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The rationale for the recanalization of a chronic total coronary occlusion is the possible improvement of left ventricular function through the recovery of hibernating myocardium. TDI can be used for assessment of both global and regional LV function with high temporal and spatial resolution. Purpose: Assessment of LV function before and after CTOPCI by PW-TDI.
The study enrolled 40 patients with CTO,37 patients succeeded to complete the final follow up ,22 patients were without infarction in the territories of recanalized CTO vessel (group I), 15 patients with infarction in CTO territories of recanalized CTO vessel (group II). All were subjected to conventional echo Doppler and DTI examination.PW-DTI was used to assess velocity curves of basal and mid segments of LV walls. The following indices were measured Tp, Sv, E', A', E'/A', Acc IVC,IVRT, IVCT, CT and TEI index.
After recanalization of CTO vessel by PCI non infarction group of patients showed highly significant improvement of LVEF% after 3 months follow up (P<0.001) while infarction group did not show any significant improvement (P=NS). In LAD,LCX and RCA subgroup non infarction patients showed reduction in LVESv, increased FS% and EF% after 3 months follow up, also there were improvement of TDI parameters in the form of increased E' and ACC of IVC in all 3 subgroups and increased E'/A' in LAD and LCX and increased in Peak velocity of IVC and reduction of A' and time to peak of IVC in both LAD and RCA, only S wave velocity increased in LAD subgroup after 3 months F.U.
Patients with CTO, Acc. of IVC measured by PW-TDI is differentiating early improvement after successful recanalization of CTO by PCI, Non infarction territories might recover at earlier stage than patients with MI.