MI More Frequent Than Expected in Territories Supplied by Chronically Occluded Arteries

Magnetic resonance imaging reveals infarcts undetectable by other means, but the clinical importance of these findings and the functional role of collateral vessels remain unclear.

Chronic total occlusions (CTOs), with or without distal collateral supply, are frequently observed during coronary angiography, yet the clinical significance and need for revascularization of such vessels is not clear. In this Korean study, investigators performed cardiac magnetic resonance imaging studies in 170 patients (median age, 62) with angiographically identified CTOs.

Fifty-eight percent of the patients had no documented clinical history of myocardial infarction (MI). Late gadolinium enhancement (LGE) in the region of the CTO was observed in 86% of patients. By contrast, electrocardiographic Q waves and regional wall motion abnormalities were observed in 25% and 69% of patients, respectively. The presence of well-developed collatera…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI