Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions

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Abstract
Background: A major goal of revascularization is the recovery of left ventricular (LV) function. Nuclear imaging techniques are widely used for detecting recovery of function with a good sensitivity, but only moderate specificity. Predictors of recovery in chronic total coronary occlusions (CTO) are not investigated. Hypothesis: The 12‐lead‐resting electrocardiogram (ECG) is a predictor of LV recovery after successful recanalization of CTO. Methods: Successful recanalization of CTO was performed in 127 patients. Of these, 62 patients, who constitute the study group, had impaired regional wall motion prior to recanalization. The 12‐lead resting ECG was evaluated for Q‐wave areas and parameters of QT dispersion. Impairment of regional wall motion was evaluated by LV angiogram at baseline and at follow‐up. Results: Angiographic follow‐up after 5 ± 1.4 months documented reocclusion in eight patients. Complete follow‐up with a patent coronary artery and an ECG without bundle‐branch block was available in 43 patients. Wall motion severity index (WMSI) improved from −2.92 ± 0.28 to −1.34 ± 0.61(pConclusions: In patients with recanalization of CTO, recovery of regional wall motion is reliably predicted by analysis of the resting 12‐lead ECG for pathologic Q waves.

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