Pp-207 Echocardiographic Evaluation of Right Ventricular Functions After Successful Percutaneous Recanalization of Right Coronary Chronic Total Occlusions

Özkan, Bülent; Urumdaş, Mehmet; Alıcı, Gökhan; Açar, Göksel; Tabakçı, Mehmet Mustafa; Kalkan, Mehmet; Demir, Sedat; Şahin, Mahmut; Alizade, Elnur; Çakır, Hakan; Esen, A.M.

doi:10.1016/s0167-5273(13)70411-x

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“…In patients with CTO-RCA, a previous observational echocardiography study found that the RV function (volumetric and strain) significantly improved 1 month after successful PCI of a CTO in the RCA, compared to baseline [ 12 ]. Contrarily, in our prospective randomized study, we found that RV function significantly improved in patients with a CTO-RCA, but this was irrespective of treatment allocation.…”

Section: Discussionmentioning

confidence: 99%

“…Separately, it is assumed that RV dysfunction after STEMI may recover within a few months [ 11 ]. Moreover, RV dysfunction resulting from CTO RCA has also been thought to be able to improve [ 12 ]. Whether this is due to successful revascularization of CTO RCA, the development of a collateral network or to a temporal effect of hibernation has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

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Recovery of right ventricular function and strain in patients with ST-segment elevation myocardial infarction and concurrent chronic total occlusion

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Elias

Dongen

et al. 2021

Int J Cardiovasc Imaging

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The right ventricle (RV) is frequently involved in ST-segment elevation myocardial infarction (STEMI) when the culprit or concurrent chronic total occlusion (CTO) is located in the right coronary artery (RCA). We investigated RV function recovery in STEMI-patients with concurrent CTO. In EXPLORE, STEMI-patients with concurrent CTO were randomized to CTO percutaneous coronary intervention (PCI) or no CTO-PCI. We analyzed 174 EXPLORE patients with serial cardiovascular magnetic resonance imaging RV data (baseline and 4-month follow-up), divided into three groups: CTO-RCA (CTO in RCA, culprit in non-RCA; n = 89), IRA-RCA (infarct related artery [IRA] in RCA, CTO in non-RCA; n = 56), and no-RCA (culprit and CTO not in RCA; n = 29). Tricuspid annular plane systolic excursion (TAPSE), RV ejection fraction (RVEF), RV global longitudinal strain (GLS) and free wall longitudinal strain (FWLS) were measured. We found that RV strain and TAPSE improved in IRA-RCA and CTO-RCA (irrespective of CTO-PCI) at follow-up, but not in no-RCA. Only RV FWLS was different among groups at baseline, which was lower in IRA-RCA than no-RCA (− 26.0 ± 8.3% versus − 31.0 ± 6.4%, p = 0.006). Baseline RVEF, RV end-diastolic volume and TAPSE were associated with RVEF at 4 months. RV function parameters were not predictive of 4 year mortality, although RV GLS showed additional predictive value for New York Heart Association Classification > 1 at 4 months. In conclusion, RV parameters significantly improved in patients with acute or chronic RCA occlusion, but not in no-RCA patients. RV FWLS was the only RV parameter able to discriminate between acute ischemic and non-ischemic myocardium. Moreover, RV GLS was independently predictive for functional status.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%