Improvement in left ventricular ejection fraction and wall motion after successful recanalization of chronic coronary occlusions

Aims This study assessed changes in left ventricular ejection fractionand regional radial shortening after successful angioplastyof chronic coronary occlusions. Methods We studied 95 patients with angina pectoris or exercise-inducedischaemia with a successfully recanalized chronic (median duration4·3 months) coronary occlusion. Intracoronary stentswere implanted in 71%. Left ventriculograms were obtained atbaseline and after 6·7±1·4 months. Leftventricular ejection fraction and regional radial shorteningwere determined by a computer-assisted method. Results Left ventricular ejection fraction increased from 0·62±0·13at baseline to 0·67±0·11 at follow-up (P<0·001).The change in left ventricular ejection fraction in patientswith a patent artery and in patients with reocclusion (n=8)was 0·05±0·06 and 0·01±0·04,respectively (P=0·04). Regional radial shortening inthe territory of the recanalized artery increased by 16% (from0·28±0·11 to 0·32±0·11,P<0·001) in patients with a patent artery at follow-up,but was unchanged in patients with reocclusion. Conclusion Long-term patency after recanalization of old, chronic coronaryocclusions in patients with angina pectoris is associated withimprovement in global and regional left ventricular function.This may be a result of recovery of hibernating myocardium andsupports the strategy of recanalizing chronic coronary occlusions.