haematomas with resultant outflow obstruction have been uniformly fatal. In our case, the use of a percutaneous right ventricle assist device was life-saving.

scholarly journals Development and first results of a dedicated chronic total occlusion programme

2019 ◽  
Vol 29 (1) ◽  
pp. 14-21 ◽  
Author(s):  
H. W. van der Werf ◽  
P. J. Vlaar ◽  
P. van der Harst ◽  
E. Lipšic
Keyword(s):  
Chronic Total Occlusion ◽  
High Volume ◽  
Coronary Intervention ◽  
Technical Success ◽  
Total Occlusion ◽  
Technical Success Rate ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
First Results ◽  
Hospital Deaths

Abstract Objective To describe the development and first results of a dedicated chronic total occlusion (CTO) programme in a tertiary medical centre. Background Because of the complexity and the increased risk of complications during percutaneous coronary intervention (PCI) for CTO, it is essential that less experienced and evolving CTO centres perform regular quality analyses. Methods We therefore performed analyses to describe the results during the first 3 years of a dedicated CTO programme at a high-volume PCI centre. In addition, we discuss the strategies employed to develop such a programme. Results A total of 179 consecutive patients undergoing 187 CTO procedures were included in the study. The complexity of the CTO lesions increased from a mean J‑CTO (Japanese Multicentre CTO Registry) score of 1.3 in 2015 to 2.1 in 2017. In the majority of cases, the antegrade wire escalation technique was performed. Final technical success rate was 78.5% in 175 patients with a single CTO and 80.2% of all 187 CTO procedures. No peri-procedural or in-hospital deaths occurred. One peri-procedural myocardial infarction occurred. Cardiac tamponade occurred in 2 cases, both managed by pericardiocentesis. No urgent cardiac surgery was necessary. Survival and revascularisation rates at 30 days and 1 year were excellent. Conclusion Following initiation of a dedicated CTO programme, using up-to-date techniques and strategies, procedural and clinical outcome were comparable with current standards in established centres.

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