Revascularization of chronic total occlusion coronary artery and cardiac regeneration

Abstract

Coronary chronic total occlusion (CTO) contributes to the progression of heart failure in patients with ischemic cardiomyopathy. Randomized controlled trials demonstrated that percutaneous coronary intervention (PCI) for CTO significantly improves angina symptoms and quality of life but fails to reduce clinical events compared with optimal medical therapy. Even so, intervening physicians strongly support CTO-PCI. Cardiac regeneration therapy after CTO-PCI should be a promising approach to improving the prognosis of ischemic cardiomyopathy. However, the relationship between CTO revascularization and cardiac regeneration has rarely been studied, and experimental studies on cardiac regeneration usually employ rodent models with permanent ligation of the coronary artery rather than reopening of the occlusive artery. Limited early-stage clinical trials demonstrated that cell therapy for cardiac regeneration in ischemic cardiomyopathy reduces scar size, reverses cardiac remodeling, and promotes angiogenesis. This review focuses on the status quo of CTO-PCI in ischemic cardiomyopathy and the clinical prospect of cardiac regeneration in this setting.

Exploring Potential Biomarkers and Molecular Mechanisms of Ischemic Cardiomyopathy and COVID-19 Comorbidity Based on Bioinformatics and Systems Biology

“…We then performed an enrichment analysis of the DEGs and discovered that the most enriched GO term under biological process was angiogenesis. Amir et al [ 26 ] reviewed pathological angiogenesis caused by endothelial cell dysfunction in COVID-19, and Liao et al [ 27 ] suggested that cell therapy could promote angiogenesis to improve ICM. We therefore speculated that angiogenesis may be one of the phenotypes of the co-morbidities.…”

Transcoronary Gradients of Mechanosensitive MicroRNAs as Predictors of Collateral Development in Chronic Total Occlusion

“…Chronic total occlusion (CTO) stands as a formidable clinical entity within the spectrum of coronary artery disease (CAD), characterized by the enduring occlusion of a coronary artery for a duration extending beyond three months [1]. The pathological significance of CTOs is underpinned by its potential to precipitate ischemia, diminishing quality of life and presenting as a conundrum in cardiovascular therapeutics due to the challenges it poses for medical and surgical management [2]. In response to the ischemic insult of CTOs, the heart initiates the formation of collateral vessels-a natural bypass system crucial for preserving myocardial perfusion [3].…”