Article

Impact of surgical ventricular restoration on ventricular shape, wall stress, and function in heart failure patients.

Department of Cardiology, National Heart Centre, Singapore.
AJP Heart and Circulatory Physiology (impact factor: 3.71). 02/2011; 300(5):H1653-60. DOI:10.1152/ajpheart.00021.2011 pp.H1653-60
Source: PubMed

ABSTRACT Surgical ventricular restoration (SVR) was designed to treat patients with aneurysms or large akinetic walls and dilated ventricles. Yet, crucial aspects essential to the efficacy of this procedure like optimal shape and size of the left ventricle (LV) are still debatable. The objective of this study is to quantify the efficacy of SVR based on LV regional shape in terms of curvedness, wall stress, and ventricular systolic function. A total of 40 patients underwent magnetic resonance imaging (MRI) before and after SVR. Both short-axis and long-axis MRI were used to reconstruct end-diastolic and end-systolic three-dimensional LV geometry. The regional shape in terms of surface curvedness, wall thickness, and wall stress indexes were determined for the entire LV. The infarct, border, and remote zones were defined in terms of end-diastolic wall thickness. The LV global systolic function in terms of global ejection fraction, the ratio between stroke work (SW) and end-diastolic volume (SW/EDV), the maximal rate of change of pressure-normalized stress (dσ*/dt(max)), and the regional function in terms of surface area change were examined. The LV end-diastolic and end-systolic volumes were significantly reduced, and global systolic function was improved in ejection fraction, SW/EDV, and dσ*/dt(max). In addition, the end-diastolic and end-systolic stresses in all zones were reduced. Although there was a slight increase in regional curvedness and surface area change in each zone, the change was not significant. Also, while SVR reduced LV wall stress with increased global LV systolic function, regional LV shape and function did not significantly improve.

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    [show abstract] [hide abstract]
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Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

crucial aspects essential
 
dilated ventricles
 
end-diastolic volume
 
end-diastolic wall thickness
 
end-systolic three-dimensional LV geometry
 
end-systolic volumes
 
entire LV
 
global LV systolic function
 
large akinetic walls
 
LV end-diastolic
 
LV global systolic function
 
LV regional shape
 
LV wall stress
 
magnetic resonance imaging
 
regional LV shape
 
remote zones
 
surface area change
 
Surgical ventricular restoration
 
ventricular systolic function
 
wall thickness