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Left ventricular reconstruction brings benefit for patients with ischemic cardiomyopathy.
Aguiar Ribeiro, Gustavo C; Antoniali, Fernando; Lopes, Mauricio M; Costa, Cledicyon Eloy; Albuquerque, Ana N; Franchini, Kleber G.
Afiliação
  • Aguiar Ribeiro GC; Department of Cardiothoracic Surgery, Clinic of Cardio-Surgery at Campinas, Brazil.
J Card Fail ; 12(3): 189-94, 2006 Apr.
Article em En | MEDLINE | ID: mdl-16624683
BACKGROUND: 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. METHODS AND RESULTS: We compared 74 consecutive patients with an ejection fraction <35% and a left end-systolic volume index >80 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). CONCLUSION: 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.
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ponte de Artéria Coronária / Isquemia Miocárdica / Vasos Coronários / Ventrículos do Coração / Cardiomiopatias / Infarto do Miocárdio Tipo de estudo: Clinical_trials / Incidence_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Card Fail Assunto da revista: CARDIOLOGIA Ano de publicação: 2006 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Buscar no Google
Adicionar na Minha BVS
Imprimir
XML
PubMed Links

Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ponte de Artéria Coronária / Isquemia Miocárdica / Vasos Coronários / Ventrículos do Coração / Cardiomiopatias / Infarto do Miocárdio Tipo de estudo: Clinical_trials / Incidence_studies / Prognostic_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Card Fail Assunto da revista: CARDIOLOGIA Ano de publicação: 2006 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos