Left ventricular reconstruction brings benefit for patients with ischemic cardiomyopathy
| Autor: | Fernando Antoniali, Ana Paula Nunes de Albuquerque, Cledicyon Eloy da Costa, Maurício Marson Lopes, Kleber G. Franchini, Gustavo Calado de Aguiar Ribeiro |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Heart Ventricles Myocardial Infarction Myocardial Ischemia Revascularization Internal medicine Secondary Prevention Medicine Humans In patient Coronary Artery Bypass Aged Mitral regurgitation Ischemic cardiomyopathy Ejection fraction business.industry Incidence Stroke Volume Middle Aged Dor procedure medicine.disease Coronary Vessels Surgery medicine.anatomical_structure Ventricle Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business Cardiomyopathies |
| Zdroj: | Journal of cardiac failure. 12(3) |
| ISSN: | 1532-8414 |
| Popis: | Optimal treatment strategies for some patients with ischemic cardiomyopathy can be unclear. We compared the outcome for patients treated with revascularization only or with additional ventricular reconstruction.We compared 74 consecutive patients with an ejection fraction35% and a left end-systolic volume index80 mL/m(2). All patients underwent revasularization but some received only revascularization (group 1) and some were randomized into a group that received additional ventricular reconstruction (group 2). Preoperative and postoperative ejection fraction, end-systolic volume, mitral regurgitation, mortality, heart failure (HF) symptoms, and recurrence were compared between groups. There was 1 postoperative death in group 2 (P =. 58). Preoperative ejection fraction between the groups was similar (P =. 19) but it differed significantly postoperatively (P.001). HF class (New York Heart Association) decreased more in group 2 (group 2, 2.3 +/- 0.4 versus group 1, 1.4 +/- 0.4; P.001). Incidence of HF recurrence and rehospitalization was significantly less in group 2 (P = .028). The postoperative development of higher-grade mitral regurgitation was greater in group 1 (147 +/- 32 mL/m(2) versus 119 +/- 25 mL/m(2), P = .024).The outcome at midterm of coronary artery surgery alone in patients with a preoperative large left ventricle was inferior compared with the outcome achieved with additional ventricular restoration. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect