Recanalization of coronary chronic total occlusion guided by cardiovascular magnetic resonance imaging and its relation
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Recanalization of coronary chronic total occlusion guided by cardiovascular magnetic resonance imaging and its relation with health outcome measures Chiara Bucciarelli-Ducci*1, Didier Locca1, Rory O'Hanlon1, Joanna Petryka1, Agata Grasso1, Wright Christine2, Ricardo Wage1, Karen Symmonds1, Eleni Asimacopoulos1, Peter Gatehouse1, Sanjay Prasad1, Carlo Di Mario2 and Dudley Pennell1 Address: 1CMR Unit, Royal Brompton Hospital, London, UK and 2Cardiology Department, Royal Brompton Hospital, London, UK * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):O38
doi:10.1186/1532-429X-12-S1-O38
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/O38 © 2010 Bucciarelli-Ducci et al; licensee BioMed Central Ltd.
Introduction The benefit of recanalizing a coronary chronic total occlusion (CTO) is controversial. Seattle Angina Questionnaire (SAQ) is one of the most widely used questionnaire to assess health outcome measures in patients with coronary artery disease.
Purpose We sought to investigate whether CMR with LV function, perfusion and viability imaging can improve the selection of patients that can benefit from revascularization and whether this is associated with an improved quality of life.
aspects of quality of life. All items used six-point descriptive scales and score were calculated.
Results Thirty-nine patients underwent successful recanalization and a repeat adenosine CMR perfusion (4 ± 4 months). Myocardial ischemia pre PCI was detected in the 30 patients (77%). No myocardial infarction was identified in 13 patients(42%), and a limited subendocardial infarction seen in 10 patients(33%). A complete or almost complete resolution of ischemia was seen in all 30 patients (p < 0.0001) after PCI.
Methods Fifty-two consecutive patients with CTO were recruited and underwent CMR perfusion before recanalization. Stress CMR was performed after infusing adenosine and 0.1 mmol/Kg of gadolinium, followed by LGE and cine imaging. The presence and extent of ischemia was quantified by myocardial perfusion reserve index (MPRI) in the CTO and remote territory. Infarct size, left ventricular volumes and ejection fraction (LVEF) were also evaluated. SAQ was carried out before and 4 ± 4 months after PCI. The SAQ consisted of 17 items measuring 5 different
MPRI in the CTO territory significantly improved after successful recanalization, from 1.8 pre-PCI to 2.3 postPCI (p < 0.01). MPRI pre-PCI in the CTO territory was significantly lower than in the remote area (p < 0.001). MPRI in the remote area did not change significantly from pre- to post-PCI (2.2 to 2.5, p = 0.13). LVEF improved from 60 ± 13%
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