Abstract
Background: —CTO PCI represents the tip of iceberg in interventional cardiology, however owing to lack of enough data, there is still debate about its benefit. CPET combines measurement of gas indices with standard exercise and ECG parameters giving a comprehensive way for patient evaluation also there is plenty of data about its use in many cardiovascular diseases and about its prognostic value in many occasions. So we thought of using CPET in evaluating value of CTO PCI on various CPET parameters. Hypothesis: CTO PCI improves cardiopulmonary performance evaluated by CPET. Methods: fifty nine patients underwent successful CTO PCI and CPET at baseline and at12 month follow up, of whom nine patients had suboptimal results in control angiography which is a higher than usual incidence of re-stenosis, we compared the results of the CPET pre and post-PCI in both groups. Results: In patent group, CPET at follow up revealed a significant increase of peak oxygen consumption (Peak VO 2 ) (13.47±1.53 ml/kg/min vs. 17.84±0.99 ml/kg/min p <0.0001), VO 2 at anaerobic threshold (AT) (11.63 ± 1.14 ml/kg/min vs. 10.35 ±1.01ml/kg/min ( p < 0.0001), peak oxygen pulse ( 16.02 ±1.34 vs. 11.15 ± 1.36, p < 0.0001) and significant increase in peak cardiac index (3.78 ± 0.5 vs. 2.98 ±0.6, p < 0.0001). Also there was significant decrease of Peak VE/VCO 2 (32.98 ± 3.2 vs. 42.98 ± 6.2, p < 0.0001).In patients with re-stenosis, CPET at follow up revealed a significant decrease of peak oxygen consumption (Peak VO 2 ) (13.36±1.48 ml/kg/min vs. 12.41±0.97 ml/kg/min, p =0.02) and a significant increase of Peak VE/VCO 2 (42.73 ± 4.33 vs. 43.27 ± 3.29, p =0.01)also there was worse numerical values of other parameters despite not being statistically significant. Conclusions: CTO revascularization improves cardiopulmonary performance assessed by CPET in addition patients with re-occlusion after successful procedure had worse parameters even than their own baseline. CPET can provide a way for non-invasive follow-up of patients after PCI and earlier detection of in-stent re-stenosis that is more common in CTO.
Published Version
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