Abstract
Background Recanalisation of chronic total occlusion (CTO = coronary occlusion > 3 months with a TIMI flow grade 0), is one of the most challenging PCI procedure with specific complications. Eventhough LGE-CMR is routinely used to assess viability, it does not assess ischemic status or inotropic reserve of regions surrounding scar lesions that are particularly at risk of jeopardy in patients with collateralized myocardium. If adenosine stress perfusion (Adeno) has an established high diagnostic accuracy for the detection of CAD, its specific value in the scope of chronic ischemia compared to LGE CMR imaging only or combined to low-dose dobutamine (LDD) is uncertain. The aim of this study was therefore to evaluate which best combination could improve prediction of functional recovery after revascularization of chronic total occlusion (CTO).
Highlights
Recanalisation of chronic total occlusion (CTO = coronary occlusion > 3 months with a TIMI flow grade 0), is one of the most challenging PCI procedure with specific complications
If adenosine stress perfusion (Adeno) has an established high diagnostic accuracy for the detection of CAD, its specific value in the scope of chronic ischemia compared to LGE CMR imaging only or combined to low-dose dobutamine (LDD) is uncertain
Transmurality of necrosis was the strongest predictor for recovery with a chance of recovery reaching an OR=3.29 that was superior to to Adenosine (OR=1.69) and dobutamine (OR=1.38)
Summary
Prediction of recovery after revascularization in chronic Coronary Total Occlusion (CTO) patients. Adenosine or low-dose dobutamine stress with LGE CMR: which is the best combination?. Antoine Gerbay2*, Emile Youssof, Marco Vola, Charles de Bourguignon, Alexis Cerisier, Magalie Viallon, Karl Isaaz, Pierre Croisille
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