Coronary chronic total occlusion (CTO) contributes to the progression of heart failure in patients with ischemic cardiomyopathy. Randomized controlled trials demonstrated that percutaneous coronary intervention (PCI) for CTO significantly improves angina symptoms and quality of life but fails to reduce clinical events compared with optimal medical therapy. Even so, intervening physicians strongly support CTO-PCI. Cardiac regeneration therapy after CTO-PCI should be a promising approach to improving the prognosis of ischemic cardiomyopathy. However, the relationship between CTO revascularization and cardiac regeneration has rarely been studied, and experimental studies on cardiac regeneration usually employ rodent models with permanent ligation of the coronary artery rather than reopening of the occlusive artery. Limited early-stage clinical trials demonstrated that cell therapy for cardiac regeneration in ischemic cardiomyopathy reduces scar size, reverses cardiac remodeling, and promotes angiogenesis. This review focuses on the status quo of CTO-PCI in ischemic cardiomyopathy and the clinical prospect of cardiac regeneration in this setting.

冠状动脉慢性完全闭塞 (CTO) 有助于缺血性心肌病患者心力衰竭的进展。随机对照试验表明，与最佳药物治疗相比，CTO 的经皮冠状动脉介入治疗 (PCI) 可显着改善心绞痛症状和生活质量，但未能减少临床事件。即便如此，介入医师强烈支持 CTO-PCI。CTO-PCI 后的心脏再生治疗应该是改善缺血性心肌病预后的有希望的方法。然而，CTO 血运重建和心脏再生之间的关系很少被研究，心脏再生的实验研究通常采用啮齿动物模型，对冠状动脉进行永久性结扎，而不是重新打开闭塞动脉。有限的早期临床试验表明，用于缺血性心肌病心脏再生的细胞疗法可减少瘢痕大小、逆转心脏重塑并促进血管生成。本次审查侧重于现状CTO-PCI 在缺血性心肌病中的应用以及在这种情况下心脏再生的临床前景。