Chronic total occlusion: To treat or not to treat

Table 4 Findings on left ventricular ejection fraction and regional wall motion variations after percutaneous coronary intervention treatment of chronic total occlusion

	Type of study	Population	LVEF estimation	Follow up	Results
					LVEF	Regional wall motion	Symptoms	Collateral function	Ventricular remodeling
1994-1995 Sirnes et al[30]	Prospective	95 CTOs treated with PCI	Ventriculography	Angiography 6 mo	LVEF increase (from 0.62 ± 0.13 to 0.67 ± 0.12) P < 0.001	Increase in regional radial shortening (from 0.279 ± 0.106 to 0.319 ± 0.107) P < 0.001	Improvement in angina class	Not mentioned	Not mentioned
1999-2003 Werner et al[31]	Prospective	126 CTOs treated with PCI	Ventriculography	Angiography	LVEF increase (from 0.60 ± 0.19 to 0.67 ± 0.16) P < 0.001	Increase in wall motion severity index (from -1.92 ± 1.32 to -1.30 ± 1.28) P < 0.001	Not mentioned	No changes in collateral function	Not mentioned
2008 Kirschbaum et al[32]	Prospective	21 CTOs treated with PCI	NMR	NMR 5 mo and 3 yr	LVEF increase (from 60% ± 9% to 63% ± 11%) P = 0.11	Increase in segmental wall thickening. From 19% ± 21% to 31% ± 30% at 5 mo (P < 0.001) and 47% ± 46% at 3 yr (P = 0.04)	Not mentioned	Not mentioned	Less ventricular remodeling in NMR at 3 yr

LVEF: Left ventricular ejection fraction; CTO: Chronic total occlusion; PCI: Percutaneous coronary intervention; NMR: Nuclear magnetic resonance.