BACKGROUND: The impact of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) on left ventricular ejection fraction (LVEF) remains controversial. METHODS: We included patients who underwent CTO PCI (2018-2022) with reported baseline and follow-up LVEF (window 1-18 months). Stratified analyses according to procedural success, baseline LVEF, and target vessel were performed. Logistic regression analysis was performed to assess predictors of LVEF improvement. RESULTS: We included 142 patients with available LVEF data, of whom 121 had successful CTO PCI (85.2%). Overall, mean age was 65.4 ± 10.3 years, 76.1% were men, and 81.0% were White. The attempted CTO vessel was left anterior descending in 31.7%, left circumflex in 17.6%, and right coronary artery in 50.0% of patients. The median time from PCI to follow-up echocardiogram was 8.4 months (IQR, 4.4-12.4). After successful CTO PCI, mean LVEF increased from a baseline of 48.2% ± 15.4% to 51.8% ± 14.2% (ΔLVEF 3.6%
CONCLUSIONS: Successful CTO PCI seems to be associated with modest LVEF improvement, which is more pronounced in patients with reduced baseline LVEF.