Improvement of left ventricular contraction and relaxation synchronism after recanalization of chronic total coronary occlusion by angioplasty.

Twenty patients with a chronic total coronary artery occlusion were studied before and 1 to 48 months (mean 9) after successful recanalization by angioplasty and compared with a group of 20 normal subjects. Before angioplasty, 19 of these 20 patients had angina. Collateral vessels to the distal part of the occluded vessel were visible in all 20 patients. A previous myocardial infarction was documented in 14 patients (9 with a Q wave and 5 with a non-Q wave infarction). At the time of follow-up, three patients were symptomatic: one had unstable angina and two had a positive stress test. The follow-up angiogram showed a significant restenosis in six patients and reocclusion in two. The mean ejection fraction had improved slightly from 59 +/- 11% to 63 +/- 9% (p less than 0.05). Left ventricular wall motion synchronism was studied using two variables for 128 shortening segments: the "time of peak contraction" and the "time of peak relaxation," as obtained from biharmonic Fourier transformation for each segment. Their respective standard deviations reflect the synchronism of contraction and relaxation. The mean standard deviations of the two variables expressed in degrees of one cardiac cycle (360 degrees) were respectively: 5.5 +/- 0.4 degrees for the time of peak contraction and 6.0 +/- 0.5 degrees for the time of peak relaxation in the 20 normal subjects, 11.7 +/- 1.7 degrees and 23.0 +/- 3.0 degrees before recanalization and 9.6 +/- 1.8 degrees and 12.5 +/- 2.2 degrees at follow-up in the group of 20 patients. These values were significantly higher (p less than 0.05) in the patients than in the normal group.(ABSTRACT TRUNCATED AT 250 WORDS)