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However, there is still a lack of evidence of correct patient selection for percutaneous coronary intervention (PCI). From July 2017 to August 2020, 68 patients with successful PCI of a CTO and previous evidence of viability for PCI by cardiovascular magnetic resonance imaging (CMR) were prospectively included in this single-centre observational study. Of these patients, 62 underwent follow-up CMR, and 56 underwent surveys using the Seattle Angina Questionnaire before PCI and 3, 12 and 24\u00a0months after PCI. The CMR results were assessed for volumetric, functional and deformation parameters. From the baseline to the follow-up, there was a significant reduction in the left ventricular volumes (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and an increase in the left ventricular ejection fraction (57.6\u2009\u00b1\u200911.6% vs. 60.3\u2009\u00b1\u20099.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). Among the deformation parameters, only the left ventricular radial strain showed significant improvement. The SAQ showed an early improvement that emphasised angina stability and frequency as well as a summary score, which persisted after 24\u00a0months. A low SAQ summary score before PCI was the best predictive factor of good clinical improvement thereafter. Improvements in myocardial function and quality of life can be achieved with PCI of a CTO. Patient selection for PCI should be performed primarily among relevantly symptomatic patients when evidence of viability for PCI is present. The SAQ can help guide such patient selection.<\/jats:p><jats:p><jats:bold><jats:italic>Trial registration<\/jats:italic><\/jats:bold> ISRCTN, identifier: ISRCTN33203221. Retrospectively registered on 01.04.2020. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.isrctn.com\/ISRCTN33203221\">https:\/\/www.isrctn.com\/ISRCTN33203221<\/jats:ext-link><\/jats:p>","DOI":"10.1007\/s10554-023-02916-9","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T08:01:35Z","timestamp":1689148895000},"page":"2205-2215","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Baseline angina burden predicts quality of life and functional improvement in patients with viable myocardium treated for chronic total occlusion"],"prefix":"10.1007","volume":"39","clinical-trial-number":[{"clinical-trial-number":"isrctn33203221","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0165-9977","authenticated-orcid":false,"given":"Johannes","family":"Kersten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Maisenbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Fengel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Hackenbroch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meinrad","family":"Beer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"Westphal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bernhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"2916_CR1","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1007\/s00392-009-0013-5","volume":"98","author":"GS Werner","year":"2009","unstructured":"Werner GS, Gitt AK, Zeymer U, Juenger C, Towae F, Wienbergen H, Senges J (2009) Chronic total coronary occlusions in patients with stable angina pectoris: impact on therapy and outcome in present day clinical practice. 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Despite this, the authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Ethics Committee of the Medical Association of Baden-W\u00fcrttemberg (Approval No. F-2018-026).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Each of the participants of this study gave written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All the authors actively participated in this work, reviewed the final draft and consented to its publication. This manuscript has not been published in part or in its entirety and is not under consideration for publication in any other journal. No portion of the text has been copied verbatim from any source, and all information provided is accompanied by appropriate references. We are aware that it is the authors\u2019 responsibility to obtain permission for any figures or tables reproduced from previous publications prior to the final acceptance of the manuscript and to fully cover any costs involved.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}