Does T1-mapping in border-zone and/or remote regions can help to predict functional recovery after revascularization in chronic Coronary Total Occlusion (CTO) patients?

Background Recanalization of chronic total occlusion (CTO-coronary occlusion > 3 months with a TIMI flow grade 0), is one of the most challenging PCI procedure with specific complications. Late-gadolinium enhancement imaging (LGE) is routinely used to assess viability by exploring transmural and circumferential extent of scar lesions in chronic ischemic regions, but is not able to further characterize adjacent and remote myocardium. Border-zone (BZ) are noninfarcted normally perfused tissue regions adjacent to the infarct that are a major target of the always active remodeling process occuring after MI in chronic ischemic myocardium. Ultrastructural changes include myocyte elongation, myofiber rearrangement that trigger collagen deposition and may lead to depressed contractility. The aim of the study was therefore to evaluate the impact of myocardial fibrosis in BZ and remote regions using T1 and ECV mapping and to determine if their change affect prediction of functional recovery after revascularization of chronic total occlusion (CTO).