Interventional cardiology surgery
Partial left ventriculectomy improves left ventricular end
systolic elastance in patients with idiopathic dilated cardiomyopathy
Z Popovi
, M Miri, S Gradinac, A N Ne
kovi, M Boji, A D Popovi
Dedinje
Cardiovascular Institute, Milana Tepia 1, 11040 Belgrade,
Yugoslavia
Correspondence to: Dr Nekovi
email: neskovic{at}hotmail.com
Accepted 13
September 1999
OBJECTIVE
To assess the effect of partial left
ventriculectomy (PLV) on estimate of left ventricular end systolic
elastance (Ees), arterial elastance, and ventriculoarterial coupling.
PATIENTS11 patients with idiopathic dilated
cardiomyopathy before and two weeks after PLV, and 11 controls.
INTERVENTIONSSingle plane left ventricular angiography
with simultaneous measurements of femoral artery pressure was performed
during right heart pacing before and after load reduction.
RESULTSPLV 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.
CONCLUSIONIt appears that PLV improves both Ees and
ventriculoarterial coupling, thus increasing left ventricular work efficiency.
Keywords: dilated cardiomyopathy; elastance; partial left ventriculectomy
© 2000 by Heart
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