Abstract
Objective Surgical left ventricular restoration by means of endoventricular patch aneurysmectomy in patients with postinfarction aneurysm should result in acute improved left ventricular performance by decreasing mechanical dyssynchrony and increasing energy efficiency. Methods Nine patients with left ventricular postinfarction aneurysm were studied intraoperatively before and after ventricular restoration with a conductance volume catheter to analyze pressure-volume relationships, energy efficiency, and mechanical dyssynchrony. The end-systolic elastance was used as a load-independent index of contractile state. Left ventricular energy efficiency was calculated from stroke work and total pressure-volume area. Segmental volume changes perpendicular to the long axis were used to calculate mechanical dyssynchrony. Statistical analysis was performed with the paired t test and least-squares linear regression. Results Endoventricular patch aneurysmectomy reduced end-diastolic volume by 37% (P <.001), with unchanged stroke volume. Systolic function improved, as derived from increased +dP/dtmax, by 42% (P <.03), peak ejection rate by 28% (P <.02), and ejection fraction by 16% (P <.0002). Early diastolic function improved, as shown by reduction of -dP/dtmax by 34% (P <.006) and shortened τ by 30% (P <.001). Left ventricular end-systolic elastance increased from 1.2 ± 0.6 to 2.2 ± 1 mm Hg/mL (P <.001). Left ventricular energy efficiency increased by 36% (P <.002). Left ventricular mechanical dyssynchrony decreased during systole by 33% (P <.001) and during diastole by 20% (P <.005). Conclusions Left ventricular restoration induced acute improvements in contractile state, energy efficiency, and relaxation, together with a decrease in left ventricular mechanical dyssynchrony.
| Original language | English |
|---|---|
| Pages (from-to) | 138-145 |
| Number of pages | 8 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 129 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2005 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Acute decrease of left ventricular mechanical dyssynchrony and improvement of contractile state and energy efficiency after left ventricular restoration. / Schreuder, Jan J.; Castiglioni, Alessandro; Maisano, Francesco; Steendijk, Paul; Donelli, Andrea; Baan, Jan; Alfieri, Ottavio.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 129, No. 1, 01.2005, p. 138-145.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Acute decrease of left ventricular mechanical dyssynchrony and improvement of contractile state and energy efficiency after left ventricular restoration
AU - Schreuder, Jan J.
AU - Castiglioni, Alessandro
AU - Maisano, Francesco
AU - Steendijk, Paul
AU - Donelli, Andrea
AU - Baan, Jan
AU - Alfieri, Ottavio
PY - 2005/1
Y1 - 2005/1
N2 - Objective Surgical left ventricular restoration by means of endoventricular patch aneurysmectomy in patients with postinfarction aneurysm should result in acute improved left ventricular performance by decreasing mechanical dyssynchrony and increasing energy efficiency. Methods Nine patients with left ventricular postinfarction aneurysm were studied intraoperatively before and after ventricular restoration with a conductance volume catheter to analyze pressure-volume relationships, energy efficiency, and mechanical dyssynchrony. The end-systolic elastance was used as a load-independent index of contractile state. Left ventricular energy efficiency was calculated from stroke work and total pressure-volume area. Segmental volume changes perpendicular to the long axis were used to calculate mechanical dyssynchrony. Statistical analysis was performed with the paired t test and least-squares linear regression. Results Endoventricular patch aneurysmectomy reduced end-diastolic volume by 37% (P <.001), with unchanged stroke volume. Systolic function improved, as derived from increased +dP/dtmax, by 42% (P <.03), peak ejection rate by 28% (P <.02), and ejection fraction by 16% (P <.0002). Early diastolic function improved, as shown by reduction of -dP/dtmax by 34% (P <.006) and shortened τ by 30% (P <.001). Left ventricular end-systolic elastance increased from 1.2 ± 0.6 to 2.2 ± 1 mm Hg/mL (P <.001). Left ventricular energy efficiency increased by 36% (P <.002). Left ventricular mechanical dyssynchrony decreased during systole by 33% (P <.001) and during diastole by 20% (P <.005). Conclusions Left ventricular restoration induced acute improvements in contractile state, energy efficiency, and relaxation, together with a decrease in left ventricular mechanical dyssynchrony.
AB - Objective Surgical left ventricular restoration by means of endoventricular patch aneurysmectomy in patients with postinfarction aneurysm should result in acute improved left ventricular performance by decreasing mechanical dyssynchrony and increasing energy efficiency. Methods Nine patients with left ventricular postinfarction aneurysm were studied intraoperatively before and after ventricular restoration with a conductance volume catheter to analyze pressure-volume relationships, energy efficiency, and mechanical dyssynchrony. The end-systolic elastance was used as a load-independent index of contractile state. Left ventricular energy efficiency was calculated from stroke work and total pressure-volume area. Segmental volume changes perpendicular to the long axis were used to calculate mechanical dyssynchrony. Statistical analysis was performed with the paired t test and least-squares linear regression. Results Endoventricular patch aneurysmectomy reduced end-diastolic volume by 37% (P <.001), with unchanged stroke volume. Systolic function improved, as derived from increased +dP/dtmax, by 42% (P <.03), peak ejection rate by 28% (P <.02), and ejection fraction by 16% (P <.0002). Early diastolic function improved, as shown by reduction of -dP/dtmax by 34% (P <.006) and shortened τ by 30% (P <.001). Left ventricular end-systolic elastance increased from 1.2 ± 0.6 to 2.2 ± 1 mm Hg/mL (P <.001). Left ventricular energy efficiency increased by 36% (P <.002). Left ventricular mechanical dyssynchrony decreased during systole by 33% (P <.001) and during diastole by 20% (P <.005). Conclusions Left ventricular restoration induced acute improvements in contractile state, energy efficiency, and relaxation, together with a decrease in left ventricular mechanical dyssynchrony.
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U2 - 10.1016/j.jtcvs.2004.03.057
DO - 10.1016/j.jtcvs.2004.03.057
M3 - Article
C2 - 15632835
AN - SCOPUS:11144352103
VL - 129
SP - 138
EP - 145
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 1
ER -