Evaluation of myocardium viability by cardiac magnetic resonance in patients with chronic total occlusion lesions / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate the relationship of wall motion abnormality and myocardium viability with chronic total occlusion (CTO) lesions by cardiac magnetic resonance (CMR) imaging. Methods We identified 128 patients with CTO lesion of at least one coronary artery confirmed by coronary arteriography at Beijing Anzhen Hospital between December 2014 to November 2017. All of the patients received CMR examination after admission. We analyzed the CMR images according to the AHA/American College of Cardiology 17-segment model, and recorded the left ventricular ejection fraction (LVEF), end-systolic volume (ESV) and end-distolic volume (EDV) calculated by CMR. Results In the myocardium regions corresponding to the 149 CTO lesions, only 11.5％ presented transmural myocardial infarction. A 58.6％ of the myocardial segments showed no delayed enhancement. Patients with delayed enhancement degree over 75％ had the lowest LVEF and the largest EDV and ESV. Conclusion CMR showed that patients with CTO lesions had different degrees of myocardial infarction. Patients with transmural myocardial infarction had significant cardiac function decline and ventricular remodeling. Only a fraction of patients had transmural infarction, suggesting that a majority of the CTO patients would benefit from treatment.