Comparison Of The Effects Of Single And Double CTO Lesions Of The Coronary Artery On Left Ventricular Function

Background and Objective:Coronary artery diseaseis the important cause of left ventriculardys function.Chronic total occlusion(CTO)lesions occupies a certain proportion in coronary artery disease.CTO lesions can lead to myocardial hibernation and some myocardial necrosis and the formation of scar,resulting in left ventricular dysfunction and left ventricular remodeling,compared with non-CTO lesions.CTO lesions have worse left ventricular function,higher mortality.Left heart function as an important indicator of the severity of coronary CTO disease,there was little evidence that the impact of single and double CTO lesions on left ventricular function.This article retrospectively compares the impact of single and double CTO lesions on left ventricular function and compares the impact of different vascular combinations in double CTO lesions on left ventricular function.Methods:From January 2014 to December 2016,a total of 1032 patients who prompted CTO patients through coronary angiography examination of Department of Cardiology in Second Hospital of Jilin University.Through analysising the angiographic datas retrospectively,the patients weredivided into single CTO group and double CTO group according to the number of CTO-related blood vessels.According to the selection and exclusion criteria screening,a total of 129 patients meet the standard,including a single CTO group of 82 patients,double CTO group of 47 patients,the two groups of patients with basic information and left ventricular function of the heart color parameters,including left atrium(LA),left ventricular diameter(LV),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were compared.In addition,the patients with significant left ventricular function were divided into two groups according to the location of the lesion.In addition,double CTO group were divided into three groups according to the lesion location group: LAD + RCA group(n=24),LAD + LCX group(n =8)and LCX + RCA group(n=15).Further analysising the basic information of patients and left ventricular function parameters were statistically different.Result:1.The two-segment CTO group has a worse left ventricular function parameters than the single CTO group(53.19±6.69 mm vs50.46±6.56 mm,p< 0.05);and has a lower LVEF(54.89±11.00% vs61.13±9.70%,p< 0.05);which has a higher LVEDV(162.64±51.80 ml vs143.41±47.05 ml,p< 0.05);and has a higher LVESV(75.70±43.60 ml vs59.11±36.73 ml,p< 0.05)。2.In addition,in the comparison of different vascular combinations of double CTO lesions:(1)LVEF: the LVEF of LAD + LCX group and LCX + RCA group are lower than LAD + RCA group(48.63±9.02% vs 59.29±10.24%,P <0.05)and(51.20±10.69% vs59.29±10.24%,P <0.05);(2)LVEDV:The LVEDV of LCX+RCA group is higher than LAD +RCA 组(183.20±44.47 m L vs 144.13±50.73 m L,P<0.05);(3)LVESV:The LVEDV of LAD+LCX group and LCX+RCA group are higher than LAD+RCA 组(96.00±46.51 m L vs 59.75±38.56 m L,P<0.05)and(90.40±42.65 m L vs 59.75±38.56 m L,P<0.05)。Conclusion:In CTO lesions,the double CTO group is more obvious than the single CTO lesions on the impact of left ventricular function,which has a worse left ventricular ejection fraction.In the three different artery combination groups of the double CTO lesions,LAD+LCX combination and LCX+RCA combination have a worse left ventricular function than LAD+RCA combination.The groups of significant effect on left ventricular function are combined with LCX,which suggests that the presence of LCX lesions in the two-segment CTO lesions will significantly affect the left ventricular function.