Left ventricular reconstruction brings benefit for patients with ischemic cardiomyopathy.
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