Document Detail


Impact of surgical ventricular restoration on ventricular shape, wall stress, and function in heart failure patients.
MedLine Citation:
PMID:  21357513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
L Zhong; Y Su; L Gobeawan; S Sola; R-S Tan; J L Navia; D N Ghista; T Chua; J Guccione; G S Kassab
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-02-25
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  300     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-07-07     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1653-60     Citation Subset:  IM    
Affiliation:
Department of Cardiology, National Heart Centre, Singapore. gkassab@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiomyopathy, Dilated / pathology*,  physiopathology,  surgery*
Cardiovascular Surgical Procedures
Diastole / physiology
Female
Heart Failure / pathology*,  physiopathology,  surgery*
Heart Ventricles / pathology*,  physiopathology,  surgery*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Myocardial Contraction / physiology
Retrospective Studies
Stroke Volume / physiology
Systole / physiology
Treatment Outcome
Ventricular Remodeling / physiology
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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