Benefits of Chronic Total Coronary Occlusion Percutaneous Intervention in Patients With Chronic Heart Failure and Reduced Ejection Fraction.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chronic Total Occlusion Vessel
- Sponsor
- Hospital Clinic of Barcelona
- Enrollment
- 39
- Primary Endpoint
- Left ventricular ejection fraction (%)
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
The investigators studied the effect of CTO-PCI on left ventricular function and clinical parameters in patients with HFrEF.
Detailed Description
Observational studies have shown that chronic total coronary occlusion percutaneous intervention (CTO-PCI) improves angina, left ventricular ejection fraction (LVEF), and survival. None of these studies aimed to assess the benefits in populations with heart failure with reduced ejection fraction (HFrEF). The investigators studied the effect of CTO-PCI on left ventricular function and clinical parameters in patients with HFrEF. Using cardiac magnetic resonance (CMR), the investigators studied 29 patients with HFrEF and evidence of viability and/or ischemia in the territory supplied by an occluded vessel who were successfully treated with CTO-PCI. Non-CTO PCI was also performed in patients with multi-vessel disease, . Imaging parameters, clinical status, and brain natriuretic peptide (BNP) levels were evaluated before and six months after CTO-PCI.
Investigators
Montserrat Cardona
Consultant
Hospital Clinic of Barcelona
Eligibility Criteria
Inclusion Criteria
- •At least one chronic total coronary occlusion
- •LVEF ≤40% by CMR
- •Evidence of myocardial viability and/or ischemia in at least two contiguous segments subtended by the occluded vessel.
Exclusion Criteria
- •Women of childbearing age or pregnant
- •Claustrophobia
- •Admission to hospital within the previous 90 days due to decompensated heart failure, myocardial infarction or unstable angina.
- •Severe valvulopathy
- •Pacemaker or implantable cardioverter defibrillator
- •Indication for coronary artery bypass surgery
- •Heart transplantation waiting list
- •Follow-up not feasible
- •Life expectancy shorter than 12 months.
- •Iodine contrast or gadolinium allergy
Outcomes
Primary Outcomes
Left ventricular ejection fraction (%)
Time Frame: 6 months
Evaluate changes in left ventricular function by cardiac magnetic resonance imaging 6 months after CTO PCI
Secondary Outcomes
- NYHA functional class (I-V)(6 months)
- Myocardial ischemia(6 months)
- Brain Natriuretic Peptide (pg/ml)(6 months)
- Incidence of in-hospital CTO PCI major adverse events(6 months)