The effect of intracoronary stent implantation on left ventricular systolic functions and functional capacity in patients with chronic total or subtotal occlusions

OBJECTIVES
We evaluated the effect of successful intracoronary stent implantation on regional and global left ventricular systolic functions and functional capacity in patients with chronic total or subtotal occlusions.

STUDY DESIGN
Thirty-six patients (31 males, 5 females; mean age 52.5 years; range 40 to 65 years) who underwent successful stent implantation were divided into two groups depending on the presence of chronic total (n=24) or subtotal (n=12) occlusion in coronary arteries. Control angiographies were obtained after three to nine months and changes in global ejection fraction and regional wall motion of the left ventricle and functional capacity were assessed. Symptoms were assessed according to the Canadian Cardiovascular Society classification system. The mean follow-up periods were 6.0±3.1 months and 5.8±2.9 months in total and subtotal occlusion groups, respectively.

RESULTS
Following the procedure, coronary restenosis and reocclusion rates were similar in both groups. Patients with restenosis and reocclusion had significantly lower functional capacity than those without restenosis and reocclusion (p<0.001). Left ventricular ejection fraction significantly improved in the total occlusion group (p=0.01), whereas the increase was not significant in patients with subtotal occlusion (p=0.07). The two groups differed significantly in this respect (p=0.04). Although both groups had improved regional systolic functions (total, p=0.008; subtotal, p=0.02) and functional capacity (total, p<0.0001; subtotal, p=0.02) following the procedure, these improvements did not differ significantly between the two groups (p>0.05).

CONCLUSION
Successful stenting is associated with more pronounced improvements in regional and global left ventricular systolic functions and functional capacity in patients with chronic total occlusion than in those with subtotal occlusion.