Document Detail

Acute hemodynamic and functional effects of surgical ventricular restoration and heart transplantation in patients with ischemic dilated cardiomyopathy.
MedLine Citation:
PMID:  18455584     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Peak oxygen uptake (VO(2)) and ventilatory efficiency have prognostic implications in the population with congestive heart failure. This study evaluated quality-of-life functional capacity after the 2 treatment strategies of surgical ventricular restoration and transplantation for severe left ventricular dysfunction of ischemic cause. METHODS: The 75-patient study population (between 2004 and 2006) with severe heart failure included 35 patients undergoing surgical ventricular restoration (mean age, 62.6 +/- 8.7 years), sometimes together with coronary artery bypass grafting or mitral surgery, and 40 cardiac transplant recipients (mean age, 55.6 +/- 7.7 years). Preoperative and 6-month postoperative function (peak VO(2), the anaerobic threshold, and the slope of minute ventilation/carbon dioxide uptake), cardiac catheterization parameters (left and right), and hospital and early outcomes were evaluated. RESULTS: The 2 groups had comparable baseline functional impairment and experienced similar hospital stay and early outcomes. They also showed similar improvements in left ventricular volume indexes and hemodynamic parameters and sustained significant improvements of median VO(2), anaerobic threshold, and minute ventilation/carbon dioxide uptake values. CONCLUSIONS: Both surgical strategies resulted in a significant and comparable improvement of functional capacity at the 6-month evaluation. These early studies must be repeated to determine the long-term benefits of surgical ventricular restoration because maximal VO(2) and ventilatory efficiency lose their prognostic survival role after transplantation.
Maurizio Cotrufo; Luca Salvatore De Santo; Alessandro Della Corte; GianPaolo Romano; Cristiano Amarelli; Marisa De Feo; Giuseppe Santarpino; Michelangelo Scardone; Gianantonio Nappi
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  135     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1054-60     Citation Subset:  AIM; IM    
Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
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MeSH Terms
Cardiomyopathy, Dilated / physiopathology,  surgery*
Exercise / physiology
Heart Transplantation*
Heart Ventricles / physiopathology,  surgery*
Middle Aged
Myocardial Ischemia / physiopathology,  surgery*
Oxygen Consumption
Prospective Studies
Recovery of Function
Ventricular Dysfunction, Left / surgery*

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