Abstract
Methods In nine pigs a CTO was created by percutaneously inserting a fibrin plug (AngiosealΤΜ) into the mid-todistal left anterior descending artery (LAD). Animals were studied six (n=3) or twelve weeks (n=6) later prior to sacrifice. An x-ray angiogram confirmed the LAD CTO at those time points. Cardiac MR (CMR) studies were then conducted on a 1.5T (n=6) or on a 3.0T MRI system (n=3), which included SSFP short axis sections for wall motion and post-gadolinium LGE-MRIs for viability. After sacrifice, both right and left coronary systems were injected with Microfil. X-ray or MSCT angiography of the fixed heart was obtained. A longitudinal cardiac section including the CTO lesion, proximal/distal LAD and the borders of infarction was removed and prepared in gel, then imaged in a microCT system at 27 micron resolution. LV functional parameters including wall thickness at end-systole (WTES) and end-diastole (WTED) were measured in border zone, infarct and remote region. Systolic wall thickening (SWT) was calculated using as (WTES-WTED) x100/ WTED. CMR and micro-CT data were processed using commercial software. The extent of collaterals on micro-CT images was rated qualitatively using a score from 0 to 3, indicating that no, minimal, moderate, or extensive collaterals were observed. A Student’s t-test was used for the statistical significance of differences between measurements at 6 and 12 weeks.
Highlights
Improvement of left ventricular (LV) functional performance in the chronic total coronary occlusion during the late stage is associated with the extensive collateral development
To investigate whether left ventricular (LV) function and regional wall motion improvement are associated with the extent of collateral development in coronary chronic total occlusion (CTO)
Ejection fraction (LVEF) at 12 weeks was significantly greater than at 6 weeks (39.45±5.38% vs. 26.27±5.77%, P=0.01) the extent of infarct was similar between these two groups (P=0.16)
Summary
Yuesong Yang1*, Bradley Strauss, Beiping Qiang, Azriel Osherov, John J Graham, Garry Liu, Xiuling Qi1, Nigel R Munce, Michelle Ladouceur-Wodzk, Normand Robert, Alexander J Dick, Graham A Wright. A Student’s t-test was used for the statistical significance of differences between measurements at 6 and 12 weeks
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