Abstract
The study was undertaken to evaluate the effect of restenosis on global and regional left ventricular function after percutaneous transluminal coronary angioplasty (PTCA) for total coronary occlusion. Thirty-one consecutive patients with total coronary occlusion treated successfully with PTCA and had follow-up angiography at 3–6 months formed the study group. Nineteen patients had restenosis (16 males, mean age 48 ± 10 years) and 12 had no restenosis (11 males, mean age 53 ± 10 years). In the LAD group there were increases in anterobasal (35.9 ± 8.5% vs 43.1 ± 5.7%, p=0.05) and apical (24.1 ± 6.8% vs 31.7 ± 2.9%, p=0.03) segment motion scores in patients without restenosis after PTCA. Global ejection fractions (63.1 ± 14.5% vs 68.9 ± 12.4%, p=0.09) and anterolater,al (28.7 ± 11.3% vs 39.7 ± 10.2%, p=0.09) segment scores increased, but did not reach statistical significance. In the LAD restenosis group anterobasal (41.5 ± 14.3% vs 34.3 ± 12.6%, p=0.001), apical (21.1 ± 15.0% vs 17.8 ± 10.9%, p=0.05) and anterolateral (32.7 ± 19.6% vs 26.6 ± 13.8%, p=0.03) segment motion scores decreased but the decrease in the global ejection fraction (60.3 ± 18.5% vs 58.6 ± 17.4, p=0.38) was not significant. In the RCA+LCX group there was a significant increases in global ejection fraction (69.0 ± 7.5% vs 74.2 ± 7.6%, p=0.03) and posterobasal (23.8 ± 7.8 vs 34.4 ± 8.0, p=0.04) segment motion scores in patients without restenosis. The wall motion scores were unchanged in patients with restenosis in the RCA+LCX group. It was concluded that restenosis after a successful PTCA for total coronary occlusion may deteriorate segmental wall motion and treatment modalities with increased patency rates should be used for total coronary occlusions.
