Exercise testing after chronic total coronary occlusion revascularization in patients with STEMI and a concurrent CTO: A subanalysis of the EXPLORE-trial.
In: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2019
Online
academicJournal
Zugriff:
To assess the effect of chronic total occlusion percutaneous coronary intervention (CTO PCI) on ventricular ectopy (VE) and symptomatology during exercise testing.During exercise, the hypoxic myocardium in the CTO-territory can act as a substrate for VE and could lead to anginal complaints.In the EXPLORE-trial, 302 ST-segment elevation myocardial infarction (STEMI)-patients were randomized to CTO PCI or no-CTO PCI. For this sub-study, we analyzed all available exercise electrocardiograms (X-ECGs) at 4 months follow-up on symptoms and electrocardiographic parameters.A total of 155 X-ECGs were available, 80 in the CTO PCI group (51.6%) and 75 in the no-CTO PCI group (48.4%). There were no differences regarding exercised time, achieved endurance, ST-deviation nor maximum heart-rate. The percentage of patients experiencing chest-pain during exercise was lower in the CTO PCI group (0% vs. 8.5%, p = .03). Also, there was a trend towards a higher maximum systolic blood pressure (SBP, 185 mmHg vs. 175, p = .09). No difference in VE was found between randomization groups, but patients with successful CTO PCI had a higher frequency of VE, compared to failed and no-CTO PCI (26% vs. 8%, p = .02). This did not result in higher frequencies of sustained ventricular arrhythmias or mortality.In conclusion, in STEMI-patients, CTO PCI is associated with a small reduction of chest-pain during exercise and tended to be associated with an increase of maximum SBP. The observation that successful CTO PCI was associated with more VE during exercise, compared with failed/no-CTO PCI needs further exploration.
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Exercise testing after chronic total coronary occlusion revascularization in patients with STEMI and a concurrent CTO: A subanalysis of the EXPLORE-trial.
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Autor/in / Beteiligte Person: | Anna, van Veelen ; Ivo M, van Dongen ; Joelle, Elias ; Råmunddal, Truls ; Erlend, Eriksen ; René, van der Schaaf ; Bimmer E P M, Claessen ; Pieter G, Postema ; José P S, Henriques ; Göteborgs universitet, Sahlgrenska akademin, Institutionen för medicin, avdelningen för molekylär och klinisk medicin ; Gothenburg University, Sahlgrenska Academy, Institute of Medicine, Department of Molecular and Clinical Medicine |
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Zeitschrift: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2019 |
Veröffentlichung: | 2019 |
Medientyp: | academicJournal |
ISSN: | 1522-726X (print) |
DOI: | 10.1002/ccd.28282 |
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