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Open Access 01-12-2020 | Stress Echocardiography | Research

Prompt and consistent improvement of coronary flow velocity reserve following successful recanalization of the coronary chronic total occlusion in patients with viable myocardium

Authors: Milan Dobric, Branko Beleslin, Milorad Tesic, Ana Djordjevic Dikic, Sinisa Stojkovic, Vojislav Giga, Miloje Tomasevic, Ivana Jovanovic, Olga Petrovic, Jelena Rakocevic, Nikola Boskovic, Dragana Sobic Saranovic, Goran Stankovic, Vladan Vukcevic, Dejan Orlic, Dragan Simic, Milan A. Nedeljkovic, Srdjan Aleksandric, Stefan Juricic, Miodrag Ostojic

Published in: Cardiovascular Ultrasound | Issue 1/2020

Abstract

Background

Coronary chronic total occlusion (CTO) is characterized by the presence of collateral blood vessels which can provide additional blood supply to CTO-artery dependent myocardium. Successful CTO recanalization is followed by significant decrease in collateral donor artery blood flow and collateral derecruitment, but data on coronary hemodynamic changes in relation to myocardial function are limited. We assessed changes in coronary flow velocity reserve (CFVR) by echocardiography in collateral donor and recanalized artery following successful opening of coronary CTO.

Methods

Our study enrolled 31 patients (60 ± 9 years; 22 male) with CTO and viable myocardium by SPECT scheduled for percutaneous coronary intervention (PCI). Non-invasive CFVR was measured in collateral donor artery before PCI, 24 h and 6 months post-PCI, and 24 h and 6 months in recanalized artery following successful PCI of CTO.

Results

Collateral donor artery showed significant increase in CFVR 24 h after CTO recanalization compared to pre-PCI values (2.30 ± 0.49 vs. 2.71 ± 0.45, p = 0.005), which remained unchanged after 6-months (2.68 ± 0.24). Baseline blood flow velocity of the collateral donor artery significantly decreased 24 h post-PCI compared to pre-PCI (0.28 ± 0.06 vs. 0.24 ± 0.04 m/s), and remained similar after 6 months, with no significant difference in maximum hyperemic blood flow velocity pre-PCI, 24 h and 6 months post-PCI. CFVR of the recanalized coronary artery 24 h post-PCI was 2.55 ± 0.35, and remained similar 6 months later (2.62 ± 0.26, p = NS).

Conclusions

In patients with viable myocardium, prompt and significant CFVR increase in both recanalized and collateral donor artery, was observed within 24 h after successful recanalization of CTO artery, which maintained constant during the 6 months.

Trial registration

ClinicalTrials.gov (Number NCT04060615).

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Title: Prompt and consistent improvement of coronary flow velocity reserve following successful recanalization of the coronary chronic total occlusion in patients with viable myocardium
Authors: Milan Dobric
Branko Beleslin
Milorad Tesic
Ana Djordjevic Dikic
Sinisa Stojkovic
Vojislav Giga
Miloje Tomasevic
Ivana Jovanovic
Olga Petrovic
Jelena Rakocevic
Nikola Boskovic
Dragana Sobic Saranovic
Goran Stankovic
Vladan Vukcevic
Dejan Orlic
Dragan Simic
Milan A. Nedeljkovic
Srdjan Aleksandric
Stefan Juricic
Miodrag Ostojic
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Stress Echocardiography
Published in: Cardiovascular Ultrasound / Issue 1/2020
Electronic ISSN: 1476-7120
DOI: https://doi.org/10.1186/s12947-020-00211-4

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Conclusions

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