Partial left ventriculectomy improves left ventricular end systolic elastance in patients with idiopathic dilated cardiomyopathy

• Published in: Heart (British Cardiac Society) Vol. 83; no. 3; pp. 316 - 319
• Main Authors: Popović, Z, Mirić, M, Gradinac, S, Nešković, A N, Bojić, M, Popović, A D
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.03.2000; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Biological and medical sciences; Cardiac arrhythmia; Cardiomyopathy; Cardiomyopathy, Dilated - physiopathology; Cardiomyopathy, Dilated - surgery; Catheters; Coronary Angiography; Coronary vessels; dilated cardiomyopathy; elastance; Estimates; Heart; Heart Ventricles - surgery; Humans; Interventional Cardiology Surgery; Male; Medical imaging; Medical sciences; Middle Aged; partial left ventriculectomy; Patients; Stroke Volume - physiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Veins & arteries; Ventricular Function, Left - physiology; Human; Cardiotomy; Cardiovascular disease; Exploration; Myocardial disease; Left ventricle; Treatment; Partial; Heart disease; Surgery; Hemodynamics; Left ventricle performance; Constrictive hypertrophic cardiomyopathy
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heart.83.3.316

OBJECTIVE To assess the effect of partial left ventriculectomy (PLV) on estimate of left ventricular end systolic elastance (Ees), arterial elastance, and ventriculoarterial coupling. PATIENTS 11 patients with idiopathic dilated cardiomyopathy before and two weeks after PLV, and 11 controls. INTERVENTIONS Single plane left ventricular angiography with simultaneous measurements of femoral artery pressure was performed during right heart pacing before and after load reduction. RESULTS PLV increased mean (SD) Ees from 0.52 (0.27) to 1.47 (0.62) mm Hg/ml (p = 0.0004). The increase in Ees remained significant after correction for the change in left ventricular mass (p = 0.004) and end diastolic volume (p = 0.048). As PLV had no effect on arterial elastance, ventriculoarterial coupling improved from 3.25 (2.17) to 1.01 (0.93) (p = 0.017), thereby maximising left ventricular stroke work. CONCLUSION It appears that PLV improves both Ees and ventriculoarterial coupling, thus increasing left ventricular work efficiency.