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Evaluation of predictors of clinical outcome after partial left ventriculectomy
1Department of Medicine, University of Louisville, Kentucky, USA. g0bhat01@gwise.louisville.edu
Background:
Outcome after partial left ventriculectomy (PLV) is difficult to predict. Our goal was to determine if clinical measurements including exercise testing could predict outcome after PLV.
Methods:
Sixteen patients with dilated cardiomyopathy had left ventricular ejection fraction, left ventricular end-diastolic diameter, amount of mitral regurgitation (MR), New York Heart Association (NYHA) functional class, and cardiopulmonary exercise testing measurements measured before PLV and 3 months after PLV. Eleven patients who remained stable after PLV (group 1) were compared with 5 patients who deteriorated after PLV (group 2).
Results:
Similar significant improvements were seen in both groups 3 months post-PLV with respect to left ventricular ejection fraction (group 1: 0.136+/-0.037 to 0.212+/-0.046; group 2: 0.139+/-0.042 to 0.179+/-0.073) and left ventricular end-diastolic diameter (group 1: 8.5+/-0.7 to 7.0+/-0.6 cm; group 2: 7.6+/-0.6 to 6.5+/-0.6 cm). The MR grade (1.0+/-0.6 versus 2.5+/-0.6), NYHA functional class (1.5+/-0.31 versus 2.5+/-0.6), and peak oxygen consumption (17.8+/-1.1 versus 12.2+/-2.0) were significantly different in the two groups 3 months after PLV (p < 0.05, analysis of variance).
Conclusions:
Patients that do not show significant improvement in peak oxygen consumption, NYHA class and significant decrease in the amount of MR 3 months after PLV, compared with pre-PLV, are at increased risk of clinically deteriorating.