Percutaneous coronary intervention for chronic total occlusions improves cardiopulmonary exercise capacity

Abstract Introduction Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is recommended in patients with an expected reduction of angina pectoris. However, whether PCI for CTO improves exercise tolerance remains controversial. Purpose To evaluate whether PCI improves cardiopulmonary exercise capacity in patients with CTO. Methods We prospectively performed both stress myocardial perfusion scintigraphy (MPS) before PCI and cardiopulmonary exercise testing (CPX) before and 6 months later of PCI in October of 2020 to September of 2022. Myocardial ischemia was defined as summed difference score ≧3. Results Of 28 patients (67.9 ± 10.6 y.o., 96% men), 31 major vessels were occluded vessels (right coronary artery 13, left anterior descending 11, and left circumflex 7). Overall, peak VO2 after PCI was higher than that before PCI (18.9 ± 4.2 vs. 17.3 ± 3.7 ml/min/kg, P < 0.05). Peak VO2 was improved in 20 patients and not in 8. Peak VO2 was improved in 13 of 16 patients (81%) with myocardial ischemia in the occluded area and 7 of 12 (58%) without. Conclusions PCI for CTO improves cardiopulmonary exercise capacity, especially in the patients with ischemic evidence in the occluded area.